ACUTE AND CHRONIC HEART FAILURE AFTER MYOCARDIAL INFARCTION: CLINICAL AND FUNCTIONAL MARKERS

Вackground. The last decade has seen an increase in the number of people who have had myocardial infarction (MI). This phenomenon contributes to an increase in the long-term incidence of chronic cardiovascular diseases, including chronic heart failure. Purpose of the study. To identify the most significant clinical and functional indicators characterizing acute and chronic heart failure after myocardial infarction. Patient Characterization and Research Methods. This analysis included 186 patients who had myocardial infarction from January 2019 to January 2020: 86 people, the main subgroup, with signs of CHF above FC 2 (NYHA) (mean age 64.3 g) and 100 people, the comparison subgroup, without signs of CHF or had CHF 1 FC (NYHA) (mean age 62.6 l). After 1 year, clinical outcomes were assessed: cardiovascular death, repeated hospitalizations due to decompensation of CHF, death from other causes, stroke, repeated myocardial infarction, unplanned coronary revascularization. Results. In the acute period of myocardial infarction in the main subgroup (MI + CHF more than 2cl NYHA), all patients had symptoms of acute heart failure (AHF) in the form of Killip II and Killip III. Predictors of the development of chronic heart failure were the presence of a history of ischemic heart disease, confirmed in accordance with the recommendations, before myocardial infarction; decreased fraction of the left ventricle, detected before discharge and on the 30th day of myocardial infarction; the presence of atrial fibrillation (AF). One-year unfavorable outcomes in the main group were significantly more frequent. Subanalysis of long-term drug therapy showed that cardiovascular death was significantly less common in the subgroup of patients taking ARNI than in the subgroup of enalapril. Conclusion. In the present study, we studied postinfarction myocardial remodeling, which is realized in the form of the formation of a syndrome of acute and chronic heart failure. It has been shown that immediate reperfusion and restriction of the necrosis zone, as well as long-term use of drugs that inhibit SAS and RAAS, stimulating NPP, can inhibit the development of AHF and death. The CHF problem requires further fundamental research in order to develop new approaches that can affect more subtle mechanisms, such as the expression of specific genes involved in the disease, in order to reduce the persisting excess mortality for this pathology.

BINDING d-ELEMENT OF THE 4TH PERIOD OF V-GROUP OF THE PERIODIC SYSTEM OF D.I. MENDELEYEV AND ITS PARAMAGNETIC PROPERTIES

Vanadium is a connecting element between the main subgroup VA and the subgroup VB. In the opinion of B.V. Nekrasov, if we compare the VВ group of vanadium elements with the valence states of P and Аs VА main subgroup, then in the oxidation states of -3, 0, +3 arsenic is an analogue of phosphorus, and in the oxidation state +5, it will not be an analogue of phosphorus. In contrast, in the low oxidation degrees of vanadium, it differs from phosphorus, and in the oxidation state of +5 vanadium is not a complete analogue of phosphorus. The similarity of the electronic configuration of atoms for vanadium and phosphorus in the +5 oxidation state specifies the similarity of the properties of their chemical compounds. When comparing vanadium and its compounds with elements of the VA subgroup, we conclude that vanadium is a binding element between the VA subgroup and the VB subgroup and the compounds have similar properties. As a result of many years of work, it was found that vanadium in the penta- and tetravalent states has paramagnetic properties. In crude oil, it is in a tetravalent state. In order to improve the standard photocalorimetric method for determining vanadium in oil and petroleum ashes, a more rapid method was proposed for estimating the total concentration of vanadium based on the interaction of V2O5 with concentrated hydrochloric acid. Studies of the EPR spectra of porphyrin complexes with transition metals such as copper were of great importance in the identification of natural porphyrin complexes. In the course of comparison of experimental works of paramagnetic properties of vanadium and phosphorus with each other, it can be said that their application is of great practical importance in different fields of science. Summing up the results of studying the reduction of triphenylphosphine with an alkali metal, we proposed a scheme for the splitting of triphenylphosphine, including the formation of radical anions.

FEATURES OF REHABILITATION TREATMENT IN CHILDREN WITH CONGENITAL AND ACQUIRED DISORDERS OF THE FIRST RAY OF THE HAND

In this paper we evaluated the results of rehabilitation treatment in 55 children aged from 1 to 6 years after the following surgical treatment: pollicization of the second finger and microsurgical autografting of the second toe in the position of the thumb. A comparative analysis of standard techniques of rehabilitation treatment and the technique developed at the department was carried out. Application of individual-oriented approach depending on the functionality of the hand provided better results in rehabilitation. In the main subgroup of children after the operation of the second finger pollicization, excellent results were obtained in 11 patients (50 %), good - 9 patients (40.9 %), satisfactory - 2 patients (9.1 %). In the control subgroup, excellent results were obtained in 5 patients (20.83 %), good - in 9 (37.5 %), satisfactory - in 8 (33.33 %), poor - in 2 (8.33 %). In the group of children who underwent free autografting of toes, in the main subgroup the excellent results were obtained in 3 patients (60 %), good - in 2 patients (40 %). In the control subgroup good results were obtained in 3 patients (75 %), satisfactory - in 1(25 %). Also we revealed a correlation between the timing of the appearance of bilateral grip and functional ability of the hand in older age.