Clinical observation pseudoobstruction syndrome of the stomach's output part and small intestine of a patient with systematic lupus erythematosis

Stomach's output part and small intestine, combining with damaging of the urinary tract is a rare systemic lupus eritematosus (SLE) manifestation. The patient is 32 years old, suffering from SLE with damaged join, blood system, secondary antiphospholipid syndrome with pulmonary embolism in the history and formation of high postembolic pulmonary hypertension on therapy with hydroxychloroquine and low doses of corticosteroids, was hospitalized because of persistent nausea, vomiting, loss of more than 10 kg body weight 1.5 months. The research have shown the obstruction's formation of the stomach's output part, small bowel obstruction at several levels, as well as thickening of the bladder wall and the unilateral expansion of the ureter. Against the backdrop of strengthening of immunosuppressive therapy these lesions completely regressed

Anti-SRP antibody-associated necrotizing myopathy: 2 clinical cases

Necrotizing myopathies are a subtype of autoimmune myopathies characterized by muscle fiber necrosis with minimal infiltration by inflammatory cells on muscle biopsy. This group of myopathies is defined by flaccid palsies due to prima‑ ry skeletal muscle damage as well as extramuscular manifestations such as fever, rash, arthritis, Raynaud’s syndrome and interstitial lung disease. The presence of anti-SRP antibodies is associated with rapidly progressive refractory myositis predominantly affecting limb muscles and axial muscles.Objective of the work is to analyze the course of severe, refractory to several lines of immunosuppressive therapies anti-SRP associated necrotizing myopathy and to highlight an adequate treatment regime.Necrotizing myopathy was suspected in patients aged 39 and 56 years with rapidly progressive flaccid tetraparesis on the basis of clinical and anamnestic data, the results of needle electromyography and muscle magnetic resonance imaging, as well as the analysis of myositis-specific and myositis-associated autoantibodies. In both cases, a rapid development of atrophies, marked muscle weakness in the limbs, without involvement of the bulbar musculature, was observed. To achieve effective control of the disease progression, several lines of therapy were required: glucocorticosteroids, intravenous immunoglobulins, methotrexate and rituximab. Our observations are consistent with those in the literature.Our observations illustrate the clinical course of severe myopathy associated with anti-SRP antibodies. Early initiation of aggressive immunosuppression is crucial to control the disease progression. Treatment and rehabilitation allow achieving significant improvement of the patient’s condition

Investigation of dispersed fluid systems during the cavitation treatment of hydrofuels

Results of investigation of the dispersed fluid systems theory and its practical application during the cavitation treatment of hydrofuels are given. Outcomes of biofuel dispersion estimation have been compared from the classic point of view and from the point of view of the dispersed fluid systems theory exemplified as fitting of water droplets diameters distribution function on sizes of water and fuel emulsion.</jats:p

Takotsubo syndrome in an adolescent with spinal amyotrophy after surgical treatment

Takotsubo syndrome (stress-induced cardiomyopathy) is well known in adult cardiology practice, and it also occurs in children. Takotsubo syndrome develops after emotional or physical stress. There is an acute transient disorder of the left ventricle contractility of the apex. The development of pain syndrome, electrocardiographic changes and troponins elevation imitate myocardial infarction. The key diagnostic point is intact coronary arteries and complete reversibility of local contractility disorders over the time.The article describes the clinical case of takotsubo syndrome in an adolescent with type III spinal muscular atrophy after planned surgery (repeated posterior spondylodesis).Takotsubo syndrome with clinical manifestations of acute left ventricular failure and pulmonary edema developed in the early postoperative period with distinctive electrocardiographic changes (ST segment elevation, local impairment of left ventricular contractility according by echocardiography and ventriculography, and increased levels of troponin). Timely examination and correction of therapy confirm the clinical diagnosis. The regression of symptoms occurred within a few days.</jats:p

Circulating miR-21-5p, miR-146a-5p, miR-320a-3p in patients with atrial fibrillation in combination with hypertension and coronary artery disease

Aim. To study the plasma profiles of circulating extracellular microribonucleic acids (miRNAs), potentially including in pathogenesis of cardiovascular diseases, in patients with atrial fibrillation (AF) in combination with hypertension (HTN) or coronary artery disease (CAD).Material and methods. The study included patients with AF in combi  nation with HTN (n=21) or CAD (n=10), as well as following control groups: patients with uncomplicated HTN without AF (n=28), patients with stable CAD without AF (n=10) and healthy individuals (n=30). MiRNA samples were isolated from blood plasma of the study participants. MiRNAs were detected by TaqMan quantitative polymerase chain reaction assay. The relative plasma levels of five candidate miRNAs were estimated relative to the reference miR-16-5p.Results. Among the analyzed circulating plasma miRNAs, a higher level of miR-320a-3p was associated with AF, while increased levels of miR 146a-5p and miR-21-5p are potentially associated with presence of both AF and CAD.Conclusion. Differences were found in the plasma miRNA profiles (miR-21-5p, miR-320a-3p, miR-146a-5p) between patients with AF, regardless of concomitant disease (CAD or HTN), and healthy individuals in the control group.</jats:p

Non-invasive fractional flow reserve: a comparison of one-dimensional and three-dimensional mathematical modeling effectiveness

Aim. Comparative analysis of the diagnostic effectiveness of onedimensional (1-D) and three-dimensional (3-D) non-invasive methods for coronary fractional flow reserve (FFR) assessment based on the coronary computed tomography angiography (CCTA).Material and methods. We carried out a retrospective analysis of CCTA data for 13 patients (men — 9, mean age — 61,07±9,73). In the original research, coronary FFR of those patients was evaluated using the original 3-D HeartFlow® Analysis followed by a standard invasive FFR assessment. We estimated coronary FFR using the 1-D algorithm of the Laboratory of Mathematical Modeling (Sechenov University) and compared the diagnostic effectiveness of these methods.Results. In per-vessel analysis, the sensitivity and specificity of the 3-D approach were 90,91% (95% confidence interval (CI) 62,26-99,53) and 20% (95% CI 0,01026-62,46, p&gt;0,9999), respectively; in per-patient analysis — 90% (95% CI 59,58-99,49) and 0% (95% CI 0-56,15, p&gt;0,9999), respectively; area under the ROC curve was 93,75% (95% CI 80,26-100), p=2,0431e-10. For the 1-D approach, the same parameters in per-patient analysis were 88,89 % (95% CI 56,50-99,43) and 25% (95% CI 0,01282-69,94, p&gt;0,9999), respectively; in per-vessel analysis — 100% (95% CI 72,25-100) and 33,33% (95% CI 0,05923-70, p=0,1250), respectively; area under the ROC curve was 84,54% (95% CI 63,93-100), p=0,001. Spearman’s rank correlation coefficient between the 3-D and 1-D techniques was 0,7326 (95% CI 0,35810,9041), p=0,0017.Conclusion. Although we have obtained lower values of area under the ROC curve, the sensitivity and specificity of experimental approach, as well as the correlation coefficient between models were rather high. However, further studies with higher statistical power are required

Анти-SRP-ассоциированная некротизирующая миопатия: 2 клинических случая

Necrotizing myopathies are a subtype of autoimmune myopathies characterized by muscle fiber necrosis with minimal infiltration by inflammatory cells on muscle biopsy. This group of myopathies is defined by flaccid palsies due to prima‑ ry skeletal muscle damage as well as extramuscular manifestations such as fever, rash, arthritis, Raynaud’s syndrome and interstitial lung disease. The presence of anti-SRP antibodies is associated with rapidly progressive refractory myositis predominantly affecting limb muscles and axial muscles.Objective of the work is to analyze the course of severe, refractory to several lines of immunosuppressive therapies anti-SRP associated necrotizing myopathy and to highlight an adequate treatment regime.Necrotizing myopathy was suspected in patients aged 39 and 56 years with rapidly progressive flaccid tetraparesis on the basis of clinical and anamnestic data, the results of needle electromyography and muscle magnetic resonance imaging, as well as the analysis of myositis-specific and myositis-associated autoantibodies. In both cases, a rapid development of atrophies, marked muscle weakness in the limbs, without involvement of the bulbar musculature, was observed. To achieve effective control of the disease progression, several lines of therapy were required: glucocorticosteroids, intravenous immunoglobulins, methotrexate and rituximab. Our observations are consistent with those in the literature.Our observations illustrate the clinical course of severe myopathy associated with anti-SRP antibodies. Early initiation of aggressive immunosuppression is crucial to control the disease progression. Treatment and rehabilitation allow achieving significant improvement of the patient’s condition.Некротизирующие миопатии – это подтип аутоиммунных миопатий, для которого характерен некроз мышечных волокон с минимальной инфильтрацией воспалительными клетками по данным мышечной биопсии. Клиническая картина данной группы миопатий определяется парезами в связи с первичным поражением скелетных мышц, а также внемышечными проявлениями, такими как лихорадка, сыпь, артриты, синдром Рейно и интерстициальная болезнь легких. Наличие анти-SRP-антител ассоциируется с развитием быстропрогрессирующих и рефрактерных к лечению миозитов с поражением мускулатуры конечностей и аксиальной мускулатуры.Цель работы – провести анализ особенностей течения рефрактерной к иммуносупрессивной терапии анти-SRP-ассоциированной некротизирующей миопатии и составить адекватный план лечения.У 2 пациенток 39 и 56 лет с быстропрогрессирующим вялым тетрапарезом на основании клинико-анамнестических данных, результатов игольчатой электромиографии и магнитно-резонансной томографии мышц, а также анализа миозитспецифических и миозит-ассоциированных аутоантител заподозрена некротизирующая миопатия. В обоих случаях отмечено быстрое развитие атрофий, выраженной слабости мышц конечностей, без вовлечения бульбарной мускулатуры. Для достижения эффективного контроля над течением болезни потребовалось назначение нескольких линий терапии: глюкокортикостероидов, внутривенных иммуноглобулинов, метотрексата и ритуксимаба. Представленные наблюдения согласуются с данными литературы.Наблюдения иллюстрируют тяжесть и быстроту течения миопатии, ассоциированной с антителами к SRP, необходимость раннего начала агрессивной иммуносупрессии. Активные лечебно-реабилитационные мероприятия позволяют добиться существенного улучшения состояния больного