[A study of the efficacy and safety of lornoxicam in patients with acute sciatica]. / Issledovanie effektivnosti i bezopasnosti vosproizvedennogo preparata lornoksikam u patsientov s ostroi lyumboishialgiei.

OBJECTIVE: To compare the efficacy, safety and tolerability of lornoxicam and xefocam used as the reference drug in patients with acute nonspecific pain in lower back caused by acute sciatica. MATERIAL AND METHODS: A simple blind clinical study was conducted with 108 patients (men and women, aged 20-55 years) with complaints of pain in the lower back and an established diagnosis of vertebrogenic radiculopathy L4, L5, S1. Patients were randomized into 2 treatment groups by randomization method of envelopes in the ratio of 1:1 (54 patients per group). The first group received lornoxicam in a dose of 16 mg/day for 2 days, the second group was treated with xefocam (the lyophilisate for preparation of solution for intravenous and intramuscular injection) according to a similar scheme. RESULTS AND CONCLUSION: The results demonstrate the comparable efficacy of lornoxicam and the reference drug. The analysis of the safety profile reveals no significant differences between treatment groups.

[CRITERIA FOR SHORT AND LONG-TERM PROGNOSIS IN HOSPITALIZED PATIENTS BASED ON THE ECG SIGNAL CHARACTERISTICS AT ADMISSION. RATIONALE AND STUDY DESIGN].

The article presents the rationale and design of a prospective observational study devoted to the evaluation of criteria for short-term and long-term prognosis in hospitalized patients based on the characteristics of the ECG signal at admission to hospital. The purpose of this study is validity and predictive accuracy of predictive scores SCS, Tan et al., characteristics of standard ECG and ECG dispersion mapping to detect the short-term (30 days) prognosis of mortality and annual mortality in patients at admission to hospital. The objectives of the study are to study the calibration and prognostic ability of the above predictive scores and criteria, as well as a comparison of their predictive accuracy.

[ECG DISPERSION MAPPING: ABILITY TO PREDICT THE PATIENTS' PROGNOSIS (REVIEW)].

ECG dispersion mapping (DM) refers to new technologies for the production and analysis of the electric field of the heart. The main area of application of the method is screening and selection of groups of patients who need further comprehensive examination. There is limited data on its use to predict mortality. The purpose of this review was to analyze studies on the application of the method for the prediction of mortality in patients hospitalized due to emergency conditions. We searched PubMed (MEDLINE) database and e-library by search words "dispersion ECG mapping" and their translation into English. Selected articles evaluating the results of DM ECG in a prospective study of mortality. A total of 342 articles were selected according to the search criteria. At the initial selection stages, 337 were excluded. Five full-text articles have been reviewed for inclusion, four have been accepted and included in this review. DM ECG Index "Myocardium" can be used as a predictor for short-term prognosis of inpatient mortality. For the medium-term prognosis combination of the index "Myocardium" and the age of the patient is more important. Further studies are needed to clarify the value of DM ECG for long-term prognosis.

[SEASONAL VARIATION OF MICROVOLT T-WAVE ALTERNANS IN PATIENTS WITH CARDIOVASCULAR DISEASE AND HEALTHY SUBJECTS].

Objective - to access seasonal variation of microvolt T-wave alternans of ECG dispersion mapping in patients with cardiovascular disease and healthy subjects. ECG data of the three groups of healthy subjects have been compared: inhabitants of Beirut, Lebanon (n=51), inhabitants of Moscow, Russia (n=94) and ECG data of healthy subjects (n=44) from the testing ECG database of the PTB - The National Metrology Institute of Germany as well as a group of patients with cardiovascular disease (n=138), inhabitants of Beirut, Lebanon. Microvolt T-wave alternans of ECG dispersion mapping was evaluated in three points - Tbeginning, Tmaximum, Tend. In healthy subjects, the seasonal variation of ECG dispersion mapping microvolt T-wave alternans was nonexistent. Myocardial lesion is characterized by an increase in Tbeg, Tmax, Tend in relation to the healthy individuals. Tbeg values are minimal in winter and summer and increase in spring and autumn. Tend values were reversed - they were maximal in winter and summer, decreasing in spring-autumn period. Seasonal variation of Tmax - Tbeg, and Tmax -Tend was detected: Tmax - Tbeg increased in the winter-summer period and decreased in spring and autumn, Tmax-Tend - increased in the spring-autumn period in relation to the winter-summer period. In patients with cardiovascular disease, in contrast to the healthy, there is a seasonal variation in microvolt T-wave alternans of ECG dispersion mapping, with the maximum differences in the winter and spring seasons, which should be taken into account when applying the method in clinical practice.

[CONTEMPORARY APPROACH TO DIAGNOSIS OF SUBCLINICAL HEART FAILURE].

Treatment of congestive heart failure (CHF) remains one of the challenging problems in cardiology. In recent years, the method of multifrequency bio-impendancemetry is used in patients with CHF for the assessment of water imbalance and determination of its severity. The aim of the study was to determine the diagnostic capabilities of bio-impendancemetry in evaluation of the early manifestations of CHF. The study included 92 healthy individuals, and 335 patients who were hospitalized in the cardiology department with NYHA I-II functional class (FC) of chronic CHF. The echocardiography, rheography and biochemical examination were performed for determination of FC of CHF. Procedures were repeated at day 5 of hospitalization, 6-minute walk test was performed to assess physical tolerance and objectification of the functional status of patients with CHF. 45 patients had signs of CHF FC III-IV, therefore, they were excluded from the study. Analysis of endpoints was conducted by telephone survey in 1 year after discharge from the hospital. The results of the comparison of the predictive value of different methods for diagnosing CHF showed maximum sensitivity for brain natriuretic peptide (BNP) which was 82%, specificity was 88%. The 6-minute walk test showed the lowest values of sensitivity and specificity (sensitivity 67%, specificity 72%) as well as leg impedance at low frequencies (LF) (sensitivity 69%, specificity 74%). The values for the leg impedance at high frequencies (HF) were as follows: sensitivity 68%, specificity 97%. High predictive value of a positive result (PPV) was shown in phase angle (91%) and BNP (91%). Left ventricle ejection fraction(LVEF) measurements had the lowest PPV (72%).

[Atrial fibrillation registered for the first time: characteristics of clinical course, treatment, prognosis].

To study the clinical presentation of the first episode of atrial fibrillation (AF), treatment tactics and its compliance with current recommendations, features of the further clinical course and prognosis in patients with AF we performed a retrospective study on data of Polyclinic No 1 of the General Management Department of the President of RF . We analyzed data from 58 patients (36 men, 22 women) from January 2009 to September 2011 inclusive. The first episode of AF was recorded in the age from 48 to 90 years (in 39.7% of patients - aged 80 to 90 years old), mostly had paroxysmal character (84.5%), in 82.1% of cases was accompanied by marked clinical symptoms: sense of disruption of the heart (50%), feeling short of breath (28.6%), weakness (17.9%). In 87% of cases clinical symptomatology required calls for medical emergencies. In 42.9% of cases uncontrolled hypertension was possible predisposing factor for developing AF. Paroxysmal AF moved to constant in 38.8% of patients during the period from 1 year to 18 years. Due to the high risk of thromboembolic complications (2 to 5 on a scale of CHADS2), after the detection AF warfarin was shown to 96.6% of patients, because of the high risk of bleeding in practice was appointed only 37.9%. Complications of therapy in the form of bleeding were 9.1%. Tactics of rhythm control by antiarrhythmic drugs I and III classes has remained in 36.7% of patients with paroxysmal AF. -adrenoblockers were constantly taken by 63.3% of the patients using antiarrhythmic drugs I and III classes for relief of arrhythmia during her recurrence (the strategy of "pill in pocket").

[Clinico-economical aspects of cardioversion of paroxysmal atrial fibrillation at phehospital stage and during hospitalization].

We carried out clinico-economical analysis of 2 tactics of rhythm restoration in patients with paroxysmal atrial fibrillation (AF) lasting less than 48 hours: cardioversion at prehospital stage with intravenous procainamide and inhospital cardioversion with any method. This retrospective study was based on the data from department of urgent aid of an outpatient clinic. The results showed that within 48 hours inhospital was a was more effective, safe, and more economically profitable compared with administration of procainamide at prehospital stage. Intravenous procainamide resulted in effective cardioversion in 70.6% of patients. It was associated with arterial hypotension and proarrhythmogenic action in 14,7% of cases. Patients with effective cardioversion with procainamide had lesser mean values of left ventricular anterior-posterior dimension (echocardiography) and shorter duration of arrhythmia.

[Newly developed atrial fibrillation among patients under active observation by an outpatient clinic].

We carried out prospective cohort study of incidence of new cases of atrial fibrillation (AF) in a sample of Moscow population (patients under observation in our policlinic). Total incidence of AF between 2003 and 2009 was 7.7 per 1000 patient/years, it was higher among men than among women. Incidence of AF progressively increased with age reaching maximum in age group more or equal 85 years. Most frequent baseline disease in patients with first appearance of AF was hypertensive disease (71%). Ischemic heart disease diagnosed according to strict criteria (postinfarction cardiosclerosis, revascularization procedures) was registered in 20.1%, diabetes - in 15.7%, chronic heart failure - in 13%, valvular heart disease - in 5.6%, and history of acute ischemic stroke - in 2.5% of patients.

[Prevalence of atrial fibrillation among patients under observation by an outpatient clinic].

Prevalence of atrial fibrillation among patients attending our policlinic (2.44 and 3.78% in 2002 and 2009, respectively) was higher among men than among women and progressively increased with age achieving maximum in the group of patients aged more or equal 85 years. Paroxysmal and persistent forms were more frequent than permanent AF. Thromboembolic complications, heart failure and valvular heart disease were to a greater degree characteristic of permanent AF.

[Aluminum induces chromosome aberrations in wheat root meristem cells]. / Aliuminiiindutsiruet aberratsii khromosom v kletakh kornevoi meristemy pshenitsy.

The yield and pattern of chromosome structure aberrations in wheat seedlings treated with aluminum nitrate and aluminum sulfate at various concentrations have been determined by the anaphase method. Aluminum has a genotoxic effect causing genome, chromatid, and chromosome aberrations in apical root meristem cells. The relationship between the total yield of structural mutations and the aluminum concentration follows a bell-shaped curve. The mutagenic activity of aluminum nitrate peaks at 10(-3) mg/ml, which is twice as high as the permissible concentration limit (PCL) of aluminum in potable water. The maximum of the mutagenic activity of aluminum sulfate is observed at 5 x 10(-4) mg/ml, i.e., one PCL. Tap water boiled for 2 h in an aluminum vessel has virtually no genotoxic effect on wheat cells.