Yu. V. Rogovskaya

Neuralgic amyotrophy (NA, Parsonage-Turner syndrome) is an autoimmune multifocal painful neuropathy that has a classic pattern of brachial plexus involvement in most patients. Cases in which motor and sensory deficits occur below the elbow joint are classified as a separate form – distal NA. In contrast to the classic pattern of NA, patients with distal NA recover less well and require surgical treatment.Objective: to describe the clinical and instrumental characteristics of patients with focal hourglass-like nerve constriction (FHNC) of the radial nerve.Material and methods. The clinical, electrophysiological and neuroimaging data of 24 patients with painful radial nerve neuropathy (5 women and 19 men, mean age 41.9±15.5 years) were analyzed. The average time from onset of pain to diagnosis was 10.8 months (median 5 months; minimum 4 days, maximum 5 years and 8 months). Glucocorticoids (GC) were taken by 8 patients (33%). Nine patients underwent surgery. The control group consisted of 60 individuals matched for age and gender.Results. All patients complained of neuropathic pain in the affected upper extremity with an average intensity of 9.4 (median 9.5) on the visual analogue scale (VAS). The duration of the pain syndrome was on average 13.4 days (median 12.5 days). According to electromyographic data, all patients showed changes in the muscles of the affected side in the form of chronic denervation. MRI of the nerve trunks in 12 patients, revealed no changes on the affected side in 5 patients (41.6 %). Edema of the nerve trunks was found in 5 patients (41.6%). Muscle atrophy was found in one patient (8.3%) and one patient (8.3%) had FHNC. Comparison of the ultrasound data of the cross-sectional area (CSA) of the affected and unaffected sides showed a significant enlargement of the radial nerve on the affected side (p=0.027); no statistically significant differences were found when comparing the affected and unaffected sides with the control group. FHNC in the radial nerve was found in 19 patients, with both sides affected in two cases. Four patients recovered completely, 3 of them (75 %) received GC and 2 (50 %) underwent surgery. Incomplete recovery was observed in 12 patients (50%). Eight patients (33%) did not recover, of whom only one received GC, while 4 (50%) underwent surgery. Of the patients who underwent surgery, 5 patients (55.6%) recovered completely or partially, 44% did not recover. The mean follow-up time was 10.2±2.9 months.Conclusions. Radial nerve painful neuropathy is a variant of NA whose morphological manifestation is the phenomenon of FHNC detected by ultrasound in the peripheral nerves. The use of ultrasound facilitates the diagnosis of the disease, leading to an earlier diagnosis and consequently to a more favorable prognosis. Surgical treatment should be favored in cases of FHNC.

Atrial fibrillation (AF) is one of the most common cardiac arrhythmias. Numerous data indicate a significant contribution of myocardial inflammatory changes in the development and progression of AF. The search for new laboratory biomarkers to assess the activity of myocardial inflammatory processes, and the study of their diagnostic significance for noninvasive diagnosis in patients with AF is relevant. Therefore, the aim was to study the features of the serum level of the biomarker Gal-3 and to identify its relationship with inflammatory changes in the myocardium in patients with AF. Depending on the results of histological studies, the patients were divided into 2 groups: group 1 – with morphologically verified active lymphocytic myocarditis (ALM), group 2 – with lymphocytic infiltration (LI). Analysis of the frequency of detection and severity of the inflammatory process in the myocardium showed that activity of 4-5 scores was detected only in group 1. In 2^nd group, activity of the inflammatory process in most patients was 1 score. All patients with LI mild interstitial inflammation were showed. In the ALM group moderate and severe interstitial inflammation was detected. A high number of CD3⁺ and CD45⁺ cells were found in 1^st group compared to group 2 (p < 0.001).There were no significant intergroup differences in the serum level of Gal-3. At the same time, in 1^st group showed a significant decrease in Gal-3 in 6 months after treatment (p = 0.028). Positive correlations of Gal-3 with the severity of the inflammatory process and endocardial involvement were revealed in patients with ALM. The association of serum Gal-3 levels with CD68⁺ levels in 1^st group was detected (R = 0.48, p = 0.030). In 2^nd group, a correlation between the level of Gal-3 in 6 months after ablation with infiltration of CD45⁺ cells was found (R = 0.69, p = 0.003). Thus, in patients with AF and active lymphocytic myocarditis, significant associations were established between biomarkers of Gal-3 and inflammatory changes in the myocardium. This confirms the important role of Gal-3 as a participant in the inflammatory process.

Type of funding sources: None. Introduction. Myocardial infarction (MI) and following heart failure (HF) have various clinical scenarios. However, despite the clinical heterogeneity, the management of MI lacks effective personalized approaches. The response to ischemic injury in the infarct zone and remote myocardium has a definite spatio-temporal sequence and underlies the mechanism of adverse cardiac remodeling. Understanding its myocardial biology remains unclear due to insufficiency of heart tissue molecular and genetic analysis. Although animal models play an important role in data accumulation, they failure to reflect all the compounds of response to ischemic injury and following HF syndrome. Purpose. The purpose of the study was to investigate myocardial expression profile in the infarct zone in comparison to remote myocardium in patients with MI. Methods. The study included 4 patients with fatal MI type 1. All patients died within 48 hours of MI. The post-mortem examination was performed according to country policy. In each case, we obtained myocardial samples from the infarct zone and remote myocardium. Genome-wide gene-level expression was assessed by microarray analysis. We used transcriptome analysis software to analyze and visualize global expression patterns of genes. The analysis included normalization process. Differentially expressed genes (DEGs) were defined as gene-level fold change <-2 or >2 and adjusted P-value of <0.05. Abstract Figure. С1: infarct zone; C2: remote myocardium Abstract Figure. С1: infarct zone; C2: remote myocardium

Fulminant type 1 diabetes mellitus is a subtype of diabetes mellitus. It is characterized by the extremely rapid development of hyperglycemia and ketoacidosis because of the near-total destruction of pancreatic -cells. A clinical case of lethal, type 1, fulminant diabetes mellitus is presented. The patient management strategy and possible causes of the adverse course and outcome of the disease are analyzed.

Клиническая эффективность катетерного лечения фибрилляции предсердий в зависимости от гистологических изменений в миокарде

Клинический случай амилоидоза сердца, ассоциированного с миеломной болезнью

Funding Acknowledgements: This work was supported by the Russian Foundation for Basic Research (grant №16-04-01268)

Background: Inflammation plays a crucial role in the progression of chronic heart failure (CHF) and its decompensation. Experimental studies have shown repeatedly that activation of inflammation in the heart provokes remodeling and left ventricular dysfunction. However, anti-inflammatory therapy widely lacks positive outcomes. However, there are no studies of molecular and cellular phenotypes of myocardial inflammation (viral, viral and autoimmune inflammatory and autoimmune type) in patients with acute decompensated chronic heart failure (ADHF) and ischemic cardiomyopathy.

We studied the possibility of seeding bone marrow-derived stromal cells onto polylactic acid-based scaffolds fabricated by electrospinning and solution blow spinning technologies. The cells were applied to the scaffolds by dynamic seeding and scaffolds were then cultured in Petri dishes in culture medium for 3 days. Cell migration to the Petri dish surface was noted only for scaffolds fabricated by electrospinning technology, but DAPI staining confirmed the presence of cells in both scaffolds. The mean number of cells in scaffolds fabricated by electrospinning and solution blow spinning was 56±9 and 81±6, respectively. The scaffold fabricated by solution blow spinning was more effectively (p<0.05) colonized by cells due to its more optimal spatial structure.