Variation cardiointervalometry in evaluating the efficiency of medical and psychological rehabilitation measures of military services

BACKGROUND: Тhe main tasks of medical and psychological rehabilitation (MPR): accelerated restoration of the functional state and working capacity of military personnel; increase of reserve capabilities; reduction of the influence of risk factors for various diseases; secondary prevention of chronic diseases and prevention of chronization of acute processes; carrying out measures to eliminate and reduce psychopathological syndromes in order to achieve mental adaptation; restoration of professional health, correction of maladaptosis. AIMS: Is to study the informative value of variational cardiointervalometry (VCM) indicators in assessing the effectiveness of MPR of military personnel. MATERIAL AND METHODS: This study was conducted in the branch Clinical Sanatorium Volga of the Federal State Budgetary Institution Privolzhsky of the Ministry of Defense of the Russian Federation during the work of the psychotherapy room with the category of MPR for 12 months. In addition to the regulated volume of diagnostic studies, the Device for psychophysiological testing UPFT-1/30 Psychophysiologist (manufacturer of LLC NPKF Medikom MTD, Russia) was used. One of the research methods is the assessment of the functional state of the heart rhythm by the method of variational cardiointervalometry (VCM) at admission to MPR and before discharge (also referred to in the literature as heart rate variability, HRV). The study was conducted with 116 servicemen undergoing MPR for fatigue of 12 degrees for 10 days. Representatives of the Strategic Missile Forces (RVSN) ― 34 people; aerospace forces (VKS) ― 32 people; ground forces (SV) ― 50 people. The data is processed in StatSoft Statistica 10 Russian Portable 10.0.1011.0 x86. RESULTS: The average values for the entire group (116 servicemen): at admission and before discharge IN (stress index) increased statistically significantly from 284.5 to 359.7 cu; VLF-decreased from 21.1% to 16.0%; LF/HF (vagosympathetic interaction index) ― from 2.7 to 4.0 cu; Centralization index ― from 3.8 to 5.1 cu; PARS (indicator of adaptation of regulatory systems) ― from 4.6 to 5.3 cu. The result is a pronounced tension of regulatory systems, active mobilization of protective mechanisms, increased activity of the sympatho-adrenal system and the pituitary-adrenal system. CONCLUSION: VCM (HRV) is one of the practical informative methods. RVSN: an increase in the voltage of regulatory systems as a reaction to physical exertion, a post-loading energy-deficient state, the index of vagosympathetic interaction has shifted to the parameters of the norm.VCS: an increase in the voltage of regulatory systems, an increase in the activation of the sympathetic nervous system, an active mobilization of protective mechanisms. SV: a tendency to reduce the voltage of regulatory systems, a post-loading energy-deficient state, a balanced state of the autonomic nervous system (VNS). A delayed training effect is likely, changes occur in the late phases of recovery, after the end of the rehabilitation period.

Mechanisms of prevention postoperative immunosuppression by regional anesthesia

The data on the factors of development of postoperative immunosuppression (PI) are presented. Among them, an important role in the development of PI belongs to hyperactivity during operations of the sympathetic nervous system (SNS) and hypothalamic-pituitary-adrenal system. It has been shown that PI is prevented by regional anesthesia, primarily epidural anesthesia and postoperative epidural analgesia, as well as prolonged ganglioplegia. It is concluded that the preventive action of regional anesthesia in relation to the development of PI is largely associated with the sympatholytic component of action.

Comparative characteristics of ketamine and sodium oxybutyrate as adjuvant sedation in patients with alcoholic delirium

Annotation. Today, the number of benzodiazepine-resistant alcoholic deliriums is growing. It is actually to search for an optimal scheme of sedation with a combination of two sedatives. The aim of the study was to compare efficacy of standard sedation with added barbiturates and the schemes with using ketamine and sodium oxybutyrate. We tested 60 cases of delirium tremens which were randomized into three groups. In the control group we conducted the traditional sedation with added sodium thiopental. In the first research group we combined the infusion of ketamine with diazepam. In the second one we gave sodium oxybutyrate with diazepam. We evaluated the duration of delirium, hemodynamics parameters, serum cortisol and serotonin, laboratory indicators of kidneys and liver condition. We used such statistical methods as Mann-Whitney test, Wilcoxon T-criterion and Kruskal-Wallis H-criterion. The duration of delirium was significantly lower in research groups in comparison with the control one. There was no difference of the duration of delirium between research groups. It indicates a comparable effect of using either ketamine, or sodium oxybutyrate. All groups showed significant reduction of hemodynamics parameters in the process of the treatment, however we observed more cases of hypertension and tachycardia on the third day of the treatment in the research groups than in the control one. These data suggest an insufficient effect of the combination of diazepam with both ketamine and sodium oxybutyrate on the sympatho-adrenal system. Serum cortisol was significantly reduced in all the groups, there was no difference between control and research groups. Serotonin was equally increased in all the groups on the third day. The obtained results indicate that the effectiveness of the combination of benzodiazepines with both ketamine and sodium oxybutyrate is comparable to the standard sedation regimen and does not differ in the reaction of these biomarkers. The laboratory indicators of kidneys condition on the third day increased only in the research groups, which indicates more negative influence on kidneys by both ketamine and sodium oxybutyrate. The indicators of liver condition were significantly reduced only in the group of ketamine, there were no difference in the rest groups. The use of ketamine and sodium oxybutyrate as adjuvant sedation may reduce the duration of a delirium episode, but has insufficient effect on hemodynamics and may adversely affect renal function.

Itsenko-Cushing’s disease in the practice of a nurse

Itsenko-Cushing’s disease is a disease characterized by dysfunctions of the hypothalamic-pituitary-adrenal system. Without therapy during the first five years, the survival rate is 50 %, and the patient’s condition improves markedly with palliative treatment, increasing the survival rate to 86 %. Today, there are a number of criteria for the diagnosis, diagnosis and treatment of this pathology.

Differential Expression of Circadian Clock Genes in the Bovine Neuroendocrine Adrenal System

The primary objective of this investigation was to determine whether circadian clock genes were differentially expressed within or among bovine hypothalamic paraventricular nucleus (PVN), anterior pituitary gland (AP), adrenocortical (AC) and adrenomedullary (AM) tissues. The PVN, AP, AC, and AM were isolated from 5-yr-old Brahman cows (n = 8) harvested humanely at an abattoir between 0800-1100 h. Expression of target genes in each sample was evaluated via RNA-sequencing analyses. Gene counts were normalized using the trimmed mean of M values (TMM) method in the edgeR Package from Bioconductor, R. The normalized gene counts of genes important for circadian rhythm were statistically analyzed using the GLM Procedure of SAS. The genes analyzed were circadian locomotor output cycles protein kaput (CLOCK), cryptochrome circadian regulator 1 and 2 (CRY1 and CRY2), aryl hydrocarbon receptor nuclear translocator like (ARNTL), period circadian regulator 1 and 2 (PER1 and PER2), neuronal PAS domain protein 2 (NPAS2), and nuclear receptor subfamily 1 group D member 1 (NR1D1). Overall, relative expression profiles of clock genes differed (P < 0.01) within each tissue with PER1 having greater expression in all tissues (P < 0.01). Within the PVN expression of CLOCK, CRY1, ARNTL, and PER2 was less than that of CRY2, NPAS2, and NR1D1 (P < 0.01). In the AP, with the exception of PER1, no other clock gene differed in degree of expression. In the AC, expression of CLOCK and NPAS2 was greater than CRY1, ARNTL, PER2, and NR1D1 (P < 0.05), whereas CRY2 expression exceeded only CRY1 (P < 0.05). Within the AM, CLOCK and CRY2 expression was greater than CRY1 and ARNTL (P < 0.05). Overall, clock gene expression among tissues differed (P < 0.01) for each individual clock gene. The AC and AM had similar clock gene expression, except expression of CRY2 and PER2 was greater in AM (P < 0.05). The AC and AM had greater expression of CLOCK than the PVN and AP (P < 0.01), with PVN having greater expression than AP (P < 0.01). The AP had greater expression of NPAS2, followed by PVN, with the least expression in the AC and AM (P < 0.01). Both PVN and AP had greater CRY1 and NR1D1 expression than AC or AM (P < 0.01). The AP had greater PER1 expression than PVN, AC, and AM (P < 0.01), whereas PVN, AC, and AM had greater ARNTL expression than AP (P < 0.05). Both AP and AM had greater expression of PER2 than PVN or AC (P < 0.01). The PVN had greater expression of CRY2 than the AP, AC, and AM (P < 0.01). These results indicated that within each tissue the various clock genes were expressed in different quantities. Also, the clock genes were expressed differentially among the tissues of the bovine neuroendocrine adrenal system. Temporal relationships of these genes with the primary endocrine products of these tissues should be investigated to define the roles of peripheral clock genes in regulation of metabolism and health.

BLOOD PROTEINS AND THEIR INFORMATIVENESS IN ASSESSING THE ADAPTIVE RESOURCES OF CHICKENS UNDER TECHNOLOGICAL STRESS

In the body of chickens, when exposed to the technological factor (the density of birds in the cage), a stress reaction developed as a result of activation of the hypathalamic-pituitary-adrenal system. The response and state of the neuroendocrine pathway is associated with the magnitude of the technological stress factor. When it is increased by 1.50 times, the maximum changes in the body of chickens are detected 4 hours after the start of the experiment. At the same time, the level of corticosterone and cortisol in the blood of birds increases by 3.42 and 2.99 times, increasing the rate of catabolic reactions in protein metabolism. Therefore, the amount of total protein in the blood-stream of chickens increases by 34.32 %, albumins by 26.74 %, urea and uric acid by 2.07 and 2.29 times, and the activity of AsAT and AlAT increases by 2.15 and 4.53 times (p<0.05). The catabolic processes involve mainly blood albumins, whose nitrogen is used for the synthesis of uric acid. This is evidenced by a decrease in the value of Alb/uric acid by 42.74 % (p<0.05). With an increase in the density of birds in the cage by 2 times, the reaction of the GGNS more pronounced and long-lasting. Although the maximum changes are registered 2 hours after the initiation of stress, they per-sist throughout the study period. At the same time, the level of corticosterone and cortisol in the blood of chickens increases by 4.17 and 3.67 times, the concentration of total protein by 39.44 %, both due to albumins (by 41.78 %) and globulins (by 37.82 %); the increase in the amount of urea and uric acid is 2.18 and 2.45 times. Both albumins and blood globulins are subjected to oxidative decomposition, which determines the decrease in the ratio TP/Urea, Alb/urea at, TP/uric acid and Alb/uric acid at 35.72-43.18 %. At the same time, the activity of AlAT increases by 7.56 times and AsAT by 2.21 times, determining the predominant use of carbon residues of free amino acids in the processes of gluconeogenesis (AlAT/AsAT increased by 3.75 times).

Unraveling the Role of Respiratory Muscle Metaboloreceptors under Inspiratory Training in Patients with Heart Failure

Exercise intolerance may be considered a hallmark in patients who suffer from heart failure (HF) syndrome. Currently, there is enough scientific evidence regarding functional and structural deterioration of skeletal musculature in these patients. It is worth noting that muscle weakness appears first in the respiratory muscles and then in the musculature of the limbs, which may be considered one of the main causes of exercise intolerance. Functional deterioration and associated atrophy of these respiratory muscles are related to an increased muscle metaboreflex leading to sympathetic–adrenal system hyperactivity and increased pulmonary ventilation. This issue contributes to increased dyspnea and/or fatigue and decreased aerobic function. Consequently, respiratory muscle weakness produces exercise limitations in these patients. In the present review, the key role that respiratory muscle metaboloreceptors play in exercise intolerance is accurately addressed in patients who suffer from HF. In conclusion, currently available scientific evidence seems to affirm that excessive metaboreflex activity of respiratory musculature under HF is the main cause of exercise intolerance and sympathetic–adrenal system hyperactivity. Inspiratory muscle training seems to be a useful personalized medicine intervention to reduce respiratory muscle metaboreflex in order to increase patients’ exercise tolerance under HF condition.

State Of Purine Exchange And Microalbuminuria In Patients With Metabolic Syndrome

The aim of the given work was study interactions of impairments sympa-thetic – adrenal systems functional condition and processes of peroxidal oxida-tion of lipids in woman with metabolic syndrome. 107women at the age of 25-49 were observation. They were randomized into 3 groups: I (control) – 15 healthy persons, II – 43 patients with arterial hypertension, III – 49 women with arterial hypertension in combination with metabolic syndrome. The results of carried investigations showed that activation of sympathetic adrenal system and processes of peroxidal oxidation of lipids took place in metabolic syn-drome. Marked lowering of sympathetic – adrenal system key ferment catechol-amins (MAO monoaminooxidaze) desamidization activity and considerable ac-tivation of peroxidal oxidation of lipid products which have great significance in revealing the mechanism of metabolic syndrome development were observed in metabolic syndrome. This results in the prolonged toxic influence of catechola-mins on myocardium.

ANALYSIS OF INDICATORS OF HYPOTHALAMO-HIPOPHYSEAL-ADRENAL SYSTEM IN PERSONS WHO HAD SUICIDE ATTEMPTS

Annotation: suicide – can be considered as a reaction in a stressful situation. The decisive role in the development of the stress reaction belongs to the hypothalamic­hipophyseal­adrenal system. Materials and methods: the content of corticoliberin, adrenocorticotropic hormone and cortisol in the peripheral blood of persons who committed suicidal attempts. The comparison group (GC) consisted of persons who experienced stress, who had not previously committed. The presence of a statistical relationship between the study groups was tested using the nonparametric Kruskal-Wallis test. Pairwise comparison of distributions by the Mann-Whitney test with Bonferroni correction for the level of significance. When identifying the relationship by non-parametric criteria, an additional one-way analysis of variance was performed, which makes it possible to compare the average values of the indicators. Results: in males, an increase in the hypothalamic-hipophyseal-adrenal system hormones is noted. Statistically significant differences in hormone cortisol were found between GC and the group of people who used highly lethal methods of self-harm and are based on the differences in the group of men over 40 years old. In females, no statistically significant differences were found between the groups. Cunclusion: 1. Statistically significant differences between the groups were noted in the severity of motivation to commit suicide and the hormone Cortisol. 2. Statistically significant differences in the hormone Cortisol were due to the presence of differences between males over 40 years old. 3. In females, there were no statistically significant differences between hormonal indices.