Unsolved Issues of Atherosclerosis Prevention and of Adequate Lipid-lowering Therapy in Patients with Acute Ischemic Cerebrovascular Accident

The existing system of medical care for patients with acute cerebrovascular accident of atherothrombotic genesis, namely lipid metabolism disorders, the modern evidence base for lipid-lowering therapy in this category of patients and the feasibility of interdisciplinary interaction of cardiologists and neurologists were discussed at a meeting of the expert council of cardiologists and neurologists in Moscow on 2021 July 7.

Atrial Fibrillation in Cancer Patients: Who is at Risk?

Cancer is the second leading cause of mortality in the world, second only to cardiovascular diseases. Simultaneously cancer mortality has been steadily decreasing due to the development of new chemotherapy and targeted drugs and the improvement of existing treatment protocols. Improving the prognosis of treatment of cancer patients leads to an unexpected result - more patients are faced with side effects of cancer treatment. Cardiotoxicity, including arrhythmia, has become a significant factor to reduce the effectiveness of cancer patient’s treatment. Atrial fibrillation is frequent and persistent a rhythm disorder, affecting all categories of patients, especially the elderly. An association between these two conditions can be expected, considering the fact that in old age the prevalence of malignant neoplasms and comorbid pathology predisposing to the onset of AF is high. Therefore, AF may be an additional factor negatively influencing the prognosis and treatment tactics in patients with malignant neoplasms. A comprehensive search was conducted using the keywords “cancer”, “atrial fibrillation” and “cardiotoxicity” using the PubMed, Scopus and Cohrane databases. We reviewed publications having the relationship between AF and cancer. The literature review considered 61 publications on the prevalence of AF in cancer patients, classification, mechanisms of development, the effect of anticancer drugs and other treatment methods on this group of patients. Analyzed articles include clinical guidelines, consensus expert opinions, systematic reviews, meta-analyzes, and previously published reviews of the literature. The problem of cardiotoxic complications diagnostics is evaluated separately, incl. arrhythmias, and their monitoring in cancer patients. Therefore, the direction of medicine named "Cardio-oncology" comes to the fore. Interdisciplinary interaction will allow identify cardiotoxic manifestations at the subclinical stage and optimize anticancer treatment.

The Choice of a Set of Operations for Forest Landscape Restoration Technology

The study is intended for forest farmers who need to make a mathematically sound and objective decision on the choice of technological operations and technical means for forest restoration. Currently, in studies implementing the forest landscapes restoration approach from the point of view of technology and the use of technical devices (FLR technology), there is some discreteness and fragmentation of the issues. There is a need for a comprehensive study of FLR technology using frontier techniques and devices, and the construction of a single technological FLR algorithm. Preliminary analysis indicates a sharp increase in the number of operational sets from nine for the implementation of the classical technological FLR algorithm to 268 in the first approximation when implementing the proposed algorithm. The FLR algorithm construction is based on the algorithm’s theory, and the verification of the similarity degree of operational sets is based on the cluster analysis by Ward and intra-group connections methods. The algorithm decomposition into six conditionally similar clusters will help plan new forest experiments taking into account interdisciplinary interaction, in addition to the modernization of plant propagation protocols for sustainable reforestation quality management. However, some questions remain for the future: which criterion should be used as a universal basis for choosing operational sets? How can the effectiveness of the FLR technology procedure be evaluated and predicted before its practical implementation?

The formation of the original repertory for the Folk Instruments Orchestra of Kharkiv I. P. Kotlyarevsky National University of Arts as a historical mission of Kharkiv composers (1950–1960)

Statement of the problem. The Folk Instruments Orchestra of Kharkiv I. P. Kotlyarevsky National University of Arts has been performing for more than 90 years. However, the original works composed for this orchestra have never been the subject of serious scientific interest. The relevance of the problem is determined by the necessity to generalize the previous generations of composers’, performers’ and teachers’ experience in the field of folk instrumental art, in particular, the training in the orchestra of folk instruments as a concert unit. Analysis of recent publications shows, that the study on folk instruments orchestral performance has not been reflected in national scientific journals for a long while, but currently this is considered as an up-to-date issue. The articles by N. Bashmakova and V. Kikas and Yu. Fedotov (2018), Z. Stelmashchuk (2014), K. Maidenberg-Todorova (2019), I. Fedun (2020) are confirming this statement. The main purpose of the article is to find basic principles of the original repertoire formation for the Folk Instruments Orchestra of Kharkiv I. P. Kotlyarevsky National University of Arts related to the creative activities of Kharkiv composers in the 1950–1960s. For the first time, the historical mission played by Kharkiv composers in the original repertoire formation of the Folk Instruments Orchestra of Kharkiv I. P. Kotlyarevsky National University of Arts is determined. The concept of the article is based on the interdisciplinary interaction of historiographical, holistic, genre-stylistic and performing methods of researching, as well as a phenomenological approach to the analysis of the individual style of a composer based on the example of the particular works. Results and conclusions. The selected works by O. Steblyanko, D. Klebanov, V. Borisov, B. Alekseev, I. Kovach, P. Haydamaka and V. Podgorny included in the concert program of the creative project of 2021 have been analyzed due to their compositional, intonation and dramaturgical structure. The compositions that have been arranged for the folk instruments orchestra from the scores of symphony orchestra or ones instrumented from the compositions for accordion, domra ensemble, domra accompanied by piano were identified. According to the results of analysis, the creative approach of the composers of Slobozhanshchina in the 1950s–1960s was based on the thematic development of folklore material (song and dance prototypes) or the creation of the original themes, which are as close as possible to the folk samples. Having created large forms for domra and balalaika, Kharkiv composers fulfilled a historical mission in the formation of the original repertoire and, correspondingly, genre and stylistic priorities of the Folk Instruments Orchestra of KhNUA named after I. P. Kotlyarevsky. Due to the arrangements of these works for the folk instruments orchestra, a high academic status of playing folk instruments was demonstrated. It is necessary to emphasize the genre and stylistic orientation of these works on the Western European tradition. Along with the traditional forms of processing and arrangement, the folk instrumental art received the entire genre palette of European music, from miniatures to suites and concerts (in terms of timbre and texture capabilities of the folk instruments). On this way we see the keys to the academic status of the folk instruments orchestra. The prospects for further development of the theme. On the basis of the formed original repertoire at a certain historical moment it is possible to substantiate other leading principles of the orchestra as a concert and educational unit: the combination of an orchestra performer’s training, the formation of his professional skills with the ensemble’s concert activity; the introduction of academic approaches in the training of the folk instruments performers, conductors etc.

INFORMATION TECHNOLOGY TOOLS FOR CONTROLLED EVOLUTION

Information and technological tools for controlled evolution are considered as a basis for a transdisciplinary approach to building a scientific picture of the world from the standpoint of the noospheric theory of V.I. Vernadsky and assessment of complexity of the system, which evolves. The noospheric theory appeals to scientific thought able to direct the evolutionary process to create a harmonious unity of the system «Human — Nature». It became the basis of the concept of sustainable development of human society. The central issue of the controlled evolution is building a scientific picture of the world related to solving complex scientific and practical problems from the standpoint of a comprehensive account of the entire set of factors, which affects the process of evolution. The emerging transdisciplinary theory as a science can provide a solution of these problems by developing methods and tools for interdisciplinary interaction while forming the integrated knowledge. An example of such interaction is a purposeful convergence of disciplines and their related technologies and as a result — the development of promising convergence clusters. Best known today is NBIC cluster (nano–bio–information–cognitive technologies). One of the central principals of transdisciplinarity states: knowledge of the laws of nature is single and indivisible. The main aspects of cognitive evolution are considered, which combine the evolution of the mechanism of human thinking (with the dominance of the logical-verbal type) and improving the life cycle of constructive knowledge and its use. The possibilities of modern cognitive intelligent technologies in relation to the development of a consolidated intelligence, an ontologically controlled knowledge market and a national diversified developing control system by the type of National Automated System (NAS) of V.M. Glushkov are analyzed. In this regard, special emphasis is placed on the development of service-oriented systems for research design which can be adapted to a many classes of tasks, can be extended functionally and intellectually. In conclusion, it is emphasized that the projection of the work on the general theory of evolution on the practical needs of Ukraine in terms of the strategy of its sustainable development is appropriate and presents a state-alone very important direction of scientific research and practical developments with applied using of the results and provisions set forth in this paper.

Infective Endocarditis in Patients with Hypertrophic Cardiomyopathy

A literature review is presented, reflecting the incidence, etiology, hemodynamics, localization, clinical manifestations, outcomes and treatment of infective endocarditis (IE) in patients with hypertrophic cardiomyopathy (HCM). Despite the relative rarity of IE in patients with HCM, the combination of these pathologies is characterized by mutual aggravation and poor prognosis. The addition of IE increases the risk of death in patients with obstructive HCM, deteriorating circulatory disorders, increasing the likelihood of uncontrolled sepsis and embolism. Conservative treatment of IE in patients with HCM does not differ from that without HCM. Interdisciplinary interaction is needed in the management of patients with IE against the background of HCM in determining the indications for cardiac surgery and choosing the optimal method. Antibacterial prophylaxis of IE before invasive medical manipulations in patients with HCM is not recommended by the current consensus documents, however, the decision for each patient should be made individually, with a mandatory assessment of the risk of IE, the severity of hemodynamic disorders and prognosis.

From the Approach to the Concept: One Health in Latin America-Experiences and Perspectives in Brazil, Chile, and Colombia

Professionals throughout the world have been working to assess the interdisciplinary interaction and interdependence between health and wellbeing in a constantly changing environment. The One Health concept was developed to encourage sustainable collaborative partnerships and to promote optimal health for people, animals, plants, the environment, and the whole planet. The dissemination of scientific discoveries and policies, by working directly with diverse communities, has been one of the main goals for Global One Health. The One Health concept has also been referred or related to as “One Medicine, One Medicine-One Health, One World-One Health, EcoHealth,” and Planetary Health,” depending on each fundamental view and approach. In Latin America, despite the concept still being discussed among health professionals and educators, several One Health initiatives have been used daily for more than decades. One Health action has been applied especially in rural and underserved urban areas where low socioeconomic status, lack of health professionals, and scarcity of medical resources may require professionals to work together. Local communities from diverse social and economic statuses, including indigenous populations have been working with institutions and social organizations for many years, accomplishing results through grassroots movements. These “bottom-up” socio-community approaches have also been tools for the prevention and control of diseases, such practice has preceded the One Health concepts in Latin American countries. It is strongly believed that collaborative, multidisciplinary, political, and economic initiatives with prosocial focus may become investments toward obtaining significant results in the face of global, economic and health challenges; working for a healthier world with inclusivity, equity, and equality. In this study, it is briefly presented how the One Health approach has been initiated and developed in Latin America, highlighting the events and actions taken in Brazil, Chile, and Colombia.

Features of nervous system damage in antiphospholipid syndrome

Antiphospholipid syndrome (APS) is an autoimmune process that increases the risk of arterial and venous thrombosis. The mechanism of damage to the central nervous system (CNS) can be not only due to thrombosis, but also antiphospholipid antibodies (APA) circulating in the peripheral blood. The latter can damage the cerebral vascular endothelium, alter the resistance of the blood-brain barrier and penetrate into the central nervous system, exerting a damaging effect on astroglia and neurons, as evidenced by the release of neurospecific proteins into the peripheral bloodstream. The role of APS in developing cerebral ischemia, migraine, epilepsy, chorea, transverse myelitis, multiple sclerosis, cognitive impairment and mental disorders, as well as the peripheral nervous system is described. It should also be noted about a role of APS for emerging neurological disorders in COVID-19, enabled apart from thrombogenesis due to APA via 2 potential mechanisms - molecular mimicry and neoepitope formation. Further study of the APS pathogenesis and interdisciplinary interaction are necessary to develop effective methods for patient management.

Necrolytic migrating erythema as a diagnostic marker of pancreatic cancer

К паранеопластическим синдромам относят заболевания, возникающие вследствие развития злокачественного новообразования и проявляющиеся симптомами, отдаленными от локализации самой опухоли и ее метастазов. Паранеопластические дерматозы – это многочисленная группа различных кожных проявлений, указывающих на возможность наличия опухоли, в том числе на ранней бессимптомной стадии развития. Одним из таких дерматозов является некролитическая мигрирующая эритема – патология кожи, имеющая ассоциацию с глюкагономой – альфа-клеточной опухолью поджелудочной железы, продуцирующей глюкагон. Представленное в статье описание клинического случая поможет улучшить понимание общности патогенетических аспектов между новообразованием и дерматозом, повысить онкологическую настороженность смежных специалистов и организовать эффективное междисциплинарное взаимодействие, улучшив качество жизни больных с опухоль-ассоциированными дерматозами. Paraneoplastic syndromes include diseases that arise as a result of the development of a malignant neoplasm, manifested by symptoms that are remote from the localization of the tumor itself and its metastases. Paraneoplastic dermatoses are a large group of various skin manifestations that indicate the possibility of the presence of a tumor, including at an early asymptomatic stage of development. One of these dermatoses is necrolytic migrating erythema, a skin pathology associated with glucagonoma, an alpha – cell tumor of the pancreas that produces glucagon. The description of the clinical case presented in the article will help to improve the understanding of the common pathogenetic aspects between neoplasm and dermatosis, increase the oncological alertness of related specialists and organize effective interdisciplinary interaction, as a result, improving the quality of life of patients with tumor-associated dermatoses.

HIV-Associated Multiple Drug Resistant Tuberculosis in a Pregnant Woman: Clinical Course, Treatment Efficacy and Perinatal Outcomes

A clinical case of HIV-associated multiple drug resistant tuberculosis in a pregnant woman is presented. The clinical situation was complicated since during the main course of treatment this patient had two pregnancies and delivery with an interval of less than 2 years, and the onset of the disease occurred during the early period in the first pregnancy. This case demonstrates effective treatment of the specific disease and favorable perinatal outcomes. The article assesses medical tactics, analyzes the time of diagnosis, complex therapy, the choice of the way of delivery, considers the need for interdisciplinary interaction at all stages of observation to improve the quality of care.