Vol 3, No 2 (2012)
- Year: 2012
- Articles: 10
- URL: https://journals.rcsi.science/clinpractice/issue/view/4341
Full Issue
Reviews
Cardiopulmonary exercise testing in clinical practice
Abstract
The review is dedicated to the use of the cardiopulmonary exercise testing (CPET) in clinical practice. Main modes of CPET, most popular protocols and testing methods are discussed in details. Ample space is dedicated to main parameters measuring during CPET, their physiological values and changes in different pathological states. Main indications for CPET are presented and special attention is given to the use of CPET in chronic heart failure, apnea, lung diseases, skeletal muscle fiber and mitochondrial myopathy, rehabilitation. Emerging applications of CPET like congenital heart disease, pulmonary resection and several other are also discussed.
Non-alcoholic fatty liver disease as a medical and social problem
Abstract
The article considers the non-alcoholic fatty liver disease as an important medical and social problem. This problem include such questions as metabolic syndrome, essential lipoproteinemia, insulinoresistance. It is possible to consider non-alcoholic steatohepatitis as predictor of liver fibrosis and chirrosis. The questions of diagnosis and treatment are discussed.
Articles
Erythropoietin improves effects of mesenchymal stem cells in an experimental model of sepsis
Abstract
In the last years several studies have shown that mesenchymal stem cells (MSCs) are able to reduce the systemic inflammatory response and mortality in experimental models of sepsis. As recently found, the surface of MSCs have receptors for erythropoietin (EPO). So we hypothesized that the introduction of EPO together with MSCs may enhance their effect and improve the results of sepsis treatment.
Aim: То evaluate morphologic and immunologic effects of combined treatment with EPO and MSC in an experimental LPS sepsis model in rats.
Methods: 50 Wistar rats were randomized into 5 groups: Group 1 - the healthy controls, Groups 2-5 were intraperitoneally introduced bacterial LPS 20 mg/kg. Two hours after LPS injection animals received the following intravenous treatments: Group 3 - 4xl05 allogeneic MSCs, Group 4 - 8.5 pg of recombinant EPO-beta, Group 5 - MSCs and EPO in the same doses. Surviving animals were euthanased on the 4th day. The morphological study of the liver, spleen, thymus, lungs, kidney tissues was performed. We analyzed the tissue changes, white blood cells count and serum level of IL-lß, IL-2, IL-6, TNF-α.
Results: Mortality in LPS groups did not differ. The highest white blood cells count was found in the group of combined treatment EPO+MSCs (8.15x106 cells/ml) compared with controls (2,15x10s cells/ml) and LPS controls (6,52x10s cells/ml). There were no differences in levels of TNF-α, IL-2 and IL-6 between the groups, but serum IL-1ß level in groups 2 and 4 was significantly higher than in treated with MSCs and MSCc + EPO animals. Histologically in the group 5 we observed significantly less leukocyte lung interalveolar septal infiltration and kidney tubular dystrophy. The most significant differences in group LPS + EPO were found in the lymphoid tissue - considerable hyperplasia of spleen white pulp and thymus cortex, whereas in the other groups different degrees of atrophy of the corresponding zones were noted.
Conclusions: Combined treatment with EPO and MSCs can reduce acute lung injury and kidney damage, cause hyperplasia of lymphoid tissue and enhance the immune response more than separate treatment in an experimental model of sepsis in rats.
Algorithm for difficult tracheal intubation
Abstract
The description of intubation problem, its causes, possibilities and predictions is given. The estimation scale can be also seen in the article. As well as the actions of the doctor in case of the intubation and different technical processes for prevention of the fatal case.
Radiofrequency catheter ablation of atrlal tachycardia due to myocarditis six months after a viper bite
Abstract
The present report describes a 20-year old man who developed an incessant atrial tachycardia several days after snakebite. Antiarrhythmic treatment was ineffective and six months later radiofrequency ablation of atrial tachycardia was successfully performed. A chronic arrythmia was considered as manifestation of toxic-allergic myocarditis. The possible mechanisms leading to myocarditis are discussed.
The experience of use the bioactive coated intramedullary flexible nailiing in treatment of long bone fracture
Abstract
The study concerns a new method of treatment of bone fractures of upper and lower limbs based on osteogenesis stimulation by intramedullary implants with bioactive organic hydroxyapatite (HA). The method decreases consolidation period of diaphyseal fractures to 2-4 times. A technology of osteosynthesis and bone formation dynamics at the fracture zone and around the implant is described.
Modern technologies of diagnosis and treatment of patient with alveolar proteinosis
Abstract
The case of a rare lung disease - alveolar proteinosis diagnosed with advanced technologies, including confocal laser endomicroscopy of respiratory tract (alveoscopy) is presented. After confirming the diagnosis the patient undewent high volume bronchoalveolar lavage of both lungs with positive clinical and radiologic dynamics.
Rare case of gall bladder squamous cell carcinoma in pacient with cholelithic illness
Abstract
The clinical case of the patient with squamous cell carcinoma of gall bladder in a combination with cholelithic illness is described. Presurgical diagnostics of gall bladder cancer is difficult, demands a complex and careful assessment of disease anamnesis, a clinical sings, results of laboratory and tool analysis. At impossibility to exclude gall bladder cancer in the presence of a cholelithic illness in all cases operative treatment is needed.
Case report of differential diagnosis of dyspnea in patient with pulmonary embolism
Abstract
The analysis of the case report of the patient suffering from bronchial asthma is presented in the article. Pulmonary embolism developed in the patient lead to the changes in the character of dyspnea. The proper analysis of complaints and the dynamics of the clinical condition allowed to establish a correct diagnosis and to perform urgent pathogenic therapy.