Еffects of percutaneous electrical stimulation of the spinal cord in combination with mechanotherapy on changes in systemic and regional hemodynamics

Objective: to evaluate changes in systemic and cerebral hemodynamics during percutaneous electrical stimulation of the spinal cord and in combination of electrical stimulation with mechanotherapy. Methodology. The subjects underwent percutaneous electrical stimulation of the spinal cord, the duration of the session was 5 minutes. Mechanotherapy was performed using a treadmill. The subjects performed walking at a power of 25W. for 5 minutes. Hemodynamics was evaluated before and after the electrical stimulation session, as well as before and after the mechanical therapy session on the track in combination with percutaneous electrical stimulation of the spinal cord. To study systemic and regional hemodynamics, a rheograph-polyanalyzer "REAN-POLY" was used. Results. Electrical stimulation of the spinal cord does not lead to significant changes in systemic and cerebral hemodynamics. Percutaneous electrical stimulation of the spinal cord in combination with physical exertion leads to reactive changes in systemic hemodynamics, increased blood filling and venous outflow, against the background of a decrease in peripheral resistance of cerebral vessels. Key words: electrostimulation, percutaneous electrostimulation, mechanotherapy, systemic hemodynamics, regional hemodynamics.

Deficient auditory gamma-BOLD coupling in schizophrenia is related to sensory gating deficits

Background: Schizophrenia is associated with aberrant gamma band power, hypothesized to reflect imbalance in the excitation-inhibition (E/I) ratio and undermine neural signal efficiency. Relationships between resting-state gamma, E/I balance, and regional hemodynamics from the fMRI BOLD signal are unknown. Methods: We recorded simultaneous EEG-fMRI at rest, with eyes open, in people with schizophrenia (n= 57) and people without a psychiatric diagnosis (n= 46) and identified gamma and aperiodic EEG parameters associated with E/I balance. Measures from all EEG channels were entered into a whole-brain, parametric modulation analysis followed by statistical correction for multiple comparisons. Sensory gating was assessed using the Sensory Gating Inventory, and psychotic symptoms were assessed using the Positive and Negative Syndrome Scale. Results: Across groups, gamma power modestly predicts a steeper aperiodic slope (greater inhibition), without group differences in either gamma power or aperiodic slope. In schizophrenia, gamma-BOLD coupling was reduced in bilateral auditory regions of the superior temporal gyri and inversely correlated with sensory gating deficits and symptom severity. Analysis of the spectral features of scanner sounds revealed distinct peaks in the gamma range, reflecting a rapidly repeating scanner pulse sound present throughout the resting state recording. Conclusion: Regional hemodynamic support for putative inhibitory and excitatory contributions to resting EEG are aberrant in SZ. Deficient gamma coupling to auditory BOLD may reflect impaired gating of fMRI-scanner sound.

Regional venous–arterial CO2 to arterial–venous O2 content difference ratio in experimental circulatory shock and hypoxia

Background Venous–arterial carbon dioxide (CO2) to arterial–venous oxygen (O2) content difference ratio (Cv-aCO2/Ca-vO2) > 1 is supposed to be both sensitive and specific for anaerobic metabolism. What regional hemodynamic and metabolic parameters determine the ratio has not been clarified. Objectives To address determinants of systemic and renal, spleen, gut and liver Cv-aCO2/Ca-vO2. Methods Post hoc analysis of original data from published experimental studies aimed to address effects of different fluid resuscitation strategies on oxygen transport, lactate metabolism and organ dysfunction in fecal peritonitis and endotoxin infusion, and from animals in cardiac tamponade or hypoxic hypoxia. Systemic and regional hemodynamics, blood flow, lactate uptake, carbon dioxide and oxygen-derived variables were determined. Generalized estimating equations (GEE) were fit to assess contributors to systemic and regional Cv-aCO2/Ca-vO2. Results Median (range) of pooled systemic Cv-aCO2/Ca-vO2 in 64 pigs was 1.02 (0.02 to 3.84). While parameters reflecting regional lactate exchange were variably associated with the respective regional Cv-aCO2/Ca-vO2 ratios, only regional ratios were independently correlated with systemic ratio: renal Cv-aCO2 /Ca-vO2 (β = 0.148, 95% CI 0.062 to 0.234; p = 0.001), spleen Cv-aCO2/Ca-vO2 (β = 0.065, 95% CI 0.002 to 0.127; p = 0.042), gut Cv-aCO2/Ca-vO2 (β = 0.117, 95% CI 0.025 to 0.209; p = 0.013), liver Cv-aCO2/Ca-vO2 (β = − 0.159, 95% CI − 0.297 to − 0.022; p = 0.023), hepatosplanchnic Cv-aCO2/Ca-vO2 (β = 0.495, 95% CI 0.205 to 0.786; p = 0.001). Conclusion In a mixed set of animals in different shock forms or during hypoxic injury, hepatosplanchnic Cv-aCO2/Ca-vO2 ratio had the strongest independent association with systemic Cv-aCO2/Ca-vO2, while no independent association was demonstrated for lactate or hemodynamic variables.

Comprehensive MRI assessment of the cardiovascular responses to food ingestion in Fontan physiology

Novel data on cardiovascular physiology in response to a meal in Fontan patients are presented. Using a previously validated dynamic MRI protocol, we demonstrated that the usual increase in cardiac output and the dilation of the superior mesenteric artery are preserved in clinically well Fontan patients. In contrast, vasoconstriction of the legs may have prevented redistribution of blood flow from this region in response to the meal. This may also affect responses to other types of stress. Celiac vasodilation was also absent in Fontan patients. This may be due to abnormal hepatic circulation. The proposed protocol may be used to study Fontan complications secondary to abnormal regional hemodynamics.

Combined application of kinesis and laser therapy for the correction of disorders in regional hemodynamics at the dilatation cardiomyopathy

Purpose: To study a combined application of kinesis and laser therapy for correcting regional hemodynamic disorders in patients having dilatation cardiomyopathy (DCMP) with simultaneous supportive pharmaceutical therapy. Material and methods. 100 patients with a verified diagnosis of DCMP were taken into the study. All patients had a differentiated supportive pharmtherapy. In three months after selection of the supportive differentiated drug therapy, patients were divided into two groups comparable by gender, age, disease course, severity of state and ways of medicine administration. Patients from Group 1, in addition to the supporting differentiated drug therapy, were given intravenous laser blood irradiation (ILBI) and unloading physical exercises. Patients from Group 2 continued their course of differentiated drug therapy.Research techniques included: clinical and functional observations; venous-occlusive plethysmography for assessing regional hemodynamics with a generally accepted method: measurement of blood flow (Qr) and regional vascular resistance (Rr) at rest; venous tone (Vt), reserve blood flow (QH) and regional vascular resistance (RH) under the functional loading test. Results. The data obtained during dynamic observations (in 1, 3, 6, 9 and 12 months) in Group 1 demonstrated a significant increase in volumetric blood flow velocity at rest (Qr) and reserve blood flow (QH); decrease of the regional vascular resistance at rest (Rr) and under functional loading (RH) as well as the decrease of venous tone (Vt), respectively. In Group 2 (controls), there were no significant positive dynamics; moreover, regional hemodynamics significantly worsened in 9 and 12 months. Conclusion. By the findings of venous-occlusive plethysmography, regional hemodynamics significantly improved in patients with DCMP under unloading therapeutic gymnastics in combination with ILBI and correctly selected differentiated drug therapy. The developed curative technique can be used in medical practice by GPs, therapists, cardiologists for optimizing treatment of patients with DCMP.

The effect of a combination of laser therapy and handling of medical gymnastics on the indices of hemodynamics with dilated cardiomyopathy

The aim of the study: Combined use of kineso- and laser therapy to correct regional hemodynamic disorders in patients with dilated cardiomyopathy (DCMP). Material and methods: The study included 100 patients diagnosed with DCMP. The diagnosis "DCMP" was established for patients with dilatation of the heart cavity of non-coronatural origin, increased heart size (final diastolic size of the left ventricle - LV CDR > 6.0 cm). The determination of the CHF FC was made according to the Russian National Recommendations of the RSCS (2018) and OSSN on the diagnosis and treatment of CHF. All patients took differentiated medication-assisted therapy according to indications during 3 months. Patients were divided into 2 comparable groups by sex, age, disease course, severity of the condition, and specifics of medication therapy. Patients of the 1st group were treated with intravenous laser irradiation of blood (ILIB) and selection of unloading therapeutic gymnastics against the background of supporting differentiated medication therapy. Patients of the 2nd group (control) received only differentiated medication therapy. The main method of investigation was venous occlusal plethysmography to evaluate regional hemodynamics with the determination of blood flow (Qr) and regional vascular resistance (Rr) at rest, venous tone (Vt), reserve blood flow (QH) and regional vascular resistance (RH) on the background of a functional load test. РResults: The data obtained during the dynamic observation (in 1, 3, 6 and 12 months) in the main group showed a reliable increase in the volume velocity of the blood flow at rest (Qr) and the reserve blood flow (QH), a decrease in the regional vascular resistance at rest (Rr) and under functional load (RH), venous tone (Vt), respectively. In the control group there was no reliable positive dynamics, after 12 months of observation indicators of regional hemodynamics significantly deteriorated. Conclusion: In patients with DCMP, according to venous occlusal plethysmography, the use of relieving therapeutic gymnastics in combination with ILIB on the background of medication therapy has significantly improved the indices of regional hemodynamics. The developed method of non-drug therapy can be used by cardiologists, general practitioners, therapists, doctors of physical and rehabilitation medicine to optimize treatment of patients with DCMP.

Local angiogenic effects of hormonal contraception: literature review

The processes of angiogenesis are one of the key in the functioning of the reproductive system in women. Studies on cyclic angiogenesis in the reproductive system have allowed us to single out a separate area of scientific research and to obtain results that have important scientific and practical value. The processes of cyclic angiogenesis in the organs of the reproductive system are studied in sufficient detail. At the same time, the issues of the influence of various methods of hormonal contraception on the relationship of angiogenic growth factors, hemostasis, regional hemodynamics remain unstudied. The assumption that such a relationship plays a significant role in the functioning of the endometrium, and modification of these factors can occur with various methods of exposure, including the appointment of hormonal contraception, can serve as a scientific research subject with a large practical component.

Features of Arthroplasty in Bilateral Knee Osteoarthritis

Introduction. Hip and knee arthroplasty are the two of the most frequently used methods of surgical treatment. The techniques of drug support in the perioperative period, as well as the rehabilitation component, are of primary importance. However, due to the increase in number of operations the number of complications is also growing. At the same time, surgical approaches to the treatment of bilateral knee OA are still not sufficiently studied. The literature describes intervals between arthroplasty operations on knee joints from 3 months to 5 years. The epidemiological and pathogenetic aspects of functional recovery in bilateral knee OA patients are also in need of further research.Materials and methods. Authors analysed outcomes in 124 patients with gonarthrosis treated with arthroplasty. 32 patients underwent arthroplasty of the contralateral joint. The outcomes were evaluated with the KSS score and X-ray imaging at 1, 3 and 6 months postop.Results and discussions. In the first month after the operation functional recovery was noted due to the relief of pain, recovery of the muscle tone and regional hemodynamics in the area of the knee joint. It was also noted that the recovery of function in the period from month 1 to month 3 in patients with bilateral gonarthrosis occurs less intensively due to decompensation of the contralateral joint.Conclusion. The study demonstrates the recovery of function in patients in the postoperative period. There is, however, the issue of functional decompensation in the opposite limb, which in turn reduces the effectiveness of motor rehabilitation and leads to the need for endoprosthetic replacement of the second joint.

CHANGES IN SYSTEMIC AND REGIONAL HEMODYNAMICS DURING INTENSIVE MUSCULAR ACTIVITY (EXPERIMENTAL STUDY)

Aim. The article deals with evaluating the changes in minute volume of blood circulation and the features of regional hemodynamics in somatic and visceral organs during intensive muscular activity. Materials and methods. Studies were conducted on outbred laboratory dogs (n = 16). At rest and at maximum physical exertion (running on a treadmill to failure), oxygen consumption (VO2), blood gas composition, the minute volume of respiration (VE) and blood circulation (Q) (according to Fick) were determined. The volumetric blood flow velocity in skeletal muscles and visceral organs (qt) was determined by introducing iodine-131-labeled microspheres into the heart cavity. Results. At maximum physical exertion, VO2 significantly increases by 11.7 times, Q – by 5.3 times. The volumetric blood flow velocity significantly (P ≤ 0.001) increases in locomotor (6.2–7.5 times) and respiratory (6.5–8.0 times) muscles. In postural muscles, blood flow does not change. In the myocardium, blood flow increases by 4.5 times and corresponds to changes in cardiac performance. In the adrenal gland, blood flow increases by 1.6 times (p ≤ 0.001), in the thyroid gland, it remains unchanged. In the kidney, blood flow decreases by 21.5%, in the liver by 23.0%, with an increase in the arterial fraction by 56.3% of organs. In organs of the splanchnic region (spleen, organs of the gastrointestinal tract), the volumetric blood flow velocity decreases by 44.9% (P ≤ 0.001). Conclusion. During extreme physical exertion, most of the cardiac output is distributed into the locomotor, respiratory muscles and organs involved in muscle activity, while reducing the volumetric blood flow in the visceral organs. It is postulated that against the background of high oxygen demand and arterial hypoxemia in the somatic and visceral organs, there are competitive relationships for blood flow and the prerequisites for the development of total tissue hypoxia.