The Role of Nonvitamin K Antagonist Oral Anticoagulants (NOACs) in Stroke Prevention in Patients with Atrial Fibrillation

Anticoagulation is important in stroke prevention in patients with atrial fibrillation. Until recently, heparins and vitamin K antagonists were the only available therapy for stroke reduction in atrial fibrillation (AF) patients. Non-vitamin K antagonist oral anticoagulants (NOACs) including direct thrombin inhibitor (dabigatran) and direct factor Xa inhibitors (rivaroxaban, apixaban and edoxaban) are now available and offer new options for stroke prevention. This article reviews the available data on the use of NOACs for primary and secondary stroke prevention in AF patients and describes specific patient populations to guide clinician in making the informed decision regarding appropriate use of those agents. It also addresses the use of NOACs early after acute stroke and use of thrombolysis while on NOAC.     

Effects of immunomodulator leukinferon on the course of experimental tuberculosis

An experiment was conducted on 60 CBA mice intravenously inoculated with cultured Mycobacteria tuberculosis (MBT), Erdmann strain, in a dose of 0.025 mg. The specific features of tissue, cellular, and biochemical reactions were studied in the lung, liver, and spleen when leukinferon (LF) was included into tuberculosis treatment regimen. LF was shown to have a positive impact on the development of reparative reactions during tuberculous inflammation by reducing the time of abacillation and recovering the structure of diseased organs. By month 3 of follow-up, MBT were not detected in mice receiving antibacterial agents (ABA) and LF, while typical and changed forms of LF were identified in the cytoplasm of alveolar macrophages in mice treated with ABA alone. A specific feature of an inflammatory reaction as a significant proliferation of lymphocytes and macrophages with their ample infiltration of target organs was noted in animals receiving LF. This was followed by the activated production of alpha- and gamma-interferons and by the mobilization of an enzymatic link of anti-oxidant defense under chronic oxidative stress, which led to a reduction of resolution of inflammatory areas and to an increase in survival of animals which had not been given ABA, but treated with LF alone.     

Treatment of complications of pylorus preserving stomach resection

Causes of unsatisfactory outcomes of pylorus preserving stomach resection are analyzed, method of prophylaxis and surgical correction is proposed. Pylorus preserving stomach resection was performed in 207 patients with chronic gastric ulcer. 2 groups of patients were compared: 166 patients who have undergone pylorus preserving stomach resection by Maky--Gorobashko (group 1); 41 patients operated according to an original method of suprapyloric stomach resection with preserving of distal Latarget nerves on serous-muscular flap formed from lesser curvature of the stomach (group 2). Of 122 examined patients of group 1 excellent and good long-term results according to Visick's criteria were achieved in 101 (82.79%), satisfactory--in 12 (9.84%), unsatisfactory--in 9 (7.37%). Bad stump evacuation due to a stable spasm of the denervated pylorus and hypokinesia of the stump were the main causes of unsatisfactory results. In group 2-39 of 41 patients were examined in long-term period. Excellent and good results were achieved in 38 patients, satisfactory--in 1. There were no unsatisfactory results.     

Scientific problems and tasks of medical monitoring

Medical monitoring is regarded as a task of detecting and classifying human abnormalities. A computer medical monitor (CMM) is a complex hierarchical system with artificial intellect elements at the top levels of hierarchy. Each level of hierarchy performs a definite task in collecting and processing current information. Based on this approach, the authors put forward tasks of medical diagnostic and prognostic studies by developing the hierarchical network architecture of CMM.     

Bioluminescence assays: effects of quinones and phenols

The influence of a series of quinones and phenols on bacteria bioluminescence systems was investigated. Three bioluminescence systems used in ecological monitoring were compared: (1) water-soluble; (2) immobilized in starch gel coupled enzyme systems: NADH:FMN-oxidoreductase-luciferase; (3) luminescent bacteria. Bioluminescence inhibition constants of quinones and phenols and bioluminescence induction periods were compared. These kinetic parameters are proportional to quinone concentrations and depend on the quinone redox potential. Different effects of the substances are related to structure and properties of the bioluminescence systems. The set of bioluminescence assays for quinones and phenols monitoring should include two bioluminescence systems: 1 (or 2) and 3.     

Iatrogenic secondary post‐partum haemorrhage: Apropos of two uncommon cases

In this article we would like to highlight uterine pseudoaneurysm as a cause of secondary post‐partum haemorrhage following Caesarean section. We would like to stress Doppler ultrasound scan as the initial screening modality for this condition. We also describe angioembolization as the prudent treatment option for this condition rather than resorting to surgery.