For the first time, medicinal plants of arid landscapes of the south of Russia were studied for amino acid composition, vitamins. The features of the accumulation of organic acids and vitamins in medicinal plants were established, the concentrations were correlated from the type and genus of the plant. The component composition of amino acids of the studied LR samples was studied. A total of 9 amino acids were found, of which 5 are irreplaceable. The content of aminoacidum in the studied samples have high levels of variation within the species list, regardless of the plant family, and have a range of total amino acid composition ranging from 3.28% to 12.42%. In general, the content of AC prevails in plants of the species Plantágo májor (12.42%), Polygonum aviculare (9.47%), Capsella bursa-pastoris (8.06%). The lowest indicators of the total number of AC were found for plants of the species Artemisia austriaca (3.28%), Cardaria draba (3.71%). The content of oxalic acid is noted in the aster family and astragalus of the esparcet family of legumes < 250 mg/kg, in other plant samples the content of oxalic acid is > 200 mg/kg. This may be due to the fact that many plants of arid territories accumulate nutrients in the form of salts of organic acids. Studies have shown that the vitamin C content in almost all plant samples is higher than the vitamin K content, with the exception of the common shepherd's purse and the bird's bittern, this may be due to specific features and growing conditions. The percentage of sugar in plant samples has a high level of variation from 1.05 to 5.32%, this may also be due to the specific species of plants, regardless of the family affiliation. A direct correlation has been established between the contents of biologically active organic acids and nutrients in vegetation. The study showed that organic acids have a strong variation in indicators and depend on the type of selected plants and the properties of the functional zone of growth.
Relevance. Acute kidney injury (AKI) and arrhythmias negatively affect the prognosis of myocardial infarction (MI). Aim. To evaluate the features of heart rhythm and conduction disturbances and electrocardiographic changes in men under 60 years old (y.o.) with AKI in MI to improve understanding of the mechanisms of development and prevention. Material and methods. The study included men aged 19-60 years old with MI and AKI were studied. The patients were divided into two age comparable groups: I - study group, with AKI - 25 patients; II - control, without it - 486 patients. A comparative analysis of the frequency of observation of arrhythmias and ECG changes in the selected groups, analysis of the influence of various factors (Pearson's Chi-square) on the risk of arrhythmia in the study group were performed. Results. The compared groups did not differ in the frequency and structure of cardiac arrhythmias and conduction disorders. For the development of arrhythmias in the study group, the most important were: diastolic (absolute risk (AR): 100%; relative (RR) - 5.3; p = 0.02) 120 mm Hg. and more and systolic (AR: 83.3%; RR: 5.3; p = 0.02) blood pressure (BP) 180 mm Hg or more, the early and late left ventricular (LV) filling velocity relationship less than 0,7 (AR: 66.7%; p = 0.002), left atrial 38 mm or more (AR: 53.3%; p = 0.007), LV end-systolic volume index (52.4 ml / m2 or more) and LV end-diastolic index (88.0 ml / m2 and more) (AR: 66.7% each; RR: 4.67 each; p = 0.01). For the development of life-threatening arrhythmias (ventricular fibrillation and asystole) in the study group, a body weight of 110.0 kg or more was of additional importance (AR: 50.0%; p = 0.01). New arrhythmias in the subacute MI period were recorded only in the control group of patients. Conclusions. For AKI in MI in men under 60 y.o., there were no specific heart rhythm and conduction disturbances. For the arrhythmias development in MI with AKI, signs of pronounced hypertension, dilatation of the left heart and LV systolic and diastolic dysfunction are primary importance. Obesity is an additional importance for the life-threatening arrhythmias development in MI with AKI.
Abstract. Relevance. Acute kidney injury during myocardial infarction worsens the prognosis. At the same time, changes in electrolyte metabolism have been studied only in cases of severe lesions. And most of the data were obtained for patients over 60 years old. Aim. To evaluate the features of changes in serum potassium, sodium, calcium, and chlorides in men under 60 years old with myocardial infarction complicated by acute kidney injury to improve prevention and outcomes. Material and methods. The study included men 19-60 years old with type I myocardial infarction. The patients were divided into two age-comparable groups: I - study group, with acute kidney injury - 25 patients; II - control, without it - 168 patients. A comparative analysis of serum sodium, potassium, calcium and chloride concentration in the first 48 hours (1) and at the end of the third week of the disease (2), their dynamics, analysis of their impact on the risk of acute kidney injury (ANOVA) were performed. Results. The study group differed from the control in high levels of sodium (143.3 ± 3.4 and 140.3 ± 4.5 (mmol/l); respectively; p = 0.004) and chlorides (104.6 ± 2.7 and 102.8 ± 3.5 (mmol/l); p = 0.047) at the end of the third week of the disease. The concentrations of the studied electrolytes increased at the second observation point in both groups of patients. The main markers of the acute kidney injury risk development in the first hours of myocardial infarction were: potassium levels < 4.75 mmol/l (absolute risk: 17.2%; p = 0.003), sodium ≥ 140 mmol/l (absolute risk: 18.2%; relative - 3.64; p = 0.01), chlorides ≥ 104 mmol/l (absolute risk: 22.6%; relative - 3.67; p = 0.02). Conclusions. Men under 60 years old with acute kidney injury in myocardial infarction are characterized by low levels of potassium (<4.75 mmol/l) as well as higher levels of sodium (≥140 mmol/l) and chloride (≥104 mmol/l) serum in the first hours of IM. The listed above values should be used in the formation of the high-risk groups for the acute kidney injury development, as well as for prognostic modeling.
Relevance. The use of nitroglycerin (NG) in cardiogenic shock (СS) helps to normalize blood pressure, reduce the risk of death and improve prognosis. Aim. To study the effect of vasopressors, inotropic drugs and nitroglycerin on hemodynamics and reducing the risk of death in patients with cardiogenic shock. Material and methods. A comparative assessment of the effectiveness of treatment of СS in myocardial infarction with nitroglycerin and traditional approaches to therapy was carried out. In the control group of patients with СS (17 people), dopamine or norepinephrine was administered in the traditional way. In the main group of patients with СS (22 people), large doses of nitroglycerin were administered. After the stabilization of the state of health, the drip injection of NG continued in the usual doses. Results. In 20 of 22 patients of the main group, immediately after the jet injection of nitroglycerin, blood pressure began to be determined or significantly increased, 14 of them survived (63.6%). In 9 cases, blood pressure did not decrease anymore, vasopressors were not administered, nitroglycerin was administered by drop for another 2-3 days, the treatment ended with discharge in a satisfactory state. In another 2 cases, it was necessary to administer vasopressors in parallel with the drip administration of nitroglycerin, after its jet administration. In the control group, the only patient survived (5.9%). Conclusions. Analysis of literature data indicates that in conditions of maximum depletion of reserves and a decrease in myocardial contractility in patients with cardiogenic shock, the use of vasopressors and inotropic drugs accelerates the decompensation of insufficient blood supply and increases the risk of death. The main way to combat СS is still urgent myocardial revascularization, however, the restoration of the functional activity of hibernated cardiomyocytes will be more successful and safer with their gradual activation. This problem can be successfully solved using the methods of mechanical support of blood circulation or with the help of nitroglycerin. It will be possible to verify the validity of this assumption only on the basis of the results of randomized clinical trials.
Relevance. The lipid metabolism changes during myocardial infarction (MI) in men with metabolic syndrome (MS) may be important for the MI complications development. Aim. To evaluate the lipid metabolism changes in acute and subacute MI periods and their role in the MI complications development in men under 60 years old with MS to improve prevention and outcomes. Material and methods. The study included men aged 19-60 years old with MI and MS. The patients were divided into two age-comparable groups: I - study group, with MS - 95 patients; II - control, without it - 571 patients. A comparative analysis of the lipid metabolism parameters and their dynamics in acute and subacute MI periods in selected groups, analysis of their influence on the risk of MI complications were performed. Results. It was found that in the first hours of MI in the study group, higher levels of triglycerides (3.19 ± 2.34 mmol/l) were noted compared to the control group (2.44 ± 1.75 mmol/l; p=0.02). The dynamics of lipid metabolism at the end of the third week of MI, significant multidirectional changes in all parameters with more pronounced atherogenic changes in the study group were revealed. The risk of MI complications was associated with levels of triglycerides (TG) ˂5.2 (p=0.02), high density (HDL) ≥0.9 (p=0.04) and very low-density lipoproteins (VLDL) ˂0.9 (p=0.04) (mmol/l) of the first hours of MI. Conclusions. The presence of MS impairs lipid metabolism in both acute and the subacute MI periods. In the study group, there is an increase in the levels of atherogenic lipids and their indices during the observation period. MI complications are associated with levels TG ˂5.2; HDL ≥0.9 and VLDL ˂0.9 (mmol/l) during the first hours of MI. It is expedient to use them in predictive modeling.
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