COMPARATIVE CHARACTERISTICS OF THE DYNAMICS OF CARDIOVASCULAR AND RESPIRATORY EFFECTS OF PNEUMOPERITONEUM BASED ON CARBON DIOXIDE AND ARGON IN LAPAROSCOPIC CHOLECYSTECTOMY

Pneumoperitoneum is one of the most critical components of laparoscopic surgery, which has a negative effect on gas exchange and stress to circulatory buffering system. One of the top priorities of laparoscopic technologies is to minimize the impact on the respiratory and cardiovascular systems, metabolic dynamics and compensatory abilities of homeostasis. The main goal of this research work is to compare the effects of carboxyperitoneum and argonoperitoneum on the intraoperative dynamics of CO2 concentration as well as cardiovascular and respiratory characteristics in patients undergoing laparoscopic cholecystectomy for various forms of cholelithiasis. Materials and methods. Four experimental groups involved patients based on their nosological form of cholelithiasis and the gas used to induce pneumoperitoneum. All patients underwent laparoscopic cholecystectomy by means of standard procedure. Either medical carbon dioxide or medical argon was used to induce pneumoperitoneum. Intraoperative monitoring of blood carbon dioxide levels PaCO2 was performed by taking venous blood every 15 minutes. Capnometry was performed by means of mainstream analysis using “BIOMED” BM1000C modular patient monitor by recording the discrete values of PetCO2 every 15 minutes, as well as by analyzing photocopies of capnography curves every 15 minutes. Intraoperative echocardiography was performed to identify the mean arterial pressure (MAP), heart rate (HR) and cardiac output (CO) in order to assess the effects of different types of pneumoperitoneum on the cardiovascular system. Results. The obtained data confirm the expected difference in the indices of cardiorespiratory functions between patients with acute cholecystitis and cholelithiasis without signs of inflammation. The investigation revealed that under the influence of pneumoperitoneum, heart rate and mean arterial pressure increase, while the cardiac output decreases. The respiratory pressure marker depends more on the intra-abdominal pressure and presumably the patient’s body type than on the presence of inflammatory syndrome. Argon insufflation has a slight negative impact on the cardiovascular system. Particularly, the mean arterial pressure and heart rate increase, while the cardiac output marker is less decreased as compared to the use of carbon dioxide. Abdominal pressure has a significant effect on the cardiovascular and respiratory systems regardless of the used type of gas. The combination of high intra-abdominal pressure with the elevated head end of the operating table, which is a common practise during cholecystectomy, has especially great influence on cardiovascular and respiratory functions. Operation which is carried out at decreased pressure allows reducing the deviations of practically all indices. Conclusions. Thus, the cardiovascular and respiratory systems adapt under the influence of pneumoperitoneum, providing compensation for the negative effects of mechanical and resorptive-metabolic character. Compensatory-adaptive abilities of the cardiovascular and respiratory systems increase with the decrease of intra-abdominal pressure. The use of argon as a working gas for insufflation into the abdominal cavity during laparoscopy reduces the negative impact of pneumoperitoneum on the cardiovascular and respiratory systems, providing a greater reserve of homeostatic and buffer systems of the body.

Assessment of the effectiveness of medical rehabilitation after COVID-19 based on the functional capacity of the cardiovascular and respiratory systems

Aim. To assess the effectiveness of medical rehabilitation after pneumonia associated with the novel coronavirus infection (COVID-19), based on the study of functional capacity of the cardiovascular system and the external respiratory system.Methods. The study included 70 patients who had COVID-19 pneumonia and underwent a medical rehabilitation program from September to December 2020. Before being included in the rehabilitation program, all patients underwent pulmonary function tests (PFT), including an assessment of the lungs diffusion capacity, cardiopulmonary exercise testing, multispiral computed tomography (MSCT) of the chest, echocardiography, an evaluation of the quality of life according to the SF-36 questionnaire and the severity of shortness of breath on the mMRC scale. The effectiveness of rehabilitation was evaluated against the changes in PFT parameters, exercise tolerance, and quality of life.Results. At the enrollment, 46% of patients retained lung tissue lesions shown by MSCT and accompanied by a decrease in the lung diffusion capacity (67 (55 - 79%) of predicted value), dyspnea of 1.6 (1.0 - 3.0) points according to mMRC scale, moderate level of exercise tolerance and quality of life. Complex cardiopulmonary rehabilitation for 12 - 14 days in a specialized hospital led to a significant improvement in the parameters of pulmonary gas exchange and ventilation, peak oxygen consumption, and an increase in the reserve capacity of the cardiorespiratory system. The factors limiting the improvement of pulmonary gas exchange were the older age of the patients and the increased pressure in the pulmonary artery system. The positive influence of rehabilitation on both the physical and psycho-emotional components of the quality of life was noted.Conclusion. Complex cardiopulmonary rehabilitation with the assessment of changes in the oxygen metabolism parameters and functional capacity of the cardiovascular and respiratory systems has shown to be safe and highly effective in the studied group of patients who have had COVID-19 pneumonia.

THE PRACTICE OF IMMOBILIZING LARGE WILD CARNIVOROUS ANIMALS IN A NATIONAL PARK

In the conditions of the Serengeti National Park (Tanzania), female lions were immobilized in order to conduct clinical, physiological and special studies using xylazine and ketamine, and atypamezol as an antidote. The first signs of immobilization in lionesses after the use of xylazine and ketamine occur in 4.8±0.8 minutes, and the restoration of mobility after the use of the antidote – in 1.5 minutes. Depression of the cardiovascular and respiratory systems in lionesses and disorders of the general condition after the use of the above-mentioned drugs were not noted, which allows us to recommend the use of such a combination of drugs for immobilizing wild animals in national parks, nature reserves and zoos.

Breathing in Birds and Crocodiles: What’s Different, What’s the Same, and Why Does It Matter?

At first glance, crocodiles and birds appear to be two very different groups of animals. Crocodiles tend to inhabit marshes and wetlands, while most birds tend to nest on dry land or in trees. Not only do they look very different, but while crocodiles walk on all fours and are excellent swimmers, most birds fly. Interestingly, researchers have found remarkable similarities in the way crocodiles and birds breathe! Different from how humans breathe, both birds and crocodiles have one-way air flow through their airways, meaning that air moves in a circular path into the lungs and back out. This article compares the structures of the respiratory systems in birds and crocodiles. We also examine how their respiratory systems are specialized for their unique environments and activities.

The possible correlation between magnesium deficiency and SARS-CoV-2 infection

Magnesium (Mg) is an essential electrolyte for living organisms. It is the fourth most abundant mineral in the body. Although Mg is usually found in hard water and high-fiber diets, wide use of soft water and refined flour impose people at risk of Mg deficiency. Imbalances in Mg status and Mg deficiency may result in a variety of complications associated with the immune, cardiovascular, urinary, nervous, and respiratory systems. Because of the important roles of magnesium in the prevention and treatment of many diseases, several studies are focusing on the correlation between Mg status and Coronavirus disease 2019 (COVID-19). The present study reviewed several types of research to indicate the importance of monitoring of Mg status as well as the possible role of Mg supplementation for supportive treatment in COVID-19 patients. The results indicated that Mg deficiency could be a risk factor for multi-organ dysfunction in COVID-19 infection. Mg supplementation improves functions of the immune, cardiovascular, nervous, urinary, and respiratory systems through different mechanisms. Suppression of cytokine storm, bronchodilation, antithrombotic function, a decrease of arterial blood pressure, preventing electrolyte imbalance, increase stress resistance are some of the related mechanisms. These findings may provide a reference regarding the possible beneficial effects of the Mg supplement as an inexpensive, safe, and easily available drug for supportive treatment in COVID-19 patients.

Alterações radiológicas presentes no sistema respiratório de pacientes com COVID-19: Uma revisão sistemática de literatura

Objetivo: investigar na literatura internacional os achados radiológicos mais frequentes no sistema respiratório de pacientes infectados pelo Sars-CoV-2. Metodologia: Trata-se de uma Revisão Sistemática de Literatura (RSL), a busca sendo realizada nas bases de dados Pubmed e Cochrane Library, sendo utilizadas estratégias de busca abrangentes dos seguintes termos e seus correlatos baseados no Medical Subject Headings (MeSH): Coronavirus Infection, Respiratory Systems, Imaging, Diagnostic. Foi incluído estudos observacionais publicados a partir de 2020 em qualquer idioma. Resultados: após a triagem, 8 estudos foram detectados, com população total de 1.089 pacientes de 6 países diferentes. Discussão: os pacientes infectados pelo Sars-CoV-2 foram avaliados por duas categorias de exames de imagem: Tomografia Computadorizada e Ultrassonografia Pulmonar, e o comprometimento pulmonar está intimamente relacionado com a gravidade e a presença de fatores de riscos. Conclusão: os resultados evidenciam a importância dos achados radiológicos como ferramenta complementar no diagnóstico e prognóstico da COVID-19, embora não deva substituir os exames laboratoriais na confirmação diagnóstica.

ОСОБЛИВОСТІ ФУНКЦІОНАЛЬНОГО СТАНУ ОРГАНІЗМУ І ОБРОБКИ СЕНСОРНОЇ ІНФОРМАЦІЇ В ОСІБ ЮНАЦЬКОГО ВІКУ

The aim of the work is to study the functional indicators of the cardiovascular and respiratory systems, indicators of the efficiency of processing of visual information and motor response in adolescents with different levels of functional reserves of the heart. We studied indicators of heart rate, blood pressure, Skibinsky index, Rosenthal’s test, the speed of the visual-motor reaction (simple and differentiated), the number of errors made during the examination, the analysis of the indicators of the correction test, the volume of operational visual memory, the dynamics of the analysis of Schulte tables, the volume and distribution of attention. The study demonstrated that the functional indicators of the cardiovascular system are within the permissible limits. However, the heart rate of individuals with a satisfactory level of heart efficiency tends to approach the upper physiological limit. Skibinsky’s index corresponds to a satisfactory level for the females. This index indicates the average potential of the external respiration system and the correspondence of activity with the blood circulatory system. For the analysis of Schulte tables, the individuals of the first group spent 161.8 s ± 10.37 s, which is significantly faster than the index of the second group. Studies have not shown a relationship between the level of heart performance and indicators of the distribution of attention. However, the indicators of the volume of operative visual memory in individuals of the first group are much better: 65 % of individuals have a high level (the same index in the second group is 20 %), the participants with a low level of operative visual memory are absent, in contrast to the second group. The speed of simple and differentiated sensorimotor reactions in individuals of the first group is higher than those in the second group by 11.4 % and 10.6 %, respectively. This indicates a sufficient level of plasticity of nervous processes and the efficiency of arousal development. The performance indicators of the cardiovascular and respiratory systems, the speed of reactions of the nervous system of the examined, the efficiency of processing sensory information indicate the maturity of the functional systems of the body and are the physiological basis for the formation of an adequate functional state of the body. Individuals with a Rufier index level above the average showed less tension in the work of the heart and an effective course of sensorimotor reactions, indicating a sufficient level of plasticity of nervous processes.

The role of magnesium in the life support of the body: diagnosis of magnesium deficiency and its supplement with mineral complexes

Magnesium takes part in metabolic processes and is an indispensable element for the functioning of the nervous, cardiovascular, respiratory systems and the gastrointestinal tract. The article analyzes the role of magnesium in the life support processes of the body, presents to the attention of readers the possibility of diagnosing magnesium deficiency, and substantiates the need for magnesium supplement using mineral complexes in various pathological processes and in order to prevent magnesium deficiency.