RESUMEN
OBJECTIVE: To study the severity of systemic metabolic dysfunction in various types of stroke and determine the parameters of optimal energy and protein supply for this category of patients in the presence of severe neurological deficit (National Institutes of Health Stroke Scale - NIHSS score of 15 points or more) during different periods of the disease. MATERIAL AND METHODS: The retrospective study included 512 patients with acute cerebrovascular accident (ACVA) who received nutritional support (NS) for 10 days or more: 367 (71.7%) people with ischemic stroke (IS) and 145 (28.3%) - with hemorrhagic stroke (HS). The course of stroke in all patients included in the study was accompanied by severe and extremely severe neurological disorders (15 points or more on the NIHSS scale). Energy expenditure and the severity of the catabolic reaction of the body were studied by dynamic assessment of indirect calorimetry indicators and actual nitrogen losses. RESULTS: More than 99% of patients received tube feeding. Using the method of indirect calorimetry, the ranges of energy expenditure during stroke were determined: for IS - 1600-2100 kcal/day (24-26 kcal/kg/day), for HS - 1900-2600 kcal/day (26-30 kcal/kg/day) in depending on the period of the disease. The average nitrogen losses at all stages of the disease in patients with IS and HS were comparable. In IS, these amounts were 19 g/day (0.25 g/kg/day), which corresponds to 119 g/day of protein (1.56 g/kg/day of protein), and in HS patients lost an average of 18.9 g/day of nitrogen (0.24 g/kg/day) or 118 g/day of protein (1.5 g/kg/day of protein). The maximum nitrogen losses were observed in the period from 10 to 20 days of illness and amounted to 24.7 g/day in patients with HS (0.31 g/kg/day or 1.93 g/kg/day protein), and in patients with IS - 24.5 g/day (0.29 g/kg/day or 1.81 g/kg/day protein). CONCLUSION: An identified trend towards a decrease in mortality in patients with acute stroke with energy supply in the amount of 27-28 kcal/kg/day and protein consumption in the amount of 1.3-1.4 g/kg/day compared with patients receiving 20-21 kcal/kg /day and 1-1.2 g/kg/day of protein requires further prospective randomized studies.
Asunto(s)
Metabolismo Energético , Accidente Cerebrovascular , Humanos , Femenino , Masculino , Estudios Retrospectivos , Persona de Mediana Edad , Anciano , Ingestión de Energía , Proteínas en la Dieta/administración & dosificación , Calorimetría Indirecta , Anciano de 80 o más Años , Apoyo Nutricional/métodos , AdultoRESUMEN
It has been suggested that circulating immune complexes containing low density lipoproteins (LDL-CIC) play a role in atherogenesis and are involved in the formation of early atherosclerotic lesions. The complexes, as well as anti-LDL antibody were found in the blood of patients with atherosclerotic process in various cardiovascular diseases, well as in the blood of animals with experimentally modulated atherosclerosis. One can assume that the presence anti-LDL antibodies in blood is a result of an immune response that is induced by modification of lipoproteins. LDL-CIC differ from native LDL in many aspects. They have much lower levels of sialic acid, a smaller diameter and a higher density electronegativity than native LDL. The fraction of the LDL-CIC in serum is an important manifestation of the atherosclerotic process. LDL-CIC, unlike the native LDL is able to induce intracellular accumulation of neutral lipids, especially esterified cholesterol in cell cultures obtained from healthy human aortic intima and macrophages in culture. After removal of the LDL-CIC, the serum of CHD-patients loses its atherogenic properties. The titer of the LDL-CIC in the blood serum significantly correlate with the progression of atherosclerosis and in vivo has the highest diagnostic yield of measured among other lipid parameters. Increasing CIC- cholesterol could also increase the risk of coronary artery atherosclerosis.
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Complejo Antígeno-Anticuerpo/sangre , Aterosclerosis/inmunología , Enfermedad de la Arteria Coronaria/inmunología , Lipoproteínas LDL/inmunología , Humanos , Factores de RiesgoRESUMEN
Afibrinogenemia is a rare congenital coagulopathy that leads to life-threatening bleeding. In afibrinogenemia, plasma fibrinogen levels are less than 0.1 g/L. The clinical manifestations of the disease can be both bleeding and thromboses of different localizations, which is determined by the multifunctional role of fibrinogen in hemostasis. The described cases demonstrate different clinical phenotypes of the disease. In both cases the diagnosis was confirmed by genetic examinations that revealed homozygous mutations in the fibrinogen A genes. The nature of the mutations assumes consanguineous marriages, as confirmed by the results of a genealogical analysis. Fibrinogen preparations are promising in treating afibrinogenemia in Russia.
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Afibrinogenemia/genética , Afibrinogenemia/complicaciones , Afibrinogenemia/diagnóstico , Afibrinogenemia/terapia , Consanguinidad , Fibrinógeno , Hemorragia/etiología , Homocigoto , Federación de RusiaRESUMEN
Small regulatory RNAs (microRNAs, siRNAs, and piRNAs) exhibit several unique features that clearly distinguish them from other known gene regulators. Their genomic organization, mode of action, and proposed biological functions raise specific questions. In this review, we focus on the quantitative aspect of small regulatory RNA biology. The original nature of these small RNAs accelerated the development of novel detection techniques and improved statistical methods and promoted new concepts that may unexpectedly generalize to other gene regulators. Quantification of natural phenomena is at the core of scientific practice, and the unique challenges raised by small regulatory RNAs have prompted many creative innovations by the scientific community.
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Interferencia de ARN , Animales , Northern Blotting , Mapeo Cromosómico , Humanos , MicroARNs/análisis , MicroARNs/metabolismo , Análisis de Secuencia por Matrices de Oligonucleótidos , ARN Interferente Pequeño/análisis , ARN Interferente Pequeño/metabolismo , Reacción en Cadena en Tiempo Real de la PolimerasaRESUMEN
UNLABELLED: Research objective was to develop an algorithm of the recombinant activated Factor VII (rFVIIa) prophylactic use for the bleeding implications prevention during central venous catheterization in Pediatric patients with acute leucosis and thrombocytopenia. METHODS: 30 Pediatric patients with acute leucosis and thrombocytopenia received rFVIIa 30-120 microg kg(-1) before the internal jugular vein catheterization with ultrasound control. Comparative group 1 included 39 Pediatric patients without preventive haemostatic treatment; comparative group 2 included 30 patients received platelet concentrate. RESULTS: the first attempt catheterization numbers increased, the time of the catheterization was reduced, platelet aggregation was improved and the bleeding implications frequency was 6.6% in patients received rFVIIa before the internal jugular vein catheterization. 23.1%--in the comparative group 1; 26.7% in the comparative group 2. CONCLUSION: Ultrasound navigation and rFVIIa preventive use together improve internal jugular vein catheterization results.
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Cateterismo Venoso Central/métodos , Factor VIIa/uso terapéutico , Hemorragia/prevención & control , Hemostáticos/uso terapéutico , Adolescente , Algoritmos , Cateterismo Venoso Central/efectos adversos , Niño , Preescolar , Relación Dosis-Respuesta a Droga , Hemorragia/etiología , Humanos , Lactante , Venas Yugulares , Leucemia/complicaciones , Agregación Plaquetaria/efectos de los fármacos , Transfusión de Plaquetas , Proteínas Recombinantes/uso terapéutico , Trombocitopenia/complicaciones , Factores de Tiempo , Ultrasonografía Intervencional/métodosRESUMEN
The effects of muscarinic M(1), M(2), and M(3) cholinergic receptor blockade on the regulation of chronotropic function of the heart were studied in vivo in 7-day-old rat pups. Intravenous injection of M(2) receptor blocker gallamine produced no changes in cardiac chronotropy. In contrast, M(1) receptor blocker pirenzepine and M(3) receptor blocker 4DAMP provoked bradycardia. These data attest to the involvement of M(1) and especially M(3) cholinergic receptors in the regulation of cardiac chronotropy in rat pups, which confirms the view on pronounced species-specific and age-related peculiarities in the heart control mechanisms.
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Frecuencia Cardíaca/efectos de los fármacos , Frecuencia Cardíaca/fisiología , Antagonistas Muscarínicos/farmacología , Receptor Muscarínico M1/antagonistas & inhibidores , Receptor Muscarínico M2/antagonistas & inhibidores , Receptor Muscarínico M3/antagonistas & inhibidores , Animales , Animales Recién Nacidos , Trietyoduro de Galamina/farmacología , Piperidinas/farmacología , Pirenzepina/farmacología , Ratas , Estimulación Química , Nervio Vago/fisiologíaRESUMEN
The contents of microelements such as Fe, Cu, Zn and As in samples of raw materials including food grade ones used in preparation of nutrient media for cultivation of antibiotic-producing organism and water were determined spectrophotometrically with using complex forming organic reagents. An original procedure for the sample combustion in the assay was developed. The natural background levels of the microelements in the nutrient media used in manufacture of some antibiotics were estimated.