PURPOSE OF REVIEW:WHO defines SCD as sudden unexpected death either within 1 h of symptom onset (witnessed) or within 24 h of having been observed alive and symptom-free (unwitnessed). Sudden cardiac arrest is a major cause of mortality worldwide, with survival to hospital discharge for hospital cardiac arrest and in-hospital cardiac arrest being only 9.3 % and 21.2 %, respectively, despite treatment highlighting the importance of effectively predicting and preventing cardiac arrest. This literature review aims to explore the role and application of AI (Artificial Intelligence) in predicting and preventing sudden cardiac arrest. MATERIAL AND METHODS:Eligible studies were searched from PubMed and Web of Science. The inclusion criteria were fulfilled if sudden cardiac death prediction and prevention, artificial intelligence, machine learning, and deep learning were included. CONCLUSIONS:Artificial intelligence, machine learning, and deep learning have shown remarkable prospects in SCA risk stratification, which can improve the survival rate from SCA. Nonetheless, they have not been adequately trained and tested, necessitating further studies with explainable techniques, larger sample sizes, external validation, more diverse patient samples, multimodal tools, ethics, and bias mitigation to unlock their full potential.
The relevance of the problem is connected with the importance of studying the factors that influence people’s choice, in this case students, positions of interaction and behavioral strategies. The purpose of this study was to identify the role of value orientations and basic beliefs in student's choice of interaction positions: coercion, manipulation, nonviolence and noninterference. The study was conducted among students from a number of universities in Moscow, Ivanovo and Cherepovets of the Russian Federation. 425 students took part in the study, 129 of them were male (30.35%), 296 female (69.65%) ages 17 to 25, average age was 19 (SD=1.25). The following diagnostic tools were used: the author's questionnaire to identify the positions of student interaction; the PVQ questionnaire. Schwartz's adaptation by N.M. Lebedeva; questionnaire of basic beliefs of the personality by R. Yanoff-Bulman in the adaptation by M.A. Padun, A.V. Kotelnikova. Based on correlation and regression analysis, it was found that the predictors of students choosing positions of coercion are a high level of the value of power combined with a low level of the values of security, benevolence and universalism. If beliefs in the value of Self, in their luck, and the perception of the world as unfairly arranged are added to this, then students will give priority to the position of manipulation. In the event that students are convinced of the justice in the world and they are dominated by the values of benevolence and universalism, they will choose a position of nonviolence. The fear of change, combined with a high level of the value of conformity and ill-will towards people, regardless of the severity of basic beliefs, will contribute to the choice of a position of non-interference. The novelty of the study lies in the fact that it reveals the joint influence of student's value orientations and basic beliefs on the choice of interaction positions. Value orientations influence the choice of all four types of positions, and basic beliefs influence the choice of a position of manipulation and non–interference. As a result, the conclusion about the importance of formation of positive value orientations of students, especially values related to the manifestations of kindness to people and universalism, as well as the belief that the world should be built according to the laws of justice, which will act as a psychological condition for the development of student's ability to nonviolent interaction.
Gender differences in heart rate variability in different body positions are largely due to the peculiarities of the women's hormonal status during the menstrual cycle. Cyclical changes in the women's sex hormones concentration affect the state of the cardiac activity regulation mechanisms. The aim of the study was investigation the gender characteristics of heart rate variability when body position changes in young men and women. The work was carried out with the participation of 50 men and 50 women (students of Ivanovo State Medical University) aged 18-20 years. The women were examined in the follicular and luteal phases of the menstrual cycle. Heart rate variability was assessed using the Poly-Spectrum complex (Neurosoft, Ivanovo, Russia). The ECG was recorded in the supine position, with active orthostasis, with passive orthostasis and with passive antiorthostasis. To analyze the results of the study, the median (Me), the first and third quartiles (Q1; Q3), and the degree of change in the studied parameters compared with the control were calculated. The differences were considered statistically significant at p<0.05. It has been shown that both active and passive orthostasis initiates an increase in the activity of sympathetic cardiac centers and a shift in autonomic balance. The deviation of the HRV parameters studied in men is greater than in women, while the differences are more pronounced in the luteal phase of the menstrual cycle. Passive antiorthostasis leads to activation of parasympathetic centers in men and to a greater extent in women in the follicular phase, whereas in the luteal phase of the cycle there are no changes in heart rate variability.
Objective . To demonstrate the role of a primary care specialist, a district therapist, in the diagnosis and subsequent monitoring of a rare and difficult-to-recognize disease, eosinophilic granulomatosis with polyangiitis (EGPA), characterized by multiple organ damage, using a clinical case example. Materials and methods . This article presents a clinical case of a 72-year-old patient with EGPA. The stages of diagnostic search are described, including the patient's initial visit to a district therapist, analysis of the patient's medical history, physical examination, laboratory and instrumental tests, verification of the diagnosis by a rheumatologist, as well as the treatment and monitoring of the patient's condition. Results . A case of a patient with ECPA manifestation after a long remission of bronchial asthma, with a predominance of neurological symptoms (ischemic stroke, polyneuropathy), subclinical damage to the heart (complete blockade of the left bundle branch, hydropericard), and kidneys is described. Presented case demonstrates the role of a primary care specialist – a district therapist – in the diagnosis and subsequent monitoring of a rare and difficult-to-recognize disease, eosinophilic granulomatosis with polyangiitis (EGPA), characterized by multiple organ damage. Timely and adequate therapy led to clinical and laboratory remission. Conclusion . This clinical case demonstrates the importance of the district therapist's alertness regarding rare diseases such as EGPAs, especially in the presence of bronchial asthma and eosinophilia. The need for a comprehensive examination of patients with multiple organ pathology is emphasized. Timely diagnosis and adequate therapy contribute to achieving remission. In the future, it is important to monitor the patient to prevent relapses and treat associated diseases. Despite the fact that the diagnosis and treatment of EGPAs are the responsibility of a rheumatologist, the early diagnosis and referring the patients to a specialist depend largely on the district therapist.
AIM:Based on data from the Russian REGION-IM registry, to study the features of reperfusion therapy in patients with ST-segment elevation myocardial infarction (STEMI) in real-life clinical practice.MATERIAL AND METHODS:REGION-IM is a multicenter prospective observational study. The observational period is divided into 3 stages: during the stay in the hospital and at 6 and 12 months after inclusion in the registry. The patient's records contain demographic and history data; information about the present case of MI, including the time of the first symptom onset, first contact with medical personnel, and admission to the hospital; coronary angiography (CAG) data, percutaneous coronary intervention (PCI) data, and information about the thrombolytic therapy (TLT).RESULTS:Reperfusion therapy was performed in 88.9 % of patients with STEMI. Primary PCI (pPCI) was performed in 60.6 % of patients. The median time from the onset of symptoms to pPCI was 315 minutes [195; 720]. The median time from ECG to pPCI was 110 minutes [84;150]. Isolated TLT was performed in 7.4 %, pharmaco-invasive treatment tactics were used only in 20.9 % of cases. The median time from ECG to TLT (prehospital and in-hospital) was 30 minutes [10; 59], whereas the median time from ECG to prehospital TLT was 18 minutes [10; 39], and in 63 % of patients, TLT was performed more than 10 minutes after diagnosis. PCI followed TLT in 73 % of patients.CONCLUSION:The frequency of reperfusion therapy for STEMI in the Russian Federation has increased considerably in recent years. The high frequency of pPCI is noteworthy, but the timing of pPCI does not always comply with clinical guidelines. The results of this registry confirm the high demand for pharmaco-invasive strategies in real-life clinical practice. Taking into account geographical and logistical features, implementing timely myocardial reperfusion requires prehospital TLT. However, the TLT frequency in the Russian Federation is still insufficient despite its proven maximum effectiveness in the shortest possible time from the detection of acute MI.
