The aim was to study the impact of predictors on the duration of inpatient treatment of MI patients. Materials and methods: We copied data of 462 inpatient medical records of myocardial infarction patients who underwent hospital treatment by different methods (coronary artery stenting, thrombolytic therapy, conventional drug therapy). We determined basic predictors and duration of inpatient treatment of MI patients. Impact of the parameters was studied using Cox regression. Results: We built models of hazard ratios of coronary artery stenting impact on treatment duration for myocardial infarction patients, which proved that this treatment method significantly reduced the treatment duration, even after correction of confounders like sex (HR=1.32; p=0.041), age over 60 (HR=1.31; p=0.048) and heart failure Stage 2A-2B (HR=1.36; p=0.020). Conclusions: The results we obtained indicate a statistically significant effect of CAS on MI patients’ treatment duration, both separately and combined with multiple effects of confounders, indicating its medical effectiveness and the need for widespread introduction of this treatment method in medical practice in every region of Ukraine.
Introduction. Traumatic events are considered to be one of the current problems in modern urban society. Beyond being the immediate cause of the death of the injured, the development of multiple organ failure syndrome is a perilous complication of severe multiple and combined trauma. An experimental cranioskeletal trauma is known to be accompanied by internal organ dysfunction. Nonetheless, the development of organ dysfunction in terms of hypoxia resistance in the presence of cranioskeletal trauma remains insufficiently studied.The objective of research: to establish the dynamics of the functional state of the liver in the presence of cranioskeletal trauma, complicated by blood loss in rats with different hypoxia resistance in the early period of traumatic disease and evaluate the efficacy of Thiocetam in the correction of identified abnormalities.Material and methods: The experimental studies were conducted on 196 white non-linear male rats weighing 180-200g. Initially, an individual resistance to hypoxia of the rats was estimated, and the animals demonstrated high- and low- resistance value to hypoxia (HR and LR, respectively) were selected for the further study. The HR- and LR-rats were separately divided into 4 groups: control and three experimental once. In the first experimental groups the HR-and LR-animals were induced the cranioskeletal trauma under thiopental sodium anesthesia (40 mg·kg-1); the animals of the second experimental groups were inflicted the acute blood loss of 20-22% of circulating blood volume; in the third experimental groups, the HR and LR animals were subjected to an acute blood loss following the cranioskeletal trauma and administered the intraperitoneal injection of the Thiocetam at a dose of 250 mg·кg-1 of body weight once a day for correction. The bile excretion function of the liver was analyzed in the controls and experimental groups of animals 1, 3 and 7 days after trauma.The results and discussion. The conducted studies indicated the higher rate of bile excretion in the control group of LR-rats compared to the control of HR-rats. The rate of bile excretion was occurred decreased in both HR- and LR-rats under the influence of the cranioskeletal trauma. However, the degree of decrease in the studied parameter of the LR-rats was considerably greater than the corresponding value of the HR-rats. An additional blood loss model resulted in more marked abnormalities, particularly in the experimental group of LR-rats. The 7-day administration of Thiocetam led to the significant decrease in the abnormal bile excretion rate in the experimental groups of HR- and LR-rats compared to the animals without corrective medication. The analysis of deviation degree of the studied parameter in the animals administered Thiocetam in relation to the animals without correction evidenced better efficacy of the medication in the experimental group consisted of LR-rats compared to the group of HR-rats, especially under the conditions of additional acute blood loss model. Consequently, Thiocetam is able to compensate less-developed defense mechanisms of LR-rats compared to the HR-rats, which should be taken into consideration in real-life clinical practice settings in the comprehensive treatment of the injured with cranioskeletal trauma complicated by blood loss considering the possibility to determine their resistance to hypoxia.Conclusions. The rate of bile excretion as a basic indicator of the functional state of the liver in the intact LR-rats is found to be substantially higher than in HR-rats. The degree of decrease in the rate of bile excretion is significantly greater in LR-rats after 7 days of the post-traumatic period under the influence of cranioskeletal trauma complicated by acute blood loss. The administration of Thiocetam is accompanied by a marked positive effect on the rate of bile excretion in the HR- and LR-rats, but the degree of increase in the studied parameter is considerably greater in the experimental group of LR-rats.
Introduction: The prevalence and incidence of cardiovascular diseases have been attracting considerable attention in recent decades. This is partly due to the fact that myocardial fibrosis is the major consequence of the most nosological units of cardiovascular diseases. We believe that early pathogenic therapy of myocardial fibrosis should be taken into consideration as a solution to this issue. The change of the connective tissue metabolism in myocardium is the central chain in pathogenesis of diffuse ischemic necrotic cardiosclerosis (DINC) occurs after repeated epinephrine injury of myocardial tissues. The aim: The present study establishes that use of metabolic therapy by trimetazidine (TM) has a protective effect on myocardium repeatedly damaged by epinephrine in hight concentration during the development of DINC in rats with different resistance to hypoxia. Materials and methods: Using the method of hypobaric hypoxia, male albino rats were divided into three groups due to their different resistance to hypoxia. Each group was divided into four equal subgroups: control group, DINC group (2 times repeated injections of epinephrine hydrotartrate (0,5 mg/kg body weight) and calcium gluconate (5 mg/ kg body weight), control group introdused with trimetazidine dihydrochloride (10 mg/kg body weight), DINC treated with TM group (2 times repeated injections of epinephrine hydrotartrate (0,5 mg/kg body weight) and calcium gluconate (5 mg/kg body weight) group introduced with TM (10 mg/kg body weight) for all period of observation. The concentration of protein-bound oxyproline in homogenate of myocardium was determined at 7, 14 and 30 days after the modelling pathology and the histological examination of Masson trichrome staining of myocardium was performed. Results: Experimental modeling of DINC increased the concentration of protein-bound oxyproline in homogenate of myocardium at 7, 14 and 30 days after the modelling pathology, as well as accompanied by metabolic imbalances in diffuse connective tissue elements, which are rich in collagens. Experimental modeling of DINC+TM increased the concentration of protein-bound oxyproline in blood serum significantly less intensive. Conclusions: The intensity of metabolic imbalances in diffuse connective tissue elements of myocardium is the highest in the low resistant animals to hypoxia. Those results are confirmed by histological examination of the myocardium of rats with different resistance to hypoxia. Fibrotic regions in myocardium are rich in collagens. It has been revealed that the most pronounced therapeutic effect of TM is observed in animals with low resistance to hypoxia, slightly less – in animals with medium resistance to hypoxia, and the lowest – in animals with high resistance to hypoxia.
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