http://elib.grsmu.by/handle/files/118 2026-04-09T12:55:06Z http://elib.grsmu.by/handle/files/9975 Blood Oxygen Transport and Prooxidant-Antioxidant Balance in Rats under Hypothermia and Rewarming Combined with a Modification of L-arginine-NO Pathway Zinchuk, V.; Hlutkin, S. Introduction: The study of processes and functional regulation in body under the changed (including the lower) body temperature is the important medical problem. Increase of body resistance to low environmental temperature is especially important for the patient reanimation after the cold exposure, and the assessment of mechanisms creating the tissue oxygen flux may help the development of ways for reanimation of a cooled body. Aim: Study effect of N-nitro-L-arginine methyl ester, L-arginine, or sodium nitroprusside on the blood oxygen transport and the prooxidant-antioxidant balance during hypothermia and rewarming in rats. Methods: Cold exposure was performed in male rats (body weight 200-250 g, n = 54) for 120 min under the box water temperature of 19°C; rewarming took the next 120 min, with a mean rate of 0.06°C/min. N-nitro-L-arginine methyl ester, L-arginine, or sodium nitroprusside were administered intravenously during the second 60 min of hypothermia in 1 mL of saline. Hemoglobin-oxygen affinity was evaluated by p50 (blood pO2 at its 50% O2 saturation) determined by the "mixing" method at 37C, pH 7.4 andpCO2 40 mm Hg and at actualpH, pCO2 and temperature. We were analyzed the antioxidant protection (catalase activity, a-tocopherol) and lipid peroxidation (conjugated diene, Schiff bases). Results: Infusion of L-arginine promoted the higher cold resistance and oxyhemoglobin dissociation curve shift rightwards, thereby reducing the hypoxic signs. It enhanced the antioxidant defense and reduced the levels of lipid peroxidation products, thereby providing the least prooxidant-antioxidant disbalance during the rewarming. However, other modifiers of L-arginine-NO pathway (N-nitro-L-arginine methyl ester, sodium nitroprusside) had not such effect. Conclusion: The L-arginine effect mediated by hemoglobin-oxygen affinity change may be used for the correction of metabolic disorders and improvement of body resistance to low environmental temperature. hypothermia, rewarming, hemoglobin-oxygen affinity, nitric oxide 2015-02-01T00:00:00Z http://elib.grsmu.by/handle/files/1779 Dynamics of Psychopathology Symptoms in Opiate-Dependent Patients During Therapy Igumnov, S. A.; Stan’ko, E. P.; Nestsiarovich, A. N. The article provides the results of the clinical and psychological investigation of indicators related to psychopathologicai state of HIV-positive (HP) and HIV~negative (HN) patients with opiate dependence before and after the treatment at the stages of establishment and stabilization of remission. Objectives: to investigate the structure and dynamics of psychopathoiogica! symptoms in HIV-positive and HIV-negative patients with opiate dependence. Material and methods: Investigated sample included 820 patients. Severity of the major psychopathologicai symptoms was assessed in dynamics with the questionnaire SCL-90-R_ The structure of psychopathologicai symptoms in patients with opiate dependence is presented. The changes of psychopathologicai indicators are revealed in the sample studied before and after the treatment course (1, 3, 6 and 12 months after the beginning of observation). Results: The findings demonstrate more severe psychopathology in HP patients versus HN ones. It was found that SCL-90-R scores in patients were higher than in healthy individuals, despite of their positive dynamics at discharge, indicating the failure of the short-term therapy course to normalize the menial state of patients with opiate dependence and the need to develop the algorithm for such patients, including the long-term, comprehensive programs of treatment and rehabilitation that are corrected according to the patient's needs. Conclusions: The course of the short-term treatment allows to achieve the clinical improvement at the stage of the remission establishment, but does not stabilize the mental state of the drug-dependent patients with HIV, that indicates the need to develop the long-term, comprehensive treatment and rehabilitation programs based on llie patient's needs. psychopathology, dynamic assessment, opiate dependence, HIV 2015-12-01T00:00:00Z http://elib.grsmu.by/handle/files/1730 Cardiac fibrosis in patients with atrial fibrillation: Mechanisms and clinical implications Dzeshka, M. S.; Lip, G. Y. H.; Snezhitskiy, V. A.; Shantsila, E. Atrial fibrillation (AF) is associated with structural, electrical and contractile remodeling of the atria. Development and progression of atrial fibrosis is the hallmark of structural remodeling in AF and is considered to be substrate for AF perpetuation. In contrast, experimental and clinical data on impact of ventricular fibrotic processes in pathogenesis of AF and its complications are controversial. Ventricular fibrosis appears to contribute to abnormalities in cardiac relaxation and contractility, and development of heart failure, a common finding in AF. Given the frequent coexistence of AF and heart failure and the fact that both conditions affect patient prognosis better understanding of mutual impact of fibrosis in AF and heart failure is of particular interest. In this review article, we provide an overview on the general mechanisms of cardiac fibrosis in AF, differences between fibrotic processes in atria and ventricles, and the clinical and prognostic significance of cardiac fibrosis in AF. atrial fibrillation, heart failure, cardiac fibrosis 2015-08-01T00:00:00Z http://elib.grsmu.by/handle/files/1729 Non-vitamin K Oral Anticoagulants in atrial fibrillation: where are we now? Dzeshka, M. S.; Lip, G. Y. Atrial fibrillation (AF) confers increased risk of stroke and other thromboembolic events, and oral anticoagulation therefore is the essential part of AF management to reduce the risk of this complication. Until recently, the vitamin K antagonists (VKAs, e.g. warfarin) were the only oral anticoagulants available, acting by decreased synthesis of vitamin K-dependent coagulation factors (II, VI, IX, and X). The VKAs had many limitations: delayed onset and prolonged offset of action, variability of anticoagulant effect among patients, multiple food and drug interactions affecting pharmacological properties of warfarin, narrow therapeutic window, obligatory regular laboratory control, which all made warfarin 'inconvenient' both for patients and clinicians. The limitations of VKAs led to development of new class of drugs collectively defined as non-VKA oral anticoagulants (NOACs), which included direct thrombin inhibitors (dabigatran) and factor Xa inhibitors (rivaroxaban, apixaban, edoxaban). The NOACs avoid many of the VKA drawbacks. In this review we will focus on the current evidence justifying use of NOACs in non-valvular AF. atrial fibrillation, non-vitamin K oral anticoagulants, dabigatran, rivaroxaban, apixaban, edoxaban, warfarin 2015-04-01T00:00:00Z http://elib.grsmu.by/handle/files/1726 Patients with atrial fibrillation undergoing percutaneous coronary intervention. Current concepts and concerns: part I. Dzeshka, M. S.; Brown, R. A.; Lip, G. Y. H. Atrial fibrillation (AF) and coronary artery disease (CAD) often coexist. Both conditions confer an increased risk of acute thrombotic complications. However, the pathogenesis of thrombus development in AF and CAD is different. Coagulation activation is the main pathway in AF, and platelet activation is the hallmark of coronary thrombosis. Antithrombotic prophylaxis is essential in both conditions. In patients with AF undergoing percutaneous coronary intervention (PCI), a combination of oral antico¬agulation and antiplatelet therapy is required, which elevates the risk of major bleeding. This has to be balanced against the risk of stroke and stent thrombosis. In the first part of the present review, the prerequisites for antithrombotic management in AF patients undergoing PCI are discussed. We cover the epidemiology of concomitant presentation of AF and CAD as well as differences in the pathogenesis of thrombus formation in both conditions. We evaluate data regarding a variety of antithrombotic regimens including triple therapy in line with stroke and bleeding risk assessment. Overall, triple therapy is often warranted but should be for the shortest possible duration. Although much of the current guidance comes from observational data, well designed, adequately powered randomized clinical trials are emerging to further inform practice in this challenging area. antithrombotic prophylaxis, atrial fibrillation, coronary artery disease, percutaneous coronary interventio 2015-01-01T00:00:00Z