Experimental dependences of measurement data on the volume of inhaled air in multi-frequency electrical impedance tomography

This paper proposes an approach to modeling the process of artificial ventilation of human lungs by their controlled filling with a fixed volume of air, using an incentive spirometer Coach 2. This makes it possible to simulate the ventilation process for a healthy person and to link the assigned respiratory volume to measurement data. The results of experimental studies of the developed system of multifrequency electric impedance tomography are presented. The tests were performed for the frequency range from 50 kHz to 400 kHz (with a pitch of 50 kHz) at assigned respiratory volumes from 500 ml to 4,000 ml (with a pitch of 500 ml) for five inhalation/exhalation cycles. The scheme of research: active inhalation ‒ passive exhalation, the number of tested volunteers ‒ 3 people from the developers of the system. As a result, the dependences of the measured values of changes in potentials on the frequency of injected current for different respiratory volumes in three test participants without pathologies of the respiratory function and the external respiration function were obtained. The obtained results of the experimental studies show that there is a dependence of the value of the measurement data both on the volume of inhaled air and on the frequency of the injected current. This feature can be used to develop a number of medical devices for personalized monitoring of human lung function. It was also revealed that there are frequencies at which the maximum spread of measurement data according to the results of a series of repeated experiments is observed. At the same time, the nature of the change in the measurement data of the EIT at an increase in the volume of inhaled air is the same for all test participants. It is assumed that this feature can also be used to increase the EIT personalization degree

Clinical Characteristics of the Combined Course of Chronic Obstructive Pulmonary Disease and Gastroesophagal Reflux Disease

The comorbid diseases can occur at any stage of bronchial obstruction, and, regardless of the severity or phase of chronic obstructive pulmonary disease, significantly affect disability, increase the frequency of hospitalizations, and increase the cost of medical care. The presence of concomitant gastroesophageal reflux disease in patients with chronic obstructive pulmonary disease is an independent aggravating risk factor for exacerbations and is associated with health deterioration of this group of patients. The purpose of the study was to study the features of the clinical course of chronic obstructive pulmonary disease in combination with gastroesophageal reflux disease. Materials and methods. Retrospective analysis of 138 patients who were treated in the pulmonology department for exacerbation of the disease and outpatient treatment by a gastroenterologist was carried out. 3 groups of patients were formed: 1 group (n=60) – patients with chronic obstructive pulmonary disease in combination with gastroesophageal reflux disease, 2 group (n=42) – patients with chronic obstructive pulmonary disease without signs of gastroesophageal reflux disease, who were treated in the pulmonology department for exacerbation of the disease and 3 group (n=36) – patients with gastroesophageal reflux disease who were treated on an outpatient basis. The patients were similar in age, stage of disease and duration of illness. The average age of the patients was 55±1.64. It should be noted, regarding the gender characteristics of the groups, that among the examined patients by gender, men predominated – 78.4% (80 out of 102). Results and discussion. The main clinical and anamnestic features of the combined pathology were studied. The significance of the assessment of functional changes in spirometry indexes in this category of patients is described. A significant decrease in external respiration function was revealed in the indicators of the external respiration function in patients of all groups. In the patients with chronic obstructive pulmonary disease in combination with gastroesophageal reflux disease the frequency of exacerbations increases. These exacerbations were associated with the presence and severity of gastrointestinal symptoms, namely increased heartburn, acid regurgitation causes worsening of respiratory symptoms, until the exacerbation of the disease with subsequent hospitalization. Also the length of stay in the hospital of the patients in this group increased by 1.5±0.4 days, which is associated with a severe exacerbation of chronic obstructive pulmonary disease and the need to use a double dose of glucocorticoids to control the symptoms of respiratory failure. Among the complaints of patients with combined pathology, extraesophageal manifestations of gastroesophageal reflux disease prevailed. Conclusion. The presence of concomitant gastroesophageal reflux disease in patients with chronic obstructive pulmonary disease expands and aggravates the clinical manifestations of the underlying disease

Mental State of Inpatients with COVID-19: a Computational Psychiatry Approach

ABSTRACTThe overload of healthcare systems around the world and the danger of infection have limited the ability of researchers to obtain sufficient and reliable data on psychopathology in hospitalized patients with COVID-19. The relationship between severe SARS-CoV-2 infection and specific mental disturbances remains poorly understood.Aimto reveal the possibility of identifying the typology and frequency of psychiatric syndromes associated with acute COVID-19 using cluster analysis of discrete psychopathological phenomena.Materials and methodsDescriptive data on the mental state of 55 inpatients with COVID-19 were obtained by young-career physicians with psychiatric backgrounds. Classification of observed clinical phenomena was performed with k-means cluster analysis of variables codded from the main psychopathological symptoms. Dispersion analysis with p-level 0.05 was used to reveal the cluster’s differences in demography, parameters of inflammation and respiration function collected on the basis of the original medical records.ResultsThree resulting clusters of patients were identified: persons with anxiety, disorders of fluency and tempo of thinking, mood, attention, motor-volitional sphere, reduced insight, and pessimistic plans for the future (n=11); persons without psychopathology (n=37); persons with disorientation, disorders of memory, attention, fluency, and tempo of thinking, reduced insight (n=7). The development of a certain type of impaired mental state was specifically associated with: age, lung lesions according to computed tomography, saturation, respiratory rate, C-reactive protein level, platelet count.ConclusionThe prevalence and typology of psychiatric disorders in patients with acute COVID-19 were described using the computational psychiatry approach.

BNIP3L/NIX-mediated mitophagy protects against glucocorticoid-induced synapse defects

Stress-induced glucocorticoids disturb mitochondrial bioenergetics and dynamics; however, instead of being removed via mitophagy, the damaged mitochondria accumulate. Therefore, we investigate the role of glucocorticoids in mitophagy inhibition and subsequent synaptic defects in hippocampal neurons, SH-SY5Y cells, and ICR mice. First, we observe that glucocorticoids decrease both synaptic density and vesicle recycling due to suppressed mitophagy. Screening data reveal that glucocorticoids downregulate BNIP3-like (BNIP3L)/NIX, resulting in the reduced mitochondrial respiration function and synaptic density. Notably, we find that glucocorticoids direct the glucocorticoid receptor to bind directly to the PGC1α promoter, downregulating its expression and nuclear translocation. PGC1α downregulation selectively decreases NIX-dependent mitophagy. Consistent with these results, NIX enhancer pre-treatment of a corticosterone-exposed mouse elevates mitophagy and synaptic density in hippocampus, improving the outcome of a spatial memory task. In conclusion, glucocorticoids inhibit mitophagy via downregulating NIX and that NIX activation represents a potential target for restoring synapse function.

The role of diagnosis of respiratory dysfunction in patients with thoracic trauma with polytrauma

Annotation. Combined thoracic trauma is one of the most unfavorable in determining the prognosis in patients with polytrauma. The aim of the study was to evaluate the informativeness of the spirography method in patients with concomitant thoracic trauma as a prognostic criterion for the severity of the course of traumatic disease and the effect of the proposed modifications of the intensive care algorithm on treatment results. A study of the state of indicators of the function of external respiration was carried out using the method of spirography in 92 patients with concomitant thoracic trauma. The patients were divided into 3 groups depending on the foreseen leading pathogenetic mechanism of respiratory failure in all periods of traumatic illness. The effect of additional administration of ceruloplasmin solution, solution of D-fructose-1,6-diphosphate sodium salt hydrate solution was compared with the classical algorithm of intensive therapy. The effect of the proposed treatment was assessed 30 days after receiving polytrauma and the parameters of the external respiration function were compared with the data obtained in conditionally healthy volunteers. It was determined that the addition of a solution of ceruloplasmin to the algorithm of intensive therapy, the leading mechanism of action of which is the effect on oxidative stress, is the most pathogenetically determined in patients with concomitant thoracic trauma in polytrauma, which is confirmed by the most restored indicators of the function of external respiration in them, determined using spirography on the 30th day of observation. The data obtained are important in determining the prognosis of the course of traumatic illness and planning a rehabilitation program in patients with concomitant thoracic trauma.

Features of the treatment of secretory evacuation disorders in acute bronchitis in children with impaired respiratory function

Objective: to increase the efficiency and safety of the treatment of the bronchi secretory-evacuation disorders in acute bronchitis with impaired respiratory function in children by using a medication with minimal effect on the cardiovascular system. Materials and methods. Under observation were 60 children aged 6 to 11 years. 2 observation groups were formed (30 children in each group): 1st group — children receiving the Bronchipret® for 10 days with acute bronchitis with impaired respiratory function; 2nd group — children who do not receive the Bronchipret in acute bronchitis with impaired respiratory function. Results. In the group of patients taking Bronchipret®, in addition to faster clinical dynamics, according to spirography, there was an improvement in the parameters of the external respiration function, characterizing the obstructive component of the obstruction of the air flow. After therapy with Bronchipret®, normalization of the functioning of the autonomic nervous system and the predominance of eutonia were observed against the background of a decrease in the number of registration of parasympathicotonia. Conclusion. The good tolerance and safety of Bronchipret® during 7-day use in patients aged 6–11 years allows us to recommend this drug as a highly effective treatment for bronchi secretory-evacuation disorders in acute bronchitis in children. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: children, bronchitis, spirography, treatment, thyme, ivy.