The study included 62 patients with uncomplicated primary and secondary infectious endocarditis admitted to S.P. Botkin city hospital from 2011 to 2014. The emphasis is laid on diagnostic significance of dynamic measurements of the levels of C-reactive protein, tumour necrosis factor, and highly sensitive troponin-1 for the evaluation of activity of the infectious/toxic process, severity of the disease, and detection of complications. The study revealed the relationship of the enhanced level of troponin-1 with changes of inflammation markers, morphofunctional characteristics of myocardium, and circulatory failure. Morphologicl study demonstrated inflammatory and dystrophic changes in myocardium, focal and diffuse cardiofibrosis suggesting development ofnon-coronarogenic myocardial lesions that play an important role in the progress of cardiac failure associated with infectious endocarditis.
Objective: The increase of morbidity results from both an increase of life expectancy of the population, and influence of various risk factors contributing to development and increase of chronic heart failure (CHF). The combination of several atherogenic mechanisms (abdominal obesity (AO), insulin resistance (IR), arterial hypertension (AH), hyperglycemia, dyslipidemia), combined as “metabolic syndrome” (MS), causes a more rapid development of CHF.
Materials and methods: The research finding of 74 patients with class II-III of CHF, including 37 patients (50%) with MS, are presented. The age structure of the pathology, severity of clinical course, data of laboratory and instrumental examination in various groups of patients were evaluated. A special program included an echocardiographic test with an assessment of various myocardial parameters.
Results and Discussion: Research materials find out a number of characteristics of CHF clinical course (its earlier development and severe course) in patients with MS. Echocardiographic tests reveal an increase of heart chambers sizes, thickness of left and right ventricle, pulmonary hypertension. Myocardium morpho-functional changes are more significant in patients with CHF and MS than in those without MS. An increase in leptin levels, a marker of obesity, fibrosis and inflammation, has been found. Leptin, C-reactive peptide (CRP) and high-sensitive troponin in patients with MS significantly exceeded those in patientswithout MS. Correlations of leptin levels, adiponectin, CRP and left ventricular mass, thickness of epicardial fat (TEF), ejection fraction were established.
Conclusion: Materials of the research indicate the important role of inflammatory and dysmetabolic processes in development and progression of CHF in patients with MS.
Bangladesh Journal of Medical Science Vol. 21(1) 2022 Page : 105-113
Неврологічне обстеження хворих із гострим інсультом є обов’язковим компонентом діагностики інсульту. Для ґрунтовного з’ясування впливу ізоосмолярного розчину 0,9% NaCl та гіперосмолярного розчину маніту на перебіг гострого порушення мозкового кровообігу за ішемічним типом становило інтерес дослідження впливу курсової терапії цими розчинами на перебіг неврологічного дефіциту за допомогою різних неврологічних шкал. Досліджувані розчини вводили в умовно ефективній дозі (визначеній в експерименті) одразу при підтвердженні діагнозу і далі щодоби кожні 12 год впродовж 7 діб. Контроль результатів терапії в дослідженні проводився щодня за допомогою шкали коми Глазго, шкали FOUR та NIHSS. Застосування 0,9% NаСl та маніту не мало вірогідного впливу на динаміку неврологічного дефіциту за показниками шкал коми Глазго, FOUR та NIHSS упродовж 7 діб спостереження (р > 0,05). Міжгруповий аналіз неврологічного дефіциту показав вірогідно гірший результат у групі маніту порівняно з 0,9% NaCl за показниками шкали FOUR (р = 0,02).
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