Search

This Expert Council focuses on the meta-analysis of studies on the risk of atrial fibrillation (AF) in patients taking omega-3 polyunsaturated fatty acids (PUFA) and of data on the omega-3 PUFA treatment in patients with cardiovascular and kidney diseases.The major statements of the Expert Council: the meta-analysis of AF risk in patients taking omega-3 PUFA showed an increased risk of this arrhythmia. However, it should be taken into account that the risk of complications was low, and there was no significant increase in the risk of AF when omega-3 PUFA was used at a dose of ≤1 g and a standard dose of the only omega-3 PUFA drug registered in the Russian Federation, considering all AF episodes in the ASCEND study.At the present time, according to Russian and international clinical guidelines, the use of omega-3 PUFA can be considered in the following cases: • for patients with chronic heart failure (CHF) with reduced left ventricular ejection fraction as a supplement to the basic therapy (2B class of recommendations according to the 2020 Russian Society of Cardiology guidelines (RSC) and the 2022 AHA / ACC / HFSA guidelines); • for patients with hypertriglyceridemia (>1.5 mmol/l) as a part of combination therapy (IIb class of recommendations and B level of evidence according to the 2021 European guidelines on cardiovascular disease prevention, etc.); • for adult patients with stage 3-4 chronic kidney disease (CKD), long-chain omega-3 PUFA 2 g/day is recommended for reducing the level of triglycerides (2C class of recommendations). Data on the use of omega-3 PUFA for other indications are heterogenous, which can be partially explained by using different form and doses of the drugs.

To determine the incidence of cognitive dependence in adults who are physically independent at discharge from acute traumatic brain injury (TBI) rehabilitation.Analysis of historical clinical and demographic data obtained from inpatient stay.Inpatient rehabilitation unit in a large, metropolitan university hospital.Adult inpatients with moderate to severe TBI (N=226) who were physically independent at discharge from acute rehabilitation.Not applicable.FIM Motor and Cognitive subscales, discharge destination, and care plan.Approximately 69% (n=155) of the physically independent inpatients were cognitively dependent at discharge from acute rehabilitation, with the highest proportions of dependence found in the domains of problem solving and memory. Most (82.6%; n=128) of these physically independent, yet cognitively dependent, patients were discharged home. Of those discharged home, 82% (n=105) were discharged to the care of family members, and 11% (n=15) were discharged home alone. Patients from racial and ethnic minority backgrounds were significantly more likely than White patients to be discharged while cognitively dependent.The majority of physically independent patients with TBI were cognitively dependent at the time of discharge from acute inpatient rehabilitation. Further research is needed to understand the effect of cognitive dependence on caregiver stress and strain and the disproportionate burden on racial and ethnic minority patients and families. Given the potential functional and safety limitations imposed by cognitive deficits, health care policy and practice should facilitate delivery of cognitive rehabilitation services in acute TBI rehabilitation.

The agreement of experts of the Eurasian Association of Therapists (EAT) discusses pathogenesis and treatment of COVID-19. Modern data on the characteristics of cardiovascular, kidney, respiratory damage in SARS-infected CoV-2 are presented. The tactics of managing patients initially having cardiovascular diseases, diabetes mellitus, chronic obstructive pulmonary disease, bronchial asthma, chronic kidney disease are discussed in detail. The article presents data on drug interaction of drugs.В соглашении экспертов Евразийской ассоциации терапевтов (ЕАТ) обсуждаются вопросы патогенеза и лечения COVID-19. Представлены современные данные об особенностях поражения сердечно-сосудистой системы, почек, органов дыхания у инфицированных SARS-Cov-2. Подробно обсуждена тактика ведения пациентов, исходно имеющих сердечно-сосудистые заболевания, сахарный диабет, хроническую обструктивную болезнь легких, бронхиальную астму, хроническую болезнь почек. В статье представлены данные о лекарственном взаимодействии препаратов.

Unusual cascade transformation was developed involving microwave assisted electrocyclic cyclization of aci (alkylideneazinic acid) forms of nitrovinylindoles acting as heterotrienes. Subsequent one-pot reduction allowed for efficient access to β-carbolines, including several natural products, alkaloids norharmane, harmane and eudistomin N.

Microwave-assisted reaction between 2-(3-oxoindolin-2-yl)-2-phenylacetonitriles andbenzene-1,2-diamines leads to the high-yielding formation of the corresponding quinoxalines as sole, easily isolaable products. The featured transformation involves unusual extrusion of phenylacetonitrile molecule and could be performed in a short sequence starting from commonly available indoles and nitroolefins.

The purpose of this study was to obtain information about psychology internship training programs involving work with individuals with disabilities receiving rehabilitation services in the United States and Canada.The Association of Psychology Postdoctoral and Internship Centers (APPIC) directory was used to identify 426 training programs that listed supervised experience in rehabilitation psychology, and these programs were sent a survey assessing characteristics of their internship. There were 227 program directors who responded (53%), and 114 of them reported that their internship involved working with disabled persons receiving rehabilitation services.The majority of training programs were at a hospital or subacute rehabilitation facility (Veteran Affairs and non-Veteran Affairs), and 41% of the programs were housed within an independent psychology department. Sixteen programs (15%) had faculty who were board certified by the American Board of Rehabilitation Psychology (ABRP).Interns were exposed to a broad range of conditions, such as brain injuries, orthopedic, and spinal cord injuries, as well as comorbid psychiatric and substance use disorders. Interns were also provided various levels of training in ABRP competencies across programs. Opportunities to improve training with rehabilitation populations at the internship level include increasing didactics related to rehabilitation psychology and increasing opportunities to work with ABRP faculty. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Indolizines and pyrazolo[1,5-a]pyridines were prepared via [3 + 2]-cycloaddition of pyridinium ylides to 1-chloro-2-nitrostyrenes. The synthesized molecules were evaluated for antiproliferative activities against a BE(2)-C neuroblastoma cell line with several compounds decreasing the viability of cancer cells. Indolizine 9db showed higher potency than that of all-trans-retinoic acid, an approved cancer drug. Mechanistically, it was found to inhibit tubulin polymerization and it is thus proposed that the discovered chemistry can be exploited for the development of novel microtubule-targeting anticancer agents.

Imidazo[1,5-a]pyridines were efficiently prepared via the cyclization of 2-picolylamines with nitroalkanes electrophilically activated in the presence of phosphorous acid in polyphosphoric acid (PPA) medium.

Unusual reaction proceeding via the electrophilic activation of nitroalkanes in the presence of polyphosphoric acid has been discovered. Subsequent nucleophilic attack with semicarbazides or thiosemicarbazides allows to access 2-amino-1,3,4-oxadiazoles and 2-amino-1,3,4-thiadiazoles, respectively.

An original, facile, and highly efficient method for the preparation of 2-(3-oxoindolin-2-ylidene)acetonitriles from ortho-nitrochalcones is described. The featured transformation is a triggered Michael addition of the cyanide anion to the chalcone followed by a cascade cyclization mechanistically related to the Baeyer–Drewson reaction.

The majority of patients with amputation defect of the lower extremities are elderly citizens with high co- and polymorbidity, the presence of several geriatric syndromes, which adversely affects the prognosis, reduces the rehabilitation potential, in some cases leads to the development of cardiovascular complications, amputation of the second limb, severe disability and high postoperative mortality. The key link in the rehabilitation process of disabled people with a lower limb stump is to provide them with a functional prosthesis. The article provides an analysis of morbidity, primary disability in the period from 2015 to 2019, gender, age and clinical characteristics of patients living in St. Petersburg who underwent amputation of the lower limb due to obliterating artery diseases is presented. It was found that there is no information on the survival rate of patients after amputation at various times of the post-hospital period in St. Petersburg. We have identified a pronounced imbalance between the number of lower limb amputations performed and the number of applications of disabled people to the bureau of medical and social expertise for providing technical means of rehabilitation and referral to primary prosthetics.Большинство пациентов с ампутационным дефектом нижних конечностей являются гражданами пожилого возраста с высокой ко- и полиморбидностью, наличием нескольких гериатрических синдромов, что неблагоприятно влияет на прогноз, снижает реабилитационный потенциал, в ряде случаев приводит к развитию сердечно-сосудистых осложнений, ампутации второй конечности, тяжелой инвалидизации и высокой послеоперационной летальности. Ключевым звеном процесса реабилитации инвалидов с культей нижней конечности является обеспечение их функциональным протезом. В статье приведен анализ заболеваемости, первичной инвалидности в период 2015–2019 гг., гендерных, возрастных и клинических характеристик пациентов, проживающих в Санкт-Петербурге, которым выполнена ампутация нижней конечности вследствие сосудистой патологии. Установлено, что отсутствует информация о выживаемости пациентов после проведения ампутации в различные сроки постгоспитального периода в Санкт-Петербурге. Выявлен выраженный дисбаланс между количеством выполняемых ампутаций нижних конечностей ежегодно и количеством обращений инвалидов в бюро медико-социальной экспертизы для обеспечения техническими средствами реабилитации и направлением на первичное протезирование, реабилитацию.

The results of studies on the antioxidant effect of a number of peptide drugs, which is manifested at various levels, ranging from cells to the whole body, in adulthood and during aging, under the influence of extreme environmental factors, indicate the important role of low-molecular peptides in the mechanisms of regulating homeostasis during aging. The antioxidant properties of regulatory peptides are shown in experiments both on intact sexually mature animals, and especially clearly during aging or the action of extreme environmental factors (hypoxia, hypokinesia). A number of the studied substances (AEDG, KE) have a membrane-stabilizing effect, preventing osmotic and acid hemolysis of red blood cells and reducing the level of extra-erythrocyte hemoglobin and total peroxidase activity in blood plasma. It is shown that the studied peptides are able to have a neuroprotective effect by stabilizing the activity of enzymes (neprilysin, an insulin degrading enzyme) that play an important role in the catabolism of beta-amyloid, and prevent its accumulation in concentrations toxic to cells. The involvement of regulatory peptides with antioxidant properties on the expression of genes that ensure the stabilization of mitochondrial membranes, the functioning of the electron transport chain and the activity of antioxidant enzymes is considered.Приведенные в работе результаты исследований об антиоксидантном действии ряда пептидных препаратов, которое наблюдается на различных уровнях, начиная от клеточного до организма в целом, свидетельствуют о важной роли низкомолекулярных пептидов в механизмах регуляции гомеостаза при старении. Антиоксидантные свойства регуляторных пептидов проявляются в экспериментах как на интактных половозрелых животных, так и особенно наглядно при старении или действии экстремальных факторов внешней среды (гипоксия, гипокинезия). Ряд исследуемых пептидов (AEDG, KE) оказывают мембраностабилизирующее действие, препятствуя осмотическому и кислотному гемолизу эритроцитов и снижая уровень содержания внеэритроцитарного гемоглобина и суммарной пероксидазной активности в плазме крови. Показано, что исследуемые пептиды способны оказывать нейропротекторный эффект путем стабилизации активности ферментов (неприлизин, инсулин деградирующий фермент), играющих важную роль в катаболизме β-амилоида, и препятствовать его накоплению в мозге. Рассматривается участие регуляторных пептидов, обладающих антиоксидантными свойствами, на экспрессию генов, обеспечивающих стабилизацию митохондриальных мембран, функционирование электрон-транспортной цепи и активность антиоксидантных ферментов.