Aim. To study the factors associated with contrast-induced acute kidney injury in elderly patients with acute coronary syndrome (ACS).Material and Methods. A retrospective analysis of 514 electronic medical records of patients aged 75 years and over (38% men and 62% women) with confirmed acute coronary syndrome has been performed. The contrast-induced acute kidney injury was defined as an increase in serum creatinine ≥26.5 μmol/L in 48 h or as an increase in serum creatinine in 1.5 times within 7 days after the contrast media exposure. Patients were divided into contrast-induced acute kidney injury and non-contrast-induced acute kidney injury group. Clinical characteristics and in-hospital outcomes were extracted from patients' medical records. Procedural characteristics were obtained from laboratory database.Results. Angiographic intervention was performed in 74% of patients, 32% of them (more often in women, p=0.033) were diagnosed with contrast-induced acute kidney injury. Patients with contrast-induced acute kidney injury are characterized by a higher death rate (17% и 3%, p<0.001) and were more likely to have heart failure with reduced ejection fraction (34% и 21%, p=0.008) and acute heart failure (Killip class II-IV) (24% и 16%, p=0.015). The risk of developing contrast-induced acute kidney injury was related the volume of contrast medium administered.Conclusions. Prevention particular care should be taken to female patients older than 75 years with ACS, with a history of the chronic heart failure with reduced ejection fraction or acute heart failure (Killip class II-IV), and with a high volume of contrast media, highlighting that a perioperative comprehensive management strategy is needed to improve the prognosis.
В статье представлены результаты применения метода корригирующего воздействия при комбинированном (продольно-поперечном) плоскостопии и постуральной асимметрии электростимуляцией с использованием различных импульсных токов для изменения в лечебных целях функционального состояния мышц и нервов в сочетании с массажером для стоп термотерапевтического персонального миостимулирующего аппарата. Научное исследование организовано Общероссийской общественной организацией «Российская ассоциация по спортивной медицине и реабилитации больных и инвалидов» на базе Федерального государственного бюджетного учреждения «Федеральный научно-клинический центр спортивной медицины ФМБА России» врачом по лечебной физкультуре, к.м.н. В. В. Кармазиным. Целью данного исследования являлась оценка воздействия миостимулирующей функции аппарата на постуральный стереотип пациентов с комбинированным плоскостопием и выявленной, по данным бароподометрии, асимметрией распределения осевой нагрузки под стопами. В исследовании приняли участие 10 пациентов с диагностированным плоскостопием различной степени выраженности и выявленной асимметрией опоры более 5% смещения вправо или влево. Всем пациентам, вошедшим в группу испытуемых, проводились процедуры. Оценка эффективности электростимулирующего воздействия была сделана на основании прохождения испытуемыми курса коррекции аппаратом электростимуляции в количестве 7-8 процедур с осуществлением бароподометрии после каждой процедуры. По результатам проведенных процедур у 70% испытуемых, по данным бароподометрии, выявлено уменьшение давления в области продольного свода стопы, в сторону которой наблюдалось изначальное смещение общего центра давления под стопами. Также подтверждено, что аппарат действительно оказывает эффективное электромиостимулирующее воздействие на мышцы стопы. Определена необходимость дальнейшего научного изучения воздействия аппарата (электростимуляция в сочетании с гипертермией) и создания научно обоснованных программ методик коррекции не только плоскостопия, но и различной патологии стоп, в том числе сопровождающейся болевым синдромом различной степени выраженности (плантарный фасциит, стресс-переломы костей плюсны, тендиниты, лигаментиты и т. д.). The article presents the results of applying the method of corrective action in case of combined (longitudinal-transverse flat feet and postural asymmetry by electrical stimulation using various pulsed currents to change the functional state of muscles and nerves for therapeutic purposes in combination with a foot massager of the thermotherapeutic personal myostimulating apparatus. The scientific study was organized by the All-Russian public organization "Russian Association for Sports Medicine and Rehabilitation of Patients and Disabled People" on the basis of the Federal State Budgetary Institution Federal Scientific and Clinical Center for Sports Medicine of the Federal Medical and Biological Agency of Russia by a doctor in physical therapy, candidate of medical sciences Karmazin V. V. The purpose of this study was to evaluate the effect of the myostimulating function of the device on the postural stereotype of patients with combined flat feet and revealed, according to baropodometry, asymmetry in the distribution of axial load under the feet.The study involved 10 patients with diagnosed flat feet of varying severity and identified support asymmetry of more than 5% displacement to the right or left. All patients included in the group of subjects underwent procedures on the apparatus. Evaluation of the effectiveness of the electrostimulating effect was made on the basis of the subjects undergoing a course of correction with the electromyostimulation apparatus in the amount of 7-8 procedures with the passage of baropodometry after each procedure. According to the results of the procedures, 70% of the subjects, according to baropodometry, revealed a decrease in pressure in the area of the longitudinal arch of the foot, towards which the initial shift of the general center of pressure under the feet was observed. It was also found that the device really has an effective electromyostimulating effect on the muscles of the foot. The need for further scientific study on the impact of the device (electromyostimulation in combination with hyperthermia) and the creation of scientifically based programs for methods of correcting not only flat feet, but various foot pathologies, including those accompanied by pain syndrome of varying severity (plantar fasciitis, stress fractures of bones) metatarsus, tendonitis, ligamentitis, etc.).
Glutamine (GLN) and glutamic acid (GLA) are involved in many metabolic processes, from nucleotide synthesis to nerve impulse conduction; GLN is also an energy substrate for immunocompetent cells, making it an important link in the immune response. In stressful situations, which include significant physical activity, plasma levels of GLN and GLA decrease as a result of the amino acid being actively consumed in many biochemical reactions. GLN deficiency can lead to a number of negative manifestations in athletes and adversely affect athletic performance. The purpose of this work was to study the effects of glutamine deficiency and the possible replenishment of the deficiency by the consumption of exogenous forms of the substance when using glutamine-containing products; special attention was paid to the study of transient decrease in immune function as a relevant factor that impairs the mode of sports training.
Numerous studies conducted in recent decades have generated vast amounts of knowledge on sport-related concussions. This review analyzes international data on pediatric and adolescent sport-related concussions. Drawing on the most recent research into the pathophysiology of brain concussions, the authors identify and discuss “pain points” associated with SRC, i.e. unsolved problems of diagnostic criteria, the use of modern neuroimaging modalities and promising biomarkers. Special attention is paid to the physiology of children and adolescents and predisposing factors important for developing adequate diagnostic and management strategies. The authors formulate problems that need to be solved in order to improve care for young athletes with brain concussions.
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