scholarly journals Surgical Treatment of a Rare Presentation of Bertolotti's Syndrome from Castellvi Type IV Lumbosacral Transitional Vertebra: Case Report and Review of the Literature

2018 ◽  
Vol 79 (03) ◽  
pp. e70-e74 ◽  
Author(s):  
Ryan Adams ◽  
Sarah Herrera-Nicol ◽  
Arthur Jenkins
Keyword(s):  
Back Pain ◽  
Surgical Treatment ◽  
Leg Pain ◽  
Lumbosacral Spine ◽  
Complete Fusion ◽  
Type I ◽  
Type Iii ◽  
Transitional Vertebra ◽  
Type Iv ◽  
The Right

Background Advancements in radiological imaging and diagnostic criteria enable doctors to more accurately identify lumbosacral transitional vertebrae (LSTV) and their association with back and L5 distribution leg pain. It is considered the most common congenital anomaly of the lumbosacral spine with an incidence between 4 and 35%,3 although many practitioners describe 10 to 12% overall incidence. LSTVs include sacralization of the L5 vertebral body and lumbarization of the S1 segment while demonstrating varying morphology, ranging from broadened transverse processes to complete fusion.5 The most common types of LSTV that present with symptomatic Bertolotti's syndrome are the Castellvi type I and type II; type III and type IV variants rarely present with symptoms referable with confirmatory and provocative testing to the transitional vertebra itself, and therefore there is limited experience and no case reports of treatment toward this particular entity. Case Description We illustrated a case of a 37 years old female in which a computed tomography scan demonstrated type III LSTV on the left and a type I anomaly on the right. The patient presented with right-sided leg pain and left-sided sacroiliac (SI) region low back pain, worse with rotation and standing, for several years, and had been on daily narcotic pain medications for more than 2 years. The patient had temporary relief of her leg pain with a transverse/ALA injection on the right, but no improvement in her back pain, whereas a left-sided injection into the region around the type III interface on the left did transiently alleviate her SI pain without improvement in her leg pain. We proposed that this particular anomaly induced mechanical back pain on the left side by flexion of the bone bridge (a form of stress-fracture, with associated sclerotic changes in the interface in the transverse/ALA junction) with associated irritation of the right L5 nerve from the type I anomaly on the right in conjunction with her typical radiating leg pain on the right. A patent, but somewhat hypoplastic L5/S1 disk space was also present. Nonsegmental pedicle screw instrumentation with low-profile screws was implanted on the right side with fusion induced using allograft and off label use of infuse rh-BMP2 bone graft substitute, and the patient was discharged the same day. The patient noted immediate improvement in her preoperative symptoms, and by 2 weeks after her surgery noted complete resolution of the preoperative symptoms, and required no narcotic medications to control her incisional pain. Conclusion Patients who present with symptoms consistent with Bertolotti's syndrome, even if they have a type III or type IV LSTV, should be considered for surgical treatment of their LSTV. These patients can respond well, even if symptoms have been present for years. Given the prevalence of these anatomic variants in the general population (10–12% in most series), Bertolotti's syndrome should be considered in the differential diagnosis of any patient with a presentation of L5 radiculopathy and/or back pain.

scholarly journals Hypoplastic Left Heart Syndrome: Prognostic Significance of Morphological Variants of the Heart in the Choice of Treatment Approach

2021 ◽  
pp. 53-59
Author(s):  
V. Zakharova ◽  
T. Savchuk ◽  
Ya. Truba ◽  
V. Lazoryshynets ◽  
O. Rudenko
Keyword(s):  
Right Ventricle ◽  
Prognostic Significance ◽  
Type I ◽  
Type Ii ◽  
Hypoplastic Left Heart ◽  
Type Iii ◽  
Type Iv ◽  
The Right ◽  
Type V ◽  
Left Heart Syndrome

Hypoplastic left heart syndrome (HLHS) is one of the most complicated congenital heart defects which leads to the inevitable fatal outcome in the natural course of the disease. Currently, Norwood procedure and fetal aortic valvuloplasty are considered the major approaches for surgical treatment of HLHS. However, the prognosis of such surgeries is often unpredictable. The aim. To study morphological variations of the left ventricle (LV) in HLHS and evaluate the prognostic significance of each of them in the choice of surgical approach. Materials. The main group included 63 hearts of newborns with HLHS, the comparison group included 53 hearts of newborns without cardiac pathology. Methods. The methods used were survey microscopy, as well as macro- and micromorphometry of various parameters of the heart, calculation of the ratio of their absolute values (indices) with subsequent statistical data processing. Results. Five types of LV were identified in HLHS patients based on the size and shape of the cavity, wall thickness, presence or absence of fibroelastosis: slit-like hypoplastic (Type I) (n = 10; 15.9%); slit-like hypertrophic (Type II) (n = 19; 30.2%); cylindrical (Type III) (n = 22; 34.9%); lacunar (Type IV) (n = 6; 9.5% ); lacunar-cylindrical (Type V) (n = 6; 9.5%). In Type I left ventricles, the interventricular index (IVI) (the ratio of the areas of the free walls of the left and right ventricles on the cross sections of the heart) was the smallest: 0.13 ± 0.03 units versus normal 1.96 ± 0.31 units. In Type II left ventricles, the value was equal to 1.69 ± 0.23 units; in Type III it was 1.59 ± 0.64 units; in Type IV it was 1.31 ± 0.03 units; in Type V it was 1.05 ± 0.52 units. The index of the working area of the right ventricular myocardium (RVI) (the ratio of the area of the free wall of the right ventricle to the sum of the areas of the free wall and interventricular septum) in Type I LV was the highest: 81.3 ± 5.7% versus normal 57.1 ± 2.02%; in Type II it was 49.7 ± 6.4%; in Type III it was 39.8 ± 2.9%; in Type IV it was 69.7 ± 16.1%; in Type V it was 41.3 ± 24.4%.Type III–V LVs have always been associated with fibroelastosis, in contrast to Type I and II LVs. Conclusions. In HLHS, Type I hearts are the most eligible for the Norwood procedure, since the LV, due to its minimal size, is not an excess ballast for the working right ventricle. Type II LV is optimal for the fetal aortic valvuloplasty, since during the II-III trimesters of gestation they can join the circulatory system due to remodeling. HLHS with LV fibroelastosis (Types III, IV, V) seem to be the least favorable for both pre- and postnatal surgery, especially in the presence of fibroelastosis of the right ventricle.

scholarly journals Root Canal Configuration Of Permanent Mandibular First Molars Using Radiographic Tube Shift Technique On Dentistry Student Of University Of Sumatera Utara

2017 ◽  
Vol 16 (2) ◽  
Author(s):  
Trelia Boel ◽  
Dewi Kartika ◽  
Liliana Liliana
Keyword(s):  
Root Canal ◽  
Dental Student ◽  
Type I ◽  
Type Ii ◽  
Type Iii ◽  
Type Iv ◽  
The Right ◽  
Type V ◽  
Mandibular First Molar ◽  
Left Region

Introduction: Permanent mandibular first molars are the most commonly experienced treatment failure. Knowledge of root canal configuration needs to be known to establish the right diagnostics and successful root canal treatment. The aim of this study is to find out the root canal configuration of permanent mandibular first molar based on Vertucci classification using tube shift radiography technique among dental student of University of Sumatera Utara. Materials and Methods: This is an experimental with cross sectional approach. 36 students were selected by purposive sampling and data were collected from questionnaire and x-ray radiograph. Results: The result showed that 97.2% of permanent mandibular first molar have two roots and 2.8% have three roots. Variation of root canal configuration according to Vertucci on mesial root right region, type I 8.3%, type II 27.8%, type III 11.1%, type IV 50%, type II classification Gulabivala 2.8%, on left region type I 5.6%, type II 44.4%, type III 2.8%, type IV 44.4%, type II classification Gulabivala 2.8%. On distal root of first molar right region, type I 86.1%, type II 2.8%, type III 8.3%, type V 2.8%, on left region, type I 100%. Conclusion(s): Root canal configuration of mandibular first molar based on Vertucci classification at mesial roots of the right region, type I, II, III, IV, and type II classification Gulabivala , on left region we found type I, II, III, IV, and type II classification Gulabivala . On distal root of the right region, type I, II, III, and type V, on left region only type I.

scholarly journals Visualisation of Rouviere’s Sulcus during Laparoscopic Cholecystectomy

2015 ◽  
Vol 53 (199) ◽  
pp. 188-191 ◽  
Author(s):  
Prabin Bikram Thapa ◽  
Dhiresh Kumar Maharjan ◽  
Theten Yonjan Tamang ◽  
Suman Kumar Shrestha
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
College Teaching ◽  
Type I ◽  
Type Ii ◽  
Open Type ◽  
Type Iii ◽  
Medical College ◽  
Calot’S Triangle ◽  
Type Iv ◽  
The Right

Introduction: Safe dissection of Calot’s Triangle is important during the performance of laparascopic cholucystectomy. The purpose of the study is to determine the frequency of demonstrable Rouviere’s sulcus in patients with symptomatic gall stones and its role in safe dissection in Calot’s triangle. Methods: This is a prospective descriptive study design done in Department of surgery, Kathmandu Medical College Teaching Hospital from Jan 2013 to Jan 2015. Patients who were posted for laparoscopic cholecystectomy were included. During laparoscopy, Rouviere’s sulcus was noted in the operative note and classified according to following: Type I: Open type was defined as a cleft in which the right hepatic pedicle was visualized and the sulcus was opened throughout its length. Type II: if the sulcus was open only at its lateral end. Type III If the sulcus was open only at its medial end. Type IV: Fused type was defined as one in which the pedicle was not visualized. Results: A total of 200 patients underwent laparoscopic cholecystectomy during period of 2 years. Out of which Rouviere’s sulcus was visualized in 150 patients (75 %).Type I (open type) was commoner in 54%, type II in 12%, Type III in 9% and type IV (fused type) in 25%. Conclusions: Rouviere’s Sulcus is an important extra biliary land mark for safe dissection of Calot’s triangle during laparoscopic cholecystectomy.  Keywords: Rouviere’s Sulcus, laparoscopic cholecystectomy, bile duct injury.

scholarly journals Segmented lordotic angles to assess lumbosacral transitional vertebra on EOS

2020 ◽  
Vol 29 (10) ◽  
pp. 2470-2476 ◽  
Author(s):  
Domenico Albano ◽  
Carmelo Messina ◽  
Angelo Gambino ◽  
Martina Gurgitano ◽  
Carmelo Sciabica ◽  
...  
Keyword(s):  
Type I ◽  
Type Ii ◽  
Optimal Cutoff ◽  
Chi Square ◽  
Type Iii ◽  
Bony Fusion ◽  
Transitional Vertebra ◽  
Type Iv ◽  
Lumbar Segment ◽  
Lumbosacral Transitional Vertebra

Abstract Purpose To test the vertical posterior vertebral angles (VPVA) of the most caudal lumbar segments measured on EOS to identify and classify the lumbosacral transitional vertebra (LSTV). Methods We reviewed the EOS examinations of 906 patients to measure the VPVA at the most caudal lumbar segment (cVPVA) and at the immediately proximal segment (pVPVA), with dVPVA being the result of their difference. Mann–Whitney, Chi-square, and ROC curve statistics were used. Results 172/906 patients (19%) had LSTV (112 females, mean age: 43 ± 21 years), and 89/172 had type I LSTV (52%), 42/172 type II (24%), 33/172 type III (19%), and 8/172 type IV (5%). The cVPVA and dVPVA in non-articulated patients were significantly higher than those of patients with LSTV, patients with only accessory articulations, and patients with only bony fusion (all p < .001). The cVPVA and dVPVA in L5 sacralization were significantly higher than in S1 lumbarization (p < .001). The following optimal cutoff was found: cVPVA of 28.2° (AUC = 0.797) and dVPVA of 11.1° (AUC = 0.782) to identify LSTV; cVPVA of 28.2° (AUC = 0.665) and dVPVA of 8° (AUC = 0.718) to identify type II LSTV; cVPVA of 25.5° (AUC = 0.797) and dVPVA of − 7.5° (AUC = 0.831) to identify type III–IV LSTV; cVPVA of 20.4° (AUC = 0.693) and dVPVA of − 1.8° (AUC = 0.665) to differentiate type II from III–IV LSTV; cVPVA of 17.9° (AUC = 0.741) and dVPVA of − 4.5° (AUC = 0.774) to differentiate L5 sacralization from S1 lumbarization. Conclusion The cVPVA and dVPVA measured on EOS showed good diagnostic performance to identify LSTV, to correctly classify it, and to differentiate L5 sacralization from S1 lumbarization.

scholarly journals A hospital based plain radiographic observational study of lumbosacral transitional vertebrae in the Nepalese population

2018 ◽  
Vol 9 (4) ◽  
pp. 46-50
Author(s):  
Manoj Bhattarai
Keyword(s):  
Observational Study ◽  
Lumbosacral Spine ◽  
Type I ◽  
Cross Sectional ◽  
Transitional Vertebra ◽  
Type Iv ◽  
Wide Range ◽  
Clinical Consequences ◽  
Lumbosacral Transitional Vertebra ◽  
Lumbosacral Transitional Vertebrae

Background: Presence of lumbosacral transitional vertebra may lead to number of clinical consequences because of failure to correctly number the problematic vertebra and also has been associated with low back pain. Different studies done at different part of the world have shown wide range of prevalence of lumbosacral transitional vertebra.Aims and Objective: This hospital based cross sectional observational study was undertaken to determine the prevalence of lumbosacral transitional vertebra among the Nepalese population.Materials and Methods: Plain radiographs (anteroposterior and lateral views of lumbosacral spine and KUB radiographs) of 947 patients (646 with lumbosacral spine and 301 with KUB radiographs) done from August 2015 to July 2016 and meeting inclusion criteria were retrospectively analyzed for the presence of lumbosacral transitional vertebra.Results: The overall prevalence of lumbosacral transitional vertebra was 14.7% with prevalence of 16.3% in patients with lumbosacral radiographs and 11.3% in patients with KUB radiographs and was statistically significant. Prevalence of sacralization was higher than lumbarization (11.9% Vs 2.7%). Lumbosacral transitional vertebra was more common in females than in males with Castellvi type I being most common and type IV least common.Conclusion: The overall prevalence of lumbosacral transitional vertebra in the studied Nepalese population was 14.7% with significantly higher prevalence in patients with lumbosacral radiographs than with KUB radiographs.Asian Journal of Medical Sciences Vol.9(4) 2018 46-50

Labelling of non-A, non-B hepatitis infected chimpanzee hepatocytes with nuclease-gold conjugates

1984 ◽  
Vol 42 ◽  
pp. 250-251
Author(s):  
G. D. Gagne ◽  
M. F. Miller ◽  
D. A. Peterson
Keyword(s):  
Endoplasmic Reticulum ◽  
Experimental Infection ◽  
Uranyl Acetate ◽  
Type I ◽  
Cellular Injury ◽  
Type Ii ◽  
Tubular Structures ◽  
Type Iii ◽  
Type Iv ◽  
Infected Chimpanzee

Experimental infection of chimpanzees with non-A, non-B hepatitis (NANB) or with delta agent hepatitis results in the appearance of characteristic cytoplasmic alterations in the hepatocytes. These alterations include spongelike inclusions (Type I), attached convoluted membranes (Type II), tubular structures (Type III), and microtubular aggregates (Type IV) (Fig. 1). Type I, II and III structures are, by association, believed to be derived from endoplasmic reticulum and may be morphogenetically related. Type IV structures are generally observed free in the cytoplasm but sometimes in the vicinity of type III structures. It is not known whether these structures are somehow involved in the replication and/or assembly of the putative NANB virus or whether they are simply nonspecific responses to cellular injury. When treated with uranyl acetate, type I, II and III structures stain intensely as if they might contain nucleic acids. If these structures do correspond to intermediates in the replication of a virus, one might expect them to contain DNA or RNA and the present study was undertaken to explore this possibility.

scholarly journals Brachial supporting structure of Spiriferida (Brachiopoda)

2020 ◽  
pp. 1-15
Author(s):  
Zhiwei Yuan ◽  
Wen Guo ◽  
Dan Lyu ◽  
Yuanlin Sun
Keyword(s):  
Mantle Cavity ◽  
Family Type ◽  
Type I ◽  
Type Ii ◽  
Feeding Apparatus ◽  
Single Family ◽  
Supporting Structure ◽  
Type Iii ◽  
Type Iv ◽  
Evolutionary Lineages

Abstract The filter-feeding organ of some extinct brachiopods is supported by a skeletal apparatus called the brachidium. Although relatively well studied in Atrypida and Athyridida, the brachidial morphology is usually neglected in Spiriferida. To investigate the variations of brachidial morphology in Spiriferida, 65 species belonging to eight superfamilies were analyzed. Based on the presence/absence of the jugal processes and normal/modified primary lamellae of the spiralia, four types of brachidium are recognized. Type-I (with jugal processes) and Type-II (without jugal processes), both having normal primary lamellae, could give rise to each other by losing/re-evolving the jugal processes. Type-III, without jugal processes, originated from Type-II through evolution of the modified lateral-convex primary lamellae, and it subsequently gave rise to Type-IV by evolving the modified medial-convex primary lamellae. The evolution of brachidia within individual evolutionary lineages must be clarified because two or more types can be present within a single family. Type-III and Type-IV are closely associated with the prolongation of the crura, representing innovative modifications of the feeding apparatus in response to possible shift in the position of the mouth towards the anterior, allowing for more efficient feeding on particles entering the mantle cavity from the anterior gape. Meanwhile, the modified primary lamellae adjusted/regulated the feeding currents. The absence of spires in some taxa with Type-IV brachidium might suggest that they developed a similar lophophore to that in some extant brachiopods, which can extend out of the shell.

scholarly journals Polysaccharides and virulence of Burkholderia pseudomallei

2007 ◽  
Vol 56 (8) ◽  
pp. 1005-1010 ◽  
Author(s):  
M. Sarkar-Tyson ◽  
J. E. Thwaite ◽  
S. V. Harding ◽  
S. J. Smither ◽  
P. C. F. Oyston ◽  
...  
Keyword(s):  
Burkholderia Pseudomallei ◽  
Capsular Polysaccharide ◽  
Gene Clusters ◽  
Type I ◽  
Wild Type ◽  
Time To Death ◽  
Type Iii ◽  
Type Iv ◽  
Mutant Strains ◽  
Delayed Time

Burkholderia pseudomallei is the causative agent of melioidosis, an infectious disease of humans and animals. Gene clusters which encode capsular polysaccharide (type I O-PS) and LPS (type II O-PS), both of which play roles in virulence, have previously been identified. Here, the identification of two further putative clusters, type III O-PS and type IV O-PS, is reported. Mice challenged with type III O-PS or type IV O-PS mutants showed increased mean times to death (7.8 and 11.6 days) compared to those challenged with wild-type B. pseudomallei (3 days). To investigate the possible roles of polysaccharides in protection, mice were immunized with killed cells of wild-type B. pseudomallei or killed cells of B. pseudomallei with mutations in the O antigen, capsular polysaccharide, type III O-PS or type IV O-PS gene clusters. Immunization with all polysaccharide mutant strains resulted in delayed time to death compared to the naïve controls, following challenge with wild-type B. pseudomallei strain K96243. However, immunization with killed polysaccharide mutant strains conferred different degrees of protection, demonstrating the immunological importance of the polysaccharide clusters on the surface of B. pseudomallei.

Response properties of units in the dorsal cochlear nucleus of unanesthetized decerebrate gerbil

1996 ◽  
Vol 75 (4) ◽  
pp. 1411-1431 ◽  
Author(s):  
K. A. Davis ◽  
J. Ding ◽  
T. E. Benson ◽  
H. F. Voigt
Keyword(s):  
Dorsal Cochlear Nucleus ◽  
Type I ◽  
Type Ii ◽  
Decerebrate Cat ◽  
Excitatory Response ◽  
Type Iii ◽  
Type Iv ◽  
Noise Type ◽  
Rate Versus ◽  
Excitatory Responses

1. The electrophysiological responses of single units in the dorsal cochlear nucleus of unanesthetized decerebrate Mongolian gerbil (Meriones unguiculatus) were recorded. Units were classified according to the response map scheme of Evans and Nelson as modified by Young and Brownell, Young and Voigt, and Shofner and Young. Type II units have a V-shaped excitatory response map similar to typical auditory nerve tuning curves but little or no spontaneous activity (SpAc < 2.5 spikes/s) and little or no response to noise. Type I/III units also have a V-shaped excitatory map and SpAc < 2.5 spikes/s, but have an excitatory response to noise. Type III units have a V-shaped excitatory map with inhibitory sidebands, SpAc > 2.5 spikes/s, and an excitatory response to noise. Type IV-T units typically also have a V-shaped excitatory map with inhibitory sidebands, but have a highly nonmonotonic rate versus level response to best frequency (BF) tones like type IV units, SpAc > 2.5 spikes/s, and an excitatory response to noise. Type IV units have a predominantly inhibitory response map above an island of excitation of BF, SpAc > 2.5 spikes/s, and an excitatory response to noise. We present results for 133 units recorded with glass micropipette electrodes. The purpose of this study was to establish a normative response map data base in this species for ongoing structure/function and correlation studies. 2. The major types of units (type II, type I/III, type III, type IV-T, and type IV) found in decerebrate cat are found in decerebrate gerbil. However, the percentage of type II (7.5%) and type IV (11.3%) units encountered are smaller and the percentage of type III (62.4%) units is larger in decerebrate gerbil than in decerebrate cat. In comparison, Shofner and Young found 18.5% type II units, 30.6% type IV units, and 23.1% type III units using metal electrodes. 3. Two new unit subtypes are described in gerbil: type III-i and type IV-i units. Type III-i units are similar to type III units except that type III-i units are inhibited by low levels of noise and excited by high levels of noise whereas type III units have strictly excitatory responses to noise. Type IV-i units are similar to type IV units except that type IV-i units are excited by low levels of noise and become inhibited by high levels of noise whereas type IV units have strictly excitatory responses to noise. Type III-i units are approximately 30% of the type III population and type IV-i units are approximately 50% of the type IV population. 4. On the basis of the paucity of classic type II units and the reciprocal responses to broadband noise of type III-i and type IV-i units, we postulate that some gerbil type III-i units are the same cell type and have similar synaptic connections as cat type II units. 5. Type II and type I/III units are distinguished from one another on the basis of both their relative noise response, rho, and the normalized slope of the BF tone rate versus level functions beyond the first maximum. Previously, type II units were defined to be those nonspontaneously active units with rho values < 0.3 where rho is defined as the ratio of the maximum noise response minus spontaneous rate to the maximum BF tone response minus spontaneous rate. In the gerbil, the average rho value for type II units is 0.25, although a few values are > 0.3, and the rate-level curves are consistently nonmonotonic with normalized slopes steeper than than -0.007/dB. The average rho value for type I/III units is 0.54, although a few values are < 0.3, and the rate-level curves tend to saturate with slopes shallower than -0.006/dB. In general, the response properties of type II units recorded in gerbil are similar to those recorded in decerebrate cat. 6. In comparison to decerebrate cat, the lower percentage of type IV units recorded in decerebrate gerbil may be due to a species difference (a reduced number of type II units in gerbil) or an electrode bias.

scholarly journals Individual-typological features of regulation of cardiorhythm in foreign students during education process

2019 ◽  
Vol 3 (Issue 4) ◽  
pp. 199 ◽  
Author(s):  
Ainura M. Satarkulova ◽  
Shadiya Yu Aisaeva ◽  
Almaz S. Shanazarov
Keyword(s):  
Foreign Students ◽  
Parasympathetic Nervous System ◽  
Heart Rhythm ◽  
The Body ◽  
Type I ◽  
Central Regulation ◽  
Type Iii ◽  
Type Iv ◽  
Autonomous Regulation ◽  
Education Process

Objective: In studies of the mechanisms of human adaptation to professional and educational activities, as well as in clinical practice, the method of mathematical analysis of heart rate variability (HRV) is widely used. Based on this, the aim of this paper is to determine the typology and characteristics of the vegetative regulation of the heart as a prenosological control of the functional state of the body of practically healthy foreign students. Methods: In 2018, 389 male students from India and Pakistan, which are studying at the International higher school of medicine (ISM) aged 17-24, served as test subjects. For each student, the main HRV parameters were recorded in a sitting position for 5 minutes by means of “PSYCHOPHYSIOLOGIST” software and hardware company Medicom MTD  (Russia). Results: In total, 52% of young men had type I (with a moderate predominance of central regulation), 5% - type II (with a pronounced predominance of central regulation), 36% - type III (with a moderate predominance of autonomous regulation), and 7% - type IV (with a pronounced predominance of autonomous regulation). Students with a predominance of central regulation (types I and II) compared with types III and IV (predominance of autonomous regulation) have an excess of sympathetic influences on the heart, as indicated by reliably low values ​​of the SDNN, Mo, TP and high level of SI, which leads to various dysfunctional disorders, especially with severe centralization. In the group of persons with type III, a balance is maintained between the tone of the sympathetic and parasympathetic nervous system, while type IV shows a significant prevalence of parasympathetic effects on the heart rhythm. Conclusion: The results indicate a risk of developing disadaptation in the students' body during education process and the importance of systematic monitoring to detect early cardiac arrhythmias.

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