New opportunities of renal denervation Agaeva, R A; Danilov, N M; Shelkova, G V ...
Terapevtic̆eskii arhiv,
2020-Jul-09, Volume:
92, Issue:
6
Journal Article
Peer reviewed
Open access
Radiofrequency renal artery denervation (RND) was introduced as a method of interventional treatment of resistant hypertension almost ten years ago. The first studies demonstrated the effectiveness ...of this procedure. This has led to growing interest in this area and the rapid development of the method. However, the results of the first randomized trial of SYMPLICITY HTN-3 questioned the role of RND in the treatment of resistant hypertension, this fact conducted to the decrease in the recommendation class and level of evidence in the Guidelines of the European Society of Cardiology and the European Society of Hypertension in 2018. To date, the medical community is actively discussing the results of recently published trials such as SPYRAL HTN-OFF MED, SPYRAL HTN-ON MED, RADIANCE-HTN SOLO and RADIOSOUND-HTN.
To present the results of work of National Medical Research Center of Treatment and Rehabilitation, reassigned for COVID-19 patients treatment during pandemic. Run-up methodology, procedures and ...working process organization are detailed.
354 COVID-19 patients were treated from 13.04.2020 to 10.06.2020 age 59 (470) years, 56% women, body mass index 28.5 (24.932.2) kg/m2. Patients were admitted at 8 (611) day of sickness. In-hospital stay was 16 (1420) days.
NEWS scale at the day of admittance was 2 (14); 2 (13) in patients discharged alive and 6 (47) in died patients, p=0.0001. So prognostic accuracy of NEWS scale was confirmed as very well (area under ROC-curve = 0.819). 69 patients (19.5%) were treated at intensive care department for 7 (413) days. 13 patients died, 11 of them had COVID-19 as direct or indirect cause of death. Total in-hospital mortality was 3.67%, in-hospital mortality of COVID-19 patients 3.1%. 17 healthcare workers (HCW), contacted with COVID-19 patients were infected (2.67%). 4 HCW, who had no direct contact with patients were also infected and 7 HCW were infected before the first patient was admitted. No one of them died.
Complex tasks of healthcare organization during COVID-19 pandemic can be solved quickly with acceptable quality, characterized by low levels of patients; mortality and HCW infection.
Every year scientific interest in studying of interventional methods of treatment of resistant hypertension steadily increases. Row of high technology device are created for performance of such ...procedures as well as techniques of their management are also developed. Non-pharmacological ways of treatment are described in this article, which are widely used in clinical practice: baroreflex activation therapy, radiofrequency renal denervation, and central iliac arteriovenous anastomosis.
Objective. To study the efficacy and safety of radiofrequency renal denervation with mono-electrode and multi-electrode devices in patients with uncontrolled arterial hypertension during follow-up ...period. Materials and methods. The study included 42 patients with uncontrolled arterial hypertension (mean age 51±12 years), while receiving multicomponent antihypertensive therapy, including diuretic. All patients underwent radiofrequency denervation of the renal arteries with a mono-electrode (n=27; group A) and multi-electrode devices (n=15; group B). The safety of the procedure was assessed using creatinine and glomerular filtration rate (MDRD equation), as well as according to ultrasound of the kidneys and renal arteries. The effectiveness of the procedure was study according to office blood pressure (BP) and ambulatory BP monitoring (ABPM). Results. In the general group, according to office BP after 6 months, there decreased in systolic (SBP)/diastolic BP (DBP) by 28/13 mm Hg (p=0.000001). According to ABPM, there was a decrease in the average daily SBP by 9 mm Hg (p=0.007) and DBP by 6 mm Hg (p=0.03). No significant changes in creatinine and glomerular filtration rate were detected in the general group. According to ABPM, after 6 months in group B, there was a decrease in the average daily SBP/DBP by 13 and 6 mm Hg (p=0.1). In group A, according to the ABPM, after 6 months, there was a decrease in the average daily SBP and DBP by 7 mm Hg (p=0.001) and 4 mm Hg (p=0.03). After 1 year, according to the office BP, there was a decrease in SBP/DBP by 14/11 mm Hg (p=0.002), and after 3 years at 15/17 mm Hg (p=0.3). Conclusion. The results confirm the safety and efficacy of radiofrequency renal denervation. Renal denervation in combination with drug therapy leads to decreasing of BP after 6 months and in the long-term
A model of the pumping of a hot liquid into an oil-bearing stratum with a well has been constructed, and the boundary-value problem on the nonstationary heat transfer in the conjugate stratum–well ...system was solved. The heat losses in the bore of the well and the temperature field of the water pumped into the stratum were determined. It is shown that heat propagates within a small region in the stratum. Numerical calculations were performed using the analytical expressions obtained for practically important values of the parameters of the stratum–well system.
This article presents the specific experience of farm management by a peasant acting independently. It is common for a peasant managing a farm to exercise both control and execution. Since management ...of a farm is influenced by external factors - natural, geographical, social ones, a peasant is required to constantly implement adaptive changes in management. These changes are brought about by the level of personal (spiritual) development of a peasant. The changes should be moderate but, at the same time, sufficient for effective management. All this is associated with responsible management as a characteristic of an activity. Such management is described as a science and an art of adapting to the natural and social conditions of economic activity. The specifics of responsible management of a farm is determined through the analysis of a peasant's abilities to analyze, forecast, plan their activities. The experience of managing a peasant farm indicates that once found was fixed in the human mind, then it was only repeated, there was no increment of information, knowledge (information).
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