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BACKGROUND: Heart failure (HF) is a major chronic illness and results in high morbidity and mortality. The most frequent cause of HF with reduced ejection fraction (HFREF) is coronary artery disease (CAD). Although revascularisation of ischemic myocardium lead to improvements in myocardial contractility and systolic function, it cannnot restore the viability of the already necrotic myocardium. METHODS/DESIGN: The aim of our prospective randomised study is to assess the efficacy of the retrograde application of non-selected bone marrow autologous cells concentrate (BMAC) in patients with HFREF of ischemic aetiology. The evaluated preparation is concentrated BMAC, obtained using Harvest SmartPReP2 (Harvest Technologies, Plymouth, MA, USA). The study population will be a total of 40 patients with established CAD, systolic dysfunction with LV EF of ≤40% and HF in the NYHA class 3. Patients have been on standard HF therapy for 3 months and in a stabilised state for at least 1 month, before enrolling in the clinical study. Patients will be randomised 1:1 to either retrograde BMAC administration via coronary sinus or standard HF therapy. The primary end-points (left ventricular end-systolic and end-diastolic diameters [LVESd/EDd] and volumes [LVESV/EDV] and left ventricular ejection fraction [LV EF]) will be assessed by magnetic resonance imaging. The follow-up period will be 12 month. DISCUSSION: The application of bone marrow stem cells into affected areas of the myocardium seems to be a promising treatment of ischemic cardiomyopathy. The Harvest BMAC contains the entire population of nuclear cells from bone marrow aspirates together with platelets. The presence of both platelets and additional granulocytes can have a positive effect on the neovascularisation potential of the resulting concentrate. Our assumption is that retrograde administration on non-selected BMAC via coronary sinus, due to the content of platelets and growth factors, might improve left ventricular function and parameters compared to standard HF therapy. Furthermore, it will be associated with improved exercise tolerance in the six-minute corridor walk test and an improvement in the life quality of patients without increasing the incidence of severe ventricular arrythmias. TRIAL REGISTRATION: (ClinicalTrials.gov; https://clinicaltrials.gov ; NCT03372954).

Článek

GENERAL HEALTH STATUS AMONG FIREFIGHTERS AND RESCUE OPERATIONS WORKERS

Georgian medical news. 2017 ; (270) : 130-135.

Georgian Med News
ISSN 1512-0112
Medvik
Zdroj

Research objective - to study the state of health of staff of service of fire extinguishing and accident rescue services department for definition of the priority directions of rendering the treatment-and-prophylactic help and rehabilitation of employees. By means of an information and analytical method the retrospective analysis of reports about the registered diseases, their result and the reasons of temporary disability of staff of service of fire extinguishing and accident rescue services department of Department on emergency situations of Almaty in 2011-2016 has been carried out. Statistical processing of the received results of research is carried out by means of Student's t-criterion. The conducted research showed that the high level of primary incidence is characteristic of the staff of service of fire extinguishing and accident rescue services department, at the same time the most significant are diseases of respiratory organs, traumas, poisoning and some other consequences of influence of the external reasons, diseases of bone and muscular system and connecting tissue, blood circulatory system illness. Studying of the state of health of staff of service of fire extinguishing and rescue services allowed to establish the priority directions of rendering the treatment-and-prophylactic help and rehabilitation. Their contents are defined by need of concentration of efforts on prevention, treatment and rehabilitation of the most widespread diseases causing the maximum damage to health.