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Volume 14 (1); March 25, 2024

Review  

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Aghayan SK, Nokhostin S, Vahdatpour T.

J. Life Sci. Biomed., 13(2): 25-34, 2023; pii:S225199392300004-13

DOI: https://dx.doi.org/10.54203/jlsb.2023.4

Abstract

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Keywords:

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Research Paper

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J. Life Sci. Biomed., 13(2): 35-41, 2023; pii:S225199392300005-13

DOI: 

Abstract

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Volume 13 (3); September 25, 2023

Research Paper

Morphometric and microbiological features of ventilator associated tracheobronchitis

Ibadov RA, Azizova GM, Ibragimov SK.

J. Life Sci. Biomed., 13(3): 48-52, 2023; pii:S225199392300007-13

DOI: https://dx.doi.org/10.54203/jlsb.2023.7

Abstract

Changes in the composition of the microbiota of the tracheobronchial tree in patients on prolonged mechanical ventilation can contribute to various disorders of the immune defense of the respiratory tract, damaging mucociliary clearance, and cause a strong inflammatory response, including the formation of ventilator-associated tracheobronchitis (VAT). The aim was to study the specifics of changes in the microflora and histopathology of the tracheobronchial tree in VAT. Over a 10 year period 975 bacteriological analyzes were carried out in 355 patients who were on extended mechanical ventilation for more than 48 hours. VAT is accompanied by a pronounced lymphoid-neutrophilic infiltration of the mucosa of the trachea and bronchi, and in a complicated course with the presence of a purulent-inflammatory and erosive-hemorrhagic component leads to a violation of the integrity of tissues due to destruction and necrosis. The leading pathogens were representatives of gram-negative flora of 65.8% (47-76%), gram-positive flora was detected in 17.5% (10-30%) of cases, fungi of the genus Candida in 16.5 (4-42%) cases. Analysis of the antibiograms of isolated cultures in patients on prolonged mechanical ventilation shows high resistance to a wide range of antibiotics, namely: acinetobacter spp. - high resistance to all antibiotics, except for imipenem (0% resistant strains), polymyxin (0%) and tetracyclines (7-15.4%). Imipenem (10.5%), polymyxin (10.5%), amikacin (31.5%) and cefoperazone/sulbactam (31.5%) are active against Esherichia coli. Klebsiella pneumoniae was susceptible to imipenem, amikacin, ofloxacin and inhibitor-protected antibiotics-cefoperazone/sulbactam, piperacillin/tazobactam. Staphylococcus aureus was susceptible to III generation cephalosporins (cefotaxime, ceftriaxone, cefoperazone) and tetracyclines - 36.3% of resistant strains. Microbiological monitoring in patients with VAT over a 10-year period revealed a trend towards the prevalence of gram-negative microflora inoculation, and over the past two years, the range of isolated multi-resistant flora has been expanding.
Keywords: Prolonged mechanical ventilation, Nosocamial infection, Ventilator associated tracheobronchitis, Microbiology, Histopathology

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Research Paper COVID-19

COVID-19-induced cardiovascular complexities

Ibadov RR, Akilov KA, and Ibragimov SK.

J. Life Sci. Biomed., 13(3): 53-58, 2023; pii:S225199392300008-13

DOI: https://dx.doi.org/10.54203/jlsb.2023.8 

Abstract

This study aimed to investigate the features of the clinical course of COVID-19 in combination with the pathology of the cardiovascular system (CVS). A prospective study was carried out. The main group (n=150) consisted of patients with changes in the cardiovascular system associated with COVID-19, i.e. newly diagnosed CV pathology, and patients with exacerbation of cardiac pathology against the background of COVID-19. The comparison group (n=154) included patients with COVID-19, but without any significant concomitant cardiac pathology. The average age of patients in the main group was 67.7 years (from 47 to 86 years), in the comparison group of 66.1 years (from 48 to 88 years). The study groups were representative and did not differ statistically in the nature of COVID-19 symptoms and the degree of lung involvement. Among the cardiac pathology, progressing or first occurring against the background of infection with COVID-19, in most cases, arterial hypertension of II-III degree (60.0%), coronary heart disease (48.7%), arrhythmias (23.3%) were diagnosed. Echocardiographic abnormalities included right ventricular dysfunction (22.7%), left ventricular contractility disorders (18.7%), with decreased ejection fraction (17.3%), diastolic dysfunction (14.0%), and toxic myocarditis (7.3%). The most significant risk factors were the presence of a burdened medical history (RR=10.39), elevated body mass index over 30 (RR=2.63) and diabetes mellitus (RR=1.55). In patients with COVID-19 in combination with CVS pathology, a relatively high incidence of acute onset (64.0% vs. 44.2%; p<0.001), respiratory failure (83.7% vs. 62.0%; p<0.001), admission to the intensive care unit (25.3% vs. 11.7%; p=0.004), development of acute respiratory distress syndrome (20.0% vs. 9.1%; p=0.012), hospital mortality (10.7% vs. 2.7%; p=0.006). Cardiac manifestations of COVID-19 included focal or global myocardial inflammation, ventricular dysfunction, heart failure, and arrhythmias. A high frequency of acute onset of the disease, respiratory failure and hospital mortality is determined.
Keywords: COVID-19, SARS-CoV-2, cardiovascular system, clinical course, comparative analysis

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Volume 13 (4); December 25, 2023

Research Paper 

Analysis of risk factors and outcomes of acute kidney injury in young children after cardiac surgery

Ismailov SI, Khaydarov AE, Mamasiddikov SM, Narziev MZh, Khamraev GM, Nosirov RN, Sobirov DM, and Mardonov ZhN.

J. Life Sci. Biomed., 13(4): 59-65, 2023; pii:S225199392300009-13

DOI: https://dx.doi.org/10.54203/jlsb.2023.9 

Abstract

The aim of this study was to analysis of risk factors and outcomes of acute kidney injury (AKI) in young children with congenital heart disease (CHD) after cardiac surgery. The study included 137 young children with CHD after various types of cardiac surgery. The stages of AKI and indications for peritoneal dialysis (PD) were determined based of Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. The incidence of AKI in young children in the general group was 40.9% (n=56). Stage 1 AKI was diagnosed in 21.9% (n=29) of patients, stage 2 AKI in 12.4% (n=17), and stage 3 AKI in 7.3% (n=10) of patients. Peritoneal dialysis was performed in 11.7% (n=16) of children. The incidence of AKI development after radical correct transposition of the great vessels (TGV) was 55.5% (n=5), truncus arteriosus (TA) was 100%, pulmonary atresia (PA)=25%, tetralogy of Fallot (TF)=38.1%, total anomalous pulmonary vein drainage (TAPVD)=60%, partial anomalous pulmonary vein drainage (PAPVD)=37.5%, atrioventricular canal (AVC)=44.4%, double outlet of main vessels from the right ventricle (DOMV from the RV)=60% , interventricular septal defect with high pulmonary hypertension (VSD)=21.6%, and combined operations was 46.6%. The need for PD after TGV correction was 22.2% (n=2), after TA=100%, after TF=33.3%, after TAPVD=20%, after AVC=11.1%, after VSD=1.9%, and after combined operations was 13.3%. Risk factors for AKI in young children were: younger age, initial heart failure, type of operation, prolonged cardiopulmonary bypass (CPB) and aortic clamping (AC), low cardiac output syndrome, inotropic and vasopressor therapy, hyperlactatemia. The development of AKI led to increased length of stay in the intensive care unit, overall hospitalization and infant mortality.
Keywords: Acute kidney injury, Children, Risk factors, AKI outcomes, Peritoneal dialysis.

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Volume 13 (2); June 25, 2023

Research Paper

Prevention of alloimmunization in patients with sickle cell disease in Chad

Djimadoum M, Nadlaou B, Kaboro M, Christian D, Alio HM, Kimassoum R.

J. Life Sci. Biomed., 13(2): 35-41, 2023; pii:S225199392300005-13

DOI: https://dx.doi.org/10.54203/jlsb.2023.5 

Abstract

The objective of this study was to contribute to the prevention of anti-erythrocyte alloimmunization in patients with sickle cell disease (DS) in Chad. This was a descriptive and analytical cross-sectional study from December 2021 to June 2022 in sickle cell patients regularly followed in two University Hospital Centers (CHU) in N'Djamena. The search for irregular antibodies was carried out by a combination of three techniques: indirect anti-globulin test (Coombs), enzymatic test (Papain) and the test in a low ionic strength medium, in a partner laboratory of the National Blood Transfusion Center in France. The study included 57 sickle cell patients, 45 of whom (78.9%) were actually transfused. Sickle cell patients accounted for 84.2% of cases. The sex ratio Male/Female (M/F) was 1.03. The average age of the transfused was 9.3 ± 5.4 years. Four of the transfused patients (8.8%) had produced 7 antibodies including 85.7% anti-rhesus and 14.3% anti-Kell. Age, sex and number of blood units were associated with antibody production with probabilities of 0.046, 0.041 and 0.035, respectively. In view of the results obtained from this study, we recommend the application of the blood transfusion rules and procedures in force in Chad.

Keywords: Allo-immunization, sickle cell disease, prevention, Chad

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Case Report

A proposed new method of hemostasis for erosive-hemorrhagic complications of the trachea and bronchi

Azizova GM, Ibragimov SK, Arifjanov AS, Ibadov RA.

J. Life Sci. Biomed., 13(2): 42-47, 2023; pii:S225199392300006-13

DOI: https://dx.doi.org/10.54203/jlsb.2023.6  

Abstract

Ventilator-associated complications are the most frequent ones that prevent the recovery of intensive care patients. This study aimed to evaluate the effectiveness of the endoscopic treatment of acute hemorrhagic lesions of the tracheobronchial tree in patients with ventilator-associated tracheobronchitis. A total of 5 patients (22.4±3.3 mean age, 18 to 36 years) with prolonged mechanical ventilation (>48 hours) in the resuscitation and intensive care unit were monitored. The diagnosis of ventilator-associated tracheobronchitis was established on the basis of clinical signs, radiological and microbiological criteria. Fine-dispersed powder with hemostatic properties (HEMOBEN) was used as a hemostatic agent when applying the method. A morphometric study noted that ventilator-associated tracheobronchitis is accompanied by a pronounced lymphoid-neutrophilic infiltration of the tracheal and bronchial mucosa (signs of diffuse catarrhal inflammation of varying degrees and erosive deforming endobronchitis are verified), and in a complicated course with the presence of a purulent-inflammatory and erosive-hemorrhagic component with its vascularization and metaplastic changes and violations of the integrity of the epithelial lining also leads to a violation of the integrity of tissues due to destruction and necrosis. Hence, a method has been developed to stop bleeding in case of mucosal damage by local application of HEMOBEN, which allows us to quickly cover the bleeding surface with an adequate hemostatic effect.

Keywords: Ventilator-associated tracheobronchitis, prolonged mechanical ventilation, clinic, endoscopic treatment, pathomorphological changes

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