Saratov JOURNAL of Medical and Scientific Research

2021, volume 17

Long-term effects of new coronavirus infection (COVID-19) in patients with chronic coronary syndromes in real clinical practice

Year: 2021, volume 17 Issue: №3 Pages: 547-553
Heading: Тhematic supplement Article type: Original article
Authors: Malinova L.I., Tolstov S.N., Lipativa Т.Е., Dolotovskaya P.V., Furman N.V., Denisova T.P.
Organization: Regional Cardiology Clinic (Saratov), Saratov State Medical University
Summary:

Objective: to assess the dynamics of hemodynamic, metabolic, hematological parameters and myocardial contractility markers in patients with chronic coronary syndromes who have undergone a new coronavirus infection (COVID-19), according to the time since its manifestation. Material and Methods. The one-center observational study of patients with chronic coronary syndromes (CCS) who underwent COVID-19 (1-10 months, n=138) was carried out. assessment of The basic clinical, laboratory and instrumental parameters were assessed depending on the time since COVID-19 manifestation. To assess the duration of post-COVID changes in continuous variable, the deviation index from normal values was calculated. Results. The median duration of the post-COVID changes in the studied parameters was 4 months. In patients with CCS, against the background of a relatively constant amount of total protein, there was an increase in the level of albumin by 12.3 (11.5; 25.1) %, with minimal values in patients survived COVID-19 within a month, p=0.008. The decrease in the leukocytes count was revealed with minimum by the 10th month since the COVID-19 manifestation: 9.0 (6.4; 10.9), *108/L(1 month) to 5.5 (4.9; 6.1), *108/L(10 months), p=0.001. Heart rate decreased by 28.2 (22.1; 31.1) %, p=0.001, and was accompanied by the left ventricular ejection fraction augmentation from 58 (59; 64) % (1 month) to 69 (67; 71) % (10 months), p=0.027. Conclusion. In patients with chronic coronary syndromes, the main long-term trends of post-COVID changes in metabolic, hematological, ECG parameters and characteristics of myocardial contractility, routinely determined in real clinical practice, were revealed.

Keywords: chronic coronary syndrome, COVID-19, post-COVID syndrome

Characteristics of COVID-19 associated coagulopathy in real clinical practice

Year: 2021, volume 17 Issue: №3 Pages: 541-547
Heading: Тhematic supplement Article type: Original article
Authors: Malinova L.I., Krasnikova V.V., Krivets A.S., Radzhabov H.M., Furman N.V. Reshetnikov A.A., Dolotovskaya P.V.
Organization: Saratov Regional Clinical Cardiological Centre, Saratov State Medical University
Summary:

Purpose: to perform a comparative analysis of the hemostasis state in patients with a SARS-CoV-2 infection (CO-VID-19) hospitalized in the intensive care unit (ICU). Material and Methods. The retrospective analysis of the medical data of patients with COVID-19 (n=105), admitted to ICU in the «COVID hospital», consisted of the following: complete blood count test; screening global clotting tests routinely performed at admission (activated partial thromboplastin time (APTT), prothrombin index, international normalized index, fibrinogen). Results. We detected sex differences in COVID-19 patients referring hemoglobin level (lower in women, p<0.05) and thrombocytopenia rates (more often in men, p=0.032). There were moderately strong negative correlations between the duration of hospitalization and the leukocytes count at admission (R=0.410; p=0.037), platelet count at admission (R=0.402; p=0.046). In COVID-19 patients we detected increased fibrinogen with a normal or slightly lower platelet count, and normal or slightly increased prothrombin time and APTT. Conclusion. The major coagulation parameters associated with COVID-19 are increased fibrinogen with a normal or slightly lower platelet count, and normal or slightly increased prothrombin time and APTT. COVID-19 associated coagulopathy is characterized by sex differences, which partly determines the specifics of the clinical course of the disease in men and women patients.

Keywords: coagulopathy, COVID-19, real clinical practice

Blood flow distribution duriing the formation of different pathogenetic variants of arterial hypertension

Year: 2021, volume 17 Issue: №3 Pages: 535-541
Heading: Тhematic supplement Article type: Original article
Authors: Lukyanov V.F., Kaplanova T.I., Petrova V.D.
Organization: Saratov State Medical University
Summary:

Purpose: to assess the volumetric blood flow distribution during the formation of different clinical and pathogenetic variants of hypertension. Material and Methods. A total of 128 patients were examined, in whom the indices of volumetric blood flow in the aorta and brachial artery were determined. Results. In vasoconstrictor hypertension, the stroke volume in the brachial artery and the blood flow distribution coefficient were 4 times less than in patients with volumetric hypertension. In patients with hyperkinetic hypertension, the energy of blood ejection and the blood flow distribution coefficient was more than 3 times higher than the same indicators in other variants of hypertension. Conclusion. Characteristic hemodynamic signs of the blood flow distribution that can be used to diagnose various pathogenetic pheno-types of arterial hypertension are identified.

Keywords: hemodynamic status, pathogenetic variants of arterial hypertension

Population health and social stress (from the prevalence of myocardial infarction and gastric and duodenal ulcer)

Year: 2021, volume 17 Issue: №3 Pages: 532-535
Heading: Тhematic supplement Article type: Original article
Authors: Lipatova Т.Е., Tyultyaeva L.A., Denisova Т.Р.
Organization: Saratov State Medical University
Summary:

Purpose: to analyze the health of the population as a marker of social stress by comparing the analytical parameters of the prevalence of myocardial infarction (Ml) and gastric and duodenal ulcer (U). Material and Methods. We examined the data of the official statistical reports of the Saratov Health Committee. The prevalence of Ml and U in 1990-2000 was studied. The excitability, sensitivity, and stability of the population system were judged by analyzing the speed characteristics and fragments of phase portraits of the prevalence of Ml and U in a multidimensional phase space. Re-sults. The multidirectional speed characteristics of the dynamics of the prevalence of Ml and U in the population were revealed; a different number of time points when the sign of the rate of change in the prevalence of pathology changed to the opposite (for Ml — 5 times, forU — 3 times); the direction of movement of the image point is centrifugal for Ml and centripetal for U. Conclusion. The excitability and stability of the population system is higher in terms of the prevalence of Ml, the sensitivity of the population system is higher in terms of the prevalence of U.

Keywords: cardiac infarction, social stress

Stable coronary heart disease and chronic periodontitis: clinical and microbiological parallels

Year: 2021, volume 17 Issue: №3 Pages: 527-531
Heading: Тhematic supplement Article type: Original article
Authors: Lipatova Т.Е., Eremin A.V., Lepilin A.V.
Organization: Saratov State Medical University
Summary:

Purpose: in patients with stable coronary heart disease (CHD) and chronic periodontitis (CP) of varying severity, to assess the clinical and laboratory status and endothelial functions in comparison with the clinical, instrumental and microbiological characteristics of the periodontium. Material and Methods. 120 patients with CHD and CP were examined; 55 were with CP without somatic pathology, 30 were with CHD and intact periodontal disease. Results. In CHD in combination with mild CP, the level of C-reactive protein (4.5±1.5 mg/l), indicators of endothelial functions (endothelin-1: 4.5±1.6 ng/ml; slCAM-1: 429.6±90.8 ng/ml; sVCAM-1: 932.2±137.4 ng/ml; endothelium-dependent va-sodilation (EDV): 9.5±1.9%), characteristics of common carotid artery intima-media thickness (CCA IMT): 0.8±0.3 mm correspond to those in CHD without CP. CHD in combination with moderate and severe CP is associated with more severe dyslipidemia, high levels of C-reactive protein (8.8±4.7 mg/L); endothelial dysfunction (endothelin-1: 5.8±1.9 ng/ml; slCAM-1: 489.7±98.1 ng/ml; sVCAM-1: 1012.5±184.6 ng/ml; EDV: 8.6±1.8%), increased CCA IMT: 0.90±0.20 mm. Conclusion. Stable coronary artery disease in combination with moderate and severe CP compared with coronary heart disease without CP and coronary heart disease with mild CP is associated with more severe dyslipidemia, vascular wall remodeling and endothelial dysfunction. Endothelial dysfunction in patients with coronary heart disease, like the activity of periodontitis, is associated with periodontal colonization by P. gingivalis and T. forsythia.

Keywords: coronary heart diseases, parodontitis

Reduced stress resistance as one of the key psychosocial factors of cardiovascular risk

Year: 2021, volume 17 Issue: №3 Pages: 523-526
Heading: Тhematic supplement Article type: Original article
Authors: Kodochigova A.I., Polidanov M.A., Kondrashkin I.E., Mayskova E.A., Olenko E.S., Bogdanova T.M., Parshina S.S., Lobanov M.E., Blokhin I.S., Sinkeev M.S., Dzheyranova M.O., Kirichuk V.F.
Organization: Saratov State Medical University
Summary:

The purpose of the study is a comparative analysis of the personal reaction characteristics and key factors of cardiovascular risk for patients with stable forms of coronary heart disease through their resistance to the stress agents. Material and Methods. 88 male patients with ischemic heart disease (IHD) were tested by using the generally accepted clinical examination, and the Subbotin, Spielberger — Hanin questionnaires, and also the Toronto Alexithymia Scale; mean age was 50,8 (49,9; 51,3) years. Results. Among the individuals we observed, patients with reduced stress resistance (65,1 %) prevailed, they formed group I, and patients with high stress resistance (34,9 %) formed group II. Patients from group I had higher indicators of anxiety, cholesterol and low-density lipoprotein blood levels, a tendency to alexithymia, lower glomerular filtration rate and more frequent indications in the history of coronary events than representatives of group II. Conclusion. IHD patients with reduced stress resistance need its correction to increase the effectiveness of secondary prevention of this pathology, and to reduce the risk of cardiovascular catastrophes.

Keywords: alexithymia, cardiovascular risks, coronary heart diseases, increased anxiety, stress resistance

Вклад А. Е. Аболиной в организацию кафедры травматологии и ортопедии и подготовку профессиональных кадров (к 100-летию со дня рождения)

Year: 2021, volume 17 Issue: №3 Pages: 506-510
Heading: Scientific schools, commemorative dates Article type: Original article
Authors: Островский В.В., Гришин С.Е., Норкин И. А.
Organization: Saratov State Medical University
Summary:

Ариадна Евгеньевна Аболина — организатор и первый заведующий кафедрой травматологии и ортопедии Саратовского медицинского института, возглавлявшая ее 26 лет. В период руководства кафедрой А. Е. Аболиной получено первое в Саратовском медицинском институте авторское свидетельство на изобретение, выполнена одна из первых операций с наложением аппарата Илизарова, проведена первая в Саратове операция эндопротезирования тазобедренного сустава, снят первый в институте цветной учебный фильм, впервые применены полиэтиленовые транспортные шины.

Keywords: A. E. Aboliona, history of medicine, history of traumatology and orthopedics, Saratov Medical Institute

Professor V.I. Goremykin and his life devoted to the University (to the 80th birth anniversary)

Year: 2021, volume 17 Issue: №3 Pages: 501-505
Heading: Anniversaries Article type:
Authors: Koroleva I.V., Prosova Е.Е., Spivakovsky Yu.M.
Organization: Saratov State Medical University
Summary:

The article describes the professional biography of the famous pediatrician, Doctor of Medical Sciences, professor V. I. Goremykin. His activity as the organizer and the first head of department of polyclinic pediatrics, as well as the head of department of faculty pediatrics of Saratov Medical University is presented. The article is devoted to the 80th birth anniversary. It contains the analysis of work of V. I. Goremykin, as the founder of scientific pediatric school and an organizer of healthcare as the rector of Saratov Medical University.

Keywords: Department of Faculty Pediatrics, pediatrics, Saratov State Medical University, Vladimir llyich Goremykin

Experimental testing of the target delivery system of tannic acid for periodontal microcirculation correction

Year: 2021, volume 17 Issue: №3 Pages: 494-500
Heading: Рathophysiology Article type: Original article
Authors: Savkina А.А., Lengert E.V., Ermakov A.V., Popykhova Е.В., Stepanova T.V., Ivanov A.N.
Organization: Saratov State Medical University
Summary:

Objective: to study the effect of the targeted delivery system based on tannic acid within silver alginate framework microcapsules on the gums microvasculature state in rats with intact periodontium and with experimental model peri-odontitis. Material and Methods. The studies were carried out using 90 white rats, divided into six groups, including a control group, 2 groups with intact periodontium, a gel with microcapsules not loaded and loaded with tannic acid was applied once, a group of rats with experimental periodontitis, 2 groups of animals with periodontitis, which were applied gel with microcapsules, without tannic acid and with its loading. In animals, gingival perfusion and blood flow modulation mechanisms were assessed using laser Doppler flowmetry. Results. Application of a gel containing silver microcapsules to an intact gum in rats causes a 7.5% transient increase in perfusion and activation of microcirculation modulation. Loading the microcapsules with tannin acid reduces the severity of transient changes in microcirculation. The use of a gel with capsules loaded with tannic acid in rats with periodontitis makes it possible to achieve a more pronounced normalization of perfusion and mechanisms of microcirculation modulation than the use of a gel containing microcapsules without active components. Conclusion. Loading of alginate microcapsules with silver ions and tannic acid allows reducing the irritating effect on the gingival mucosa accompanied by increase in the efficiency of microcir-culatory disorders correction in experimental model periodontitis.

Keywords: microcirculation, parodontitis, tannin acid

Phagocytic reactivity of neutrophils in peripheral blood of patients with infectious complications after total knee replacement

Year: 2021, volume 17 Issue: №3 Pages: 490-494
Heading: Рathophysiology Article type: Original article
Authors: Galashina Е.А., Babushkina I.V., Gladkova E.V., Shpinyak S.P., Ulyanov V.Yu.
Organization: Saratov State Medical University
Summary:

Objective: to study phagocytic reactivity of neutrophils in peripheral blood of patients with infectious complications after total knee replacement. Material and Methods. We identified indicators of Phagocytic Activity of Neutrophils (PAN) in peripheral blood in 40 patients with implant-associated infection (main group) and 30 individuals without infectious inflammatory complications including aseptic loosening of knee implant components (comparison group). Results. In patients of the main group on the 5th day of the revision total knee replacement the increase in Phagocytic Index (PI) (p<0.05) was observed as well as in Phagocyte Index in 5 min Incubation (PI5) (p<0.05), Phagocyte Index in 30 min Incubation (PI30) (p<0.05), Phagocytosis Completeness Index (PCI) (p<0.05), and Number of Active Phagocytes (NAP) (p<0.05). In 14 days PI (p^O.05) and NAP (p.,<0.05) decreased as compared to the 5th day, while PI5 and PCI significantly increased. In patients of the comparison group PI (p<0.05), PI5 (p<0.05), and NAP (p<0.05) all grew by the 5th day. In 14 days PI30 grew (p^O.05) as compared to the day before. Conclusion. The incepting and digesting functions of neutrophils increased over 5 days in patients of the main group. On the 14th day we observed even higher incepting and digesting functions of neutrophils as compared to the 5th day. In patients of the comparison group the increase of incepting function of neutrophils was revealed over the 5th and 14th days of post-surgery.

Keywords: implant-associated infection, phagocytic activity of neutrophils, reverse arthroplasty