Pub Date : 2022-11-09DOI: 10.14739/2310-1210.2022.5.259697
H. M. Dmytriakova, L. Boiarska, O. I. Podlianova, T. O. Levchuk-Vorontsova, L. Hrebeniuk
Currently, there is an increase in the incidence of inflammatory bowel disease in children, including Crohn’s disease. Detection of typical endoscopic signs is the gold endoscopic standard for this disease diagnosis. When such endoscopic picture is accompanied by chronic diarrhea, abdominal pain, weight loss, and laboratory changes in the form of increased levels of faecal calprotectin and C-reactive protein, the diagnosis of Crohn’s disease becomes apparent and the diagnostic search is stopped. But there are other diseases, including of infectious type, that may have similar clinical, laboratory and endoscopic symptoms, which should be included in the scope of diagnostic search. Aim. To acquaint physicians with the features of diagnosis and monitoring of a patient with Yersinia infection on the background of lactase deficiency, clinically reminiscent of Crohn’s disease. Clinical case. A boy, 14 years old, complained of abdominal pain, recurrent diarrhea, weakness, lack of weight gain. A mother considered the child sick for 9 months, when periodic abdominal pain, diarrhea up to 10–12 times a day, sometimes nausea and vomiting occurred. Over time, episodes of diarrhea became more frequent, mainly after drinking milk. Four months after the disease onset, the child lost appetite, developed weakness, abdominal pain, recurrent diarrhea, no weight gain with increasing body length. Eight months after presenting complaints, the child was admitted to a hospital with acute disease manifestations (fever, abdominal pain, vomiting, diarrhea for 10 days). The boy was examined by a surgeon and a pediatric gastroenterologist. During colonoscopy, terminal ileitis was detected. The boy received non-specific treatment (mesalazine 3 g/day, etc.), there was a rapid improvement: abdominal pain disappeared, asthenic syndrome regressed, diarrhea reduced. Although amnestic, clinical, laboratory and instrumental data were very characteristic of Crohn’s disease, the diagnosis was questionable due to the lack of inflammatory changes in the general blood test and the fact that spontaneous remission of such severe exacerbation, for which mesalazine was usually ineffective. It was necessary to exclude other causes of inflammation of the small intestine (intestinal infections, tuberculosis). RNGA with pseudotuberculosis diagnosticum gave a positive result (intestinal yersiniosis diagnosticum O3). Conclusions. In children with suspected inflammatory bowel disease, intestinal infections, namely yersinia infection, should be ruled out as the cause of symptoms. Even with clear manifestations of terminal ileitis, which is characteristic of Crohn’s disease, the results of intestinal endoscopy may be relatively nonspecific, so the disease history, a correspondence with laboratory results, serological markers of some infectious diseases should also be taken into account in the diagnostic process for the ileitis etiology.
{"title":"A case of terminal ileitis that was not Crohn’s disease","authors":"H. M. Dmytriakova, L. Boiarska, O. I. Podlianova, T. O. Levchuk-Vorontsova, L. Hrebeniuk","doi":"10.14739/2310-1210.2022.5.259697","DOIUrl":"https://doi.org/10.14739/2310-1210.2022.5.259697","url":null,"abstract":"Currently, there is an increase in the incidence of inflammatory bowel disease in children, including Crohn’s disease. Detection of typical endoscopic signs is the gold endoscopic standard for this disease diagnosis. When such endoscopic picture is accompanied by chronic diarrhea, abdominal pain, weight loss, and laboratory changes in the form of increased levels of faecal calprotectin and C-reactive protein, the diagnosis of Crohn’s disease becomes apparent and the diagnostic search is stopped. But there are other diseases, including of infectious type, that may have similar clinical, laboratory and endoscopic symptoms, which should be included in the scope of diagnostic search.\u0000Aim. To acquaint physicians with the features of diagnosis and monitoring of a patient with Yersinia infection on the background of lactase deficiency, clinically reminiscent of Crohn’s disease.\u0000Clinical case. A boy, 14 years old, complained of abdominal pain, recurrent diarrhea, weakness, lack of weight gain. A mother considered the child sick for 9 months, when periodic abdominal pain, diarrhea up to 10–12 times a day, sometimes nausea and vomiting occurred. Over time, episodes of diarrhea became more frequent, mainly after drinking milk. Four months after the disease onset, the child lost appetite, developed weakness, abdominal pain, recurrent diarrhea, no weight gain with increasing body length. Eight months after presenting complaints, the child was admitted to a hospital with acute disease manifestations (fever, abdominal pain, vomiting, diarrhea for 10 days). The boy was examined by a surgeon and a pediatric gastroenterologist. During colonoscopy, terminal ileitis was detected. The boy received non-specific treatment (mesalazine 3 g/day, etc.), there was a rapid improvement: abdominal pain disappeared, asthenic syndrome regressed, diarrhea reduced. Although amnestic, clinical, laboratory and instrumental data were very characteristic of Crohn’s disease, the diagnosis was questionable due to the lack of inflammatory changes in the general blood test and the fact that spontaneous remission of such severe exacerbation, for which mesalazine was usually ineffective. It was necessary to exclude other causes of inflammation of the small intestine (intestinal infections, tuberculosis). RNGA with pseudotuberculosis diagnosticum gave a positive result (intestinal yersiniosis diagnosticum O3).\u0000Conclusions. In children with suspected inflammatory bowel disease, intestinal infections, namely yersinia infection, should be ruled out as the cause of symptoms. Even with clear manifestations of terminal ileitis, which is characteristic of Crohn’s disease, the results of intestinal endoscopy may be relatively nonspecific, so the disease history, a correspondence with laboratory results, serological markers of some infectious diseases should also be taken into account in the diagnostic process for the ileitis etiology.\u0000 ","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80187151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-09DOI: 10.14739/2310-1210.2022.5.261327
T. Shulyatnikova, V. Tumanskyi
The aim of the study – determining the immunohistochemical levels of the GFAP, GS and AQP4 in different regions of the human brain in the conditions of liver cirrhosis of different degree. Materials and methods. The study was performed on sectional material of 90 patients who suffered during lifetime from liver non-alcoholic cirrhosis of classes A (n = 30, group “A”), B (n = 30, group “B”) and C (n = 30, group “C”) according to Child–Pugh classification, including 59 (65.55 %) cases with clinical symptoms of I–IV grade hepatic encephalopathy. Cortex, white matter, hippocampus, thalamus, striopallidum, cerebellum, were examined using immunohistochemical method for evaluation of GFAP, GS and AQP4 levels. Results. GFAP expression gradually decreased from classes A to C of cirrhosis. The most expressed GFAP decline was found in class C in the cortex and thalamus (6.74- and 6.23-fold decrease). Contrary to GFAP, GS expression gradually increased along with aggravation of cirrhosis. The most prominent augmentation of GS was related in the cortex and thalamus in “C” group, respectively 4.34- and 4.26-fold increase. AQP4 levels also showed growing mode correlated with cirrhosis aggravation. The highest increase was found in the cortex and thalamus in “C” group (4.25- and 4.34-fold increase, respectively). Starting from class B, altered GFAP, GS, and AQP4 levels showed region-dependent relationships. GS and AQP4 were positively correlated in all 6 studied regions, while the inverse relationships were found between GFAP vs. GS and GFAP vs. AQP4 proteins. Conclusions. As early as in class A of cirrhosis, dynamic molecular alterations are occurred in the brain astrocytes, indicating the progressive development of astroglial remodeling with a violation of its cytoskeleton and redistribution of molecular domains within cells. This phenomenon is region- and time-specific; its signs get stronger with time from class to class, becoming most pronounced in class C. Among studied brain regions, cortex and thalamus are characterized by the most pronounced protein changes. Starting from class B, the remarkable relationship is seen between molecular changes of both direct and inverse type. Simultaneously emerging links might indicate synergistic involvement of these molecules in astroglial remodeling in chronic hepatic encephalopathy. Alterations in the mentioned astroglial molecular complex can serve both as a diagnostic marker of reactive astrogliosis during liver cirrhosis and represent a target for novel therapeutic approaches regarding encephalopathy in cirrhotic patients.
{"title":"Key astroglial markers in human liver cirrhosis of different degree: immunohistochemical study","authors":"T. Shulyatnikova, V. Tumanskyi","doi":"10.14739/2310-1210.2022.5.261327","DOIUrl":"https://doi.org/10.14739/2310-1210.2022.5.261327","url":null,"abstract":"The aim of the study – determining the immunohistochemical levels of the GFAP, GS and AQP4 in different regions of the human brain in the conditions of liver cirrhosis of different degree.\u0000Materials and methods. The study was performed on sectional material of 90 patients who suffered during lifetime from liver non-alcoholic cirrhosis of classes A (n = 30, group “A”), B (n = 30, group “B”) and C (n = 30, group “C”) according to Child–Pugh classification, including 59 (65.55 %) cases with clinical symptoms of I–IV grade hepatic encephalopathy. Cortex, white matter, hippocampus, thalamus, striopallidum, cerebellum, were examined using immunohistochemical method for evaluation of GFAP, GS and AQP4 levels.\u0000Results. GFAP expression gradually decreased from classes A to C of cirrhosis. The most expressed GFAP decline was found in class C in the cortex and thalamus (6.74- and 6.23-fold decrease). Contrary to GFAP, GS expression gradually increased along with aggravation of cirrhosis. The most prominent augmentation of GS was related in the cortex and thalamus in “C” group, respectively 4.34- and 4.26-fold increase. AQP4 levels also showed growing mode correlated with cirrhosis aggravation. The highest increase was found in the cortex and thalamus in “C” group (4.25- and 4.34-fold increase, respectively). Starting from class B, altered GFAP, GS, and AQP4 levels showed region-dependent relationships. GS and AQP4 were positively correlated in all 6 studied regions, while the inverse relationships were found between GFAP vs. GS and GFAP vs. AQP4 proteins.\u0000Conclusions. As early as in class A of cirrhosis, dynamic molecular alterations are occurred in the brain astrocytes, indicating the progressive development of astroglial remodeling with a violation of its cytoskeleton and redistribution of molecular domains within cells. This phenomenon is region- and time-specific; its signs get stronger with time from class to class, becoming most pronounced in class C. Among studied brain regions, cortex and thalamus are characterized by the most pronounced protein changes. Starting from class B, the remarkable relationship is seen between molecular changes of both direct and inverse type. Simultaneously emerging links might indicate synergistic involvement of these molecules in astroglial remodeling in chronic hepatic encephalopathy. Alterations in the mentioned astroglial molecular complex can serve both as a diagnostic marker of reactive astrogliosis during liver cirrhosis and represent a target for novel therapeutic approaches regarding encephalopathy in cirrhotic patients.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90922661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-09DOI: 10.14739/2310-1210.2022.5.260450
O. А. Kozolkin, A. Kuznietsov
The aim of the study was to develop criteria for predicting the outcome of the acute period of spontaneous supratentorial intracerebral hemorrhage (SSICH) on the background of conservative therapy, taking into consideration the lesion localization in conjunction with neuroimaging parameters of the quantitative severity assessment of the damage to cerebral structures. Materials and methods. Prospective cohort examination of 314 patients in acute period of SSICH on the ground of conservative treatment. Clinical and neurological examination consisted of using the Full Outline of Unresponsiveness coma scale and NIHHS, neuroimaging with the help of computed tomography with detection of SSICH localization, volume of intracranial hemorrhage, secondary intraventricular hemorrhage and midline shift. Disease acute period outcome was evaluated on the 21st day by the Rankin scale. Results. It was detected that integrated neuroimaging SSICH’s type considering its localization and quantitative severity estimation of cerebral structure injury was closely associated with the disease acute period outcome on the ground of conservative therapy (χ2 Pearson = 308.6, Р < 0.0001). Thus, mortality rate was the highest in patients with posteromedial type of thalamic hemorrhage (50.0 %), global type of thalamic hemorrhage (91.7 %) and massive type of striatocapsular hemorrhage (89.8 %). Unfavorable functional outcome as the modified Rankin scale score 4–5 on 21st disease day predominated among patients with posterolateral types of thalamic hemorrhage (76.5 %) and striacapsular hemorrhage (64.3 %). Whereas the frequency of favorable outcome was the highest among patients with anterior/dorsal type of thalamic hemorrhage (100.0 %), posteromedial (88.0 %), middle (95.0 %), lateral types of striatocapsular hemorrhage (61.9 %) and lobar (74.5 %) hemorrhage. Conclusions. Posteromedial type of thalamic hemorrhage, global type of thalamic hemorrhage and massive type of striatocapsular hemorrhage are the predictors of lethal outcome of the acute period of SSIСH on the background of conservative therapy. Criteria for unfavorable short-term functional outcome are posterolateral types of thalamic and striatocapsular hemorrhage, while anterior/dorsal type of thalamic hemorrhage, posteromedial/middle type of striatocapsular hemorrhage and lobar hemorrhage are associated with favorable outcome of the acute period of the disease.
本研究的目的是在保守治疗的背景下，考虑病灶定位，结合定量评估脑结构损伤严重程度的神经影像学参数，建立预测自发性幕上脑出血(sich)急性期预后的标准。材料和方法。基于保守治疗的314例sich急性期前瞻性队列研究。临床和神经学检查包括使用无反应性昏迷量表和NIHHS，利用计算机断层扫描检测SSICH定位的神经影像学，颅内出血容量，继发性脑室内出血和中线移位。第21天采用Rankin评分法评价疾病急性期结局。在保守治疗的基础上发现，综合神经影像学诊断的SSICH类型考虑其局限性和脑结构损伤的定量严重程度与疾病急性期结局密切相关(χ2 Pearson = 308.6， Р < 0.0001)。因此，死亡率最高的是后内侧型丘脑出血(50.0%)、整体型丘脑出血(91.7%)和块状纹状囊出血(89.8%)。后外侧型丘脑出血(76.5%)和纹状囊出血(64.3%)以改良Rankin评分4-5分的21天功能预后不良为主。而丘脑前/背侧型出血(100.0%)、后内侧型(88.0%)、中部型(95.0%)、外侧型纹状囊型出血(61.9%)和大叶型出血(74.5%)患者预后良好的频率最高。后内侧型丘脑出血、整体型丘脑出血和大量型纹状囊出血是SSIСH急性期致死性结局的预测因素。不良的短期功能预后的标准是后外侧型丘脑和纹状囊出血，而前/背侧型丘脑出血、后内侧/中间型纹状囊出血和大叶出血与疾病急性期的良好预后相关。
{"title":"Integral neuroimaging criteria for predicting the outcome of the acute period of spontaneous supratentorial intracerebral hemorrhage on the background of conservative therapy","authors":"O. А. Kozolkin, A. Kuznietsov","doi":"10.14739/2310-1210.2022.5.260450","DOIUrl":"https://doi.org/10.14739/2310-1210.2022.5.260450","url":null,"abstract":"The aim of the study was to develop criteria for predicting the outcome of the acute period of spontaneous supratentorial intracerebral hemorrhage (SSICH) on the background of conservative therapy, taking into consideration the lesion localization in conjunction with neuroimaging parameters of the quantitative severity assessment of the damage to cerebral structures.\u0000Materials and methods. Prospective cohort examination of 314 patients in acute period of SSICH on the ground of conservative treatment. Clinical and neurological examination consisted of using the Full Outline of Unresponsiveness coma scale and NIHHS, neuroimaging with the help of computed tomography with detection of SSICH localization, volume of intracranial hemorrhage, secondary intraventricular hemorrhage and midline shift. Disease acute period outcome was evaluated on the 21st day by the Rankin scale.\u0000Results. It was detected that integrated neuroimaging SSICH’s type considering its localization and quantitative severity estimation of cerebral structure injury was closely associated with the disease acute period outcome on the ground of conservative therapy (χ2 Pearson = 308.6, Р < 0.0001). Thus, mortality rate was the highest in patients with posteromedial type of thalamic hemorrhage (50.0 %), global type of thalamic hemorrhage (91.7 %) and massive type of striatocapsular hemorrhage (89.8 %). Unfavorable functional outcome as the modified Rankin scale score 4–5 on 21st disease day predominated among patients with posterolateral types of thalamic hemorrhage (76.5 %) and striacapsular hemorrhage (64.3 %). Whereas the frequency of favorable outcome was the highest among patients with anterior/dorsal type of thalamic hemorrhage (100.0 %), posteromedial (88.0 %), middle (95.0 %), lateral types of striatocapsular hemorrhage (61.9 %) and lobar (74.5 %) hemorrhage.\u0000Conclusions. Posteromedial type of thalamic hemorrhage, global type of thalamic hemorrhage and massive type of striatocapsular hemorrhage are the predictors of lethal outcome of the acute period of SSIСH on the background of conservative therapy. Criteria for unfavorable short-term functional outcome are posterolateral types of thalamic and striatocapsular hemorrhage, while anterior/dorsal type of thalamic hemorrhage, posteromedial/middle type of striatocapsular hemorrhage and lobar hemorrhage are associated with favorable outcome of the acute period of the disease.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85345476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-22DOI: 10.14739/2310-1210.2022.5.256779
V. Chuhunov, V. L. Pidlubnyi, S. Chabaniuk
Issues of treatment and rehabilitation of adolescents with mental retardation, improvement of old and new therapies using an integrated approach to rehabilitation, which allows increasing social activity of adolescents with mild mental retardation and improving their quality of life, are remaining relevant and needing further study. The aim of the work is a comprehensive study of clinical and phenomenological structure, comorbid pathology, socio-hygienic factors and criteria for assessing the limitations of life and its quality among adolescents with mild mental retardation, and to develop recommendations for rehabilitation measures in modern conditions. Materials and methods. At the Kryvyi Rih Psychoneurological Dispensary, 154 patients born in 2003–2008 who were under the dispensary observation of a teenage psychiatrist were examined. The study consisted of two stages: the first – at the initial visit for psychiatric care of patients with mild mental retardation, and the second – follow-up, at the age of 18–23 years. Clinical and epidemiological, clinical and psychopathological, psychodiagnostic and statistical methods were used in the study. The main tool of the study was the “Map for clinical and epidemiological studies”, which included socio-demographic and anamnestic information, the clinical part with a description of existing symptoms and syndromes. Results. As a result of rehabilitation measures, there was a decrease in cases and in the severity of comorbid pathology, improved cognitive functioning (attention, memory, language and writing skills, reading, arithmetic), motility, spatial orientation. Adaptive skills of statodynamic functions were improved in 36.4 % of cases, self-care ability – in 22.7 %. At the time of the study completion, 73.38 % of all respondents could be considered socially adapted. Among adolescents with mild mental retardation and comorbid mental and other pathologies, in addition to positive dynamics, there were negative dynamics (19.04 %) or no dynamics (14.29 %), emphasizing the need for longer time and larger number of rehabilitation measures among this category of patients. Conclusions. Biopsychosocial model of care for adolescents with mental retardation with the inclusion of medical-biological, psychological-pedagogical and social aspects helps to increase the effectiveness of rehabilitation measures aimed at reducing the severity of the underlying disease and improving social adaptation.
{"title":"Effectiveness assessment of the medical-social rehabilitation of adolescents with mild mental retardation","authors":"V. Chuhunov, V. L. Pidlubnyi, S. Chabaniuk","doi":"10.14739/2310-1210.2022.5.256779","DOIUrl":"https://doi.org/10.14739/2310-1210.2022.5.256779","url":null,"abstract":"Issues of treatment and rehabilitation of adolescents with mental retardation, improvement of old and new therapies using an integrated approach to rehabilitation, which allows increasing social activity of adolescents with mild mental retardation and improving their quality of life, are remaining relevant and needing further study.\u0000The aim of the work is a comprehensive study of clinical and phenomenological structure, comorbid pathology, socio-hygienic factors and criteria for assessing the limitations of life and its quality among adolescents with mild mental retardation, and to develop recommendations for rehabilitation measures in modern conditions.\u0000Materials and methods. At the Kryvyi Rih Psychoneurological Dispensary, 154 patients born in 2003–2008 who were under the dispensary observation of a teenage psychiatrist were examined. The study consisted of two stages: the first – at the initial visit for psychiatric care of patients with mild mental retardation, and the second – follow-up, at the age of 18–23 years. Clinical and epidemiological, clinical and psychopathological, psychodiagnostic and statistical methods were used in the study. The main tool of the study was the “Map for clinical and epidemiological studies”, which included socio-demographic and anamnestic information, the clinical part with a description of existing symptoms and syndromes.\u0000Results. As a result of rehabilitation measures, there was a decrease in cases and in the severity of comorbid pathology, improved cognitive functioning (attention, memory, language and writing skills, reading, arithmetic), motility, spatial orientation. Adaptive skills of statodynamic functions were improved in 36.4 % of cases, self-care ability – in 22.7 %. At the time of the study completion, 73.38 % of all respondents could be considered socially adapted. Among adolescents with mild mental retardation and comorbid mental and other pathologies, in addition to positive dynamics, there were negative dynamics (19.04 %) or no dynamics (14.29 %), emphasizing the need for longer time and larger number of rehabilitation measures among this category of patients.\u0000Conclusions. Biopsychosocial model of care for adolescents with mental retardation with the inclusion of medical-biological, psychological-pedagogical and social aspects helps to increase the effectiveness of rehabilitation measures aimed at reducing the severity of the underlying disease and improving social adaptation.\u0000 ","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81618702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-22DOI: 10.14739/2310-1210.2022.5.256942
M. Semen, O. Lychkovska, V. Şemen, O. P. Yelisieieva
Aim. The aim of current study was to evaluate parameters of heart rate variability and their correlation with the levels of anxiety in children with irritable bowel syndrome. Materials and methods. We enrolled 22 children aged 6–12 years with verified diagnosis of irritable bowel syndrome according to the Rome criteria IV. The control group included 10 children of the same age and sex. The CMAS (Children’s Manifest Anxiety Scale) test was used for evaluation of the trait anxiety level. A non-invasive method of heart rate variability is used as a transdiagnostic biomarker of neurohumoral regulation and, thus, of the stress resistance. Time and frequency domain parameters of heart rate variability were studied in 5 min ECG-recordings in supine position. Data were processed using Microsoft Excel 2016 and analyzed with GraphPad (Prism 5.0). Results. Children with irritable bowel syndrome had significantly 1.7-fold higher levels of trait anxiety and 2.2-fold lower values of heart rate variability parameters as compared to the control group. In addition, reduced sympathetic (LF) activity was accompanied by upregulation of neurohumoral component (VLF) and parasympathetic (HF) activity. A positive correlation between parameters of heart rate variability and trait anxiety was found in children with irritable bowel syndrome. Conclusions. Children with irritable bowel syndrome were shown with increased levels of trait anxiety. Reduction in heart rate variability and changes of its spectral structure were suggestive about the dysregulation in the gut-brain axis with reduction of the autonomic activity and predominance of neurohumoral regulation. In summary, our study has provided important information about the pathophysiology of irritable bowel syndrome in children.
{"title":"Heart rate variability and trait anxiety in children with irritable bowel syndrome: is there a link?","authors":"M. Semen, O. Lychkovska, V. Şemen, O. P. Yelisieieva","doi":"10.14739/2310-1210.2022.5.256942","DOIUrl":"https://doi.org/10.14739/2310-1210.2022.5.256942","url":null,"abstract":"Aim. The aim of current study was to evaluate parameters of heart rate variability and their correlation with the levels of anxiety in children with irritable bowel syndrome.\u0000Materials and methods. We enrolled 22 children aged 6–12 years with verified diagnosis of irritable bowel syndrome according to the Rome criteria IV. The control group included 10 children of the same age and sex. The CMAS (Children’s Manifest Anxiety Scale) test was used for evaluation of the trait anxiety level. A non-invasive method of heart rate variability is used as a transdiagnostic biomarker of neurohumoral regulation and, thus, of the stress resistance. Time and frequency domain parameters of heart rate variability were studied in 5 min ECG-recordings in supine position. Data were processed using Microsoft Excel 2016 and analyzed with GraphPad (Prism 5.0).\u0000Results. Children with irritable bowel syndrome had significantly 1.7-fold higher levels of trait anxiety and 2.2-fold lower values of heart rate variability parameters as compared to the control group. In addition, reduced sympathetic (LF) activity was accompanied by upregulation of neurohumoral component (VLF) and parasympathetic (HF) activity. A positive correlation between parameters of heart rate variability and trait anxiety was found in children with irritable bowel syndrome.\u0000Conclusions. Children with irritable bowel syndrome were shown with increased levels of trait anxiety. Reduction in heart rate variability and changes of its spectral structure were suggestive about the dysregulation in the gut-brain axis with reduction of the autonomic activity and predominance of neurohumoral regulation. In summary, our study has provided important information about the pathophysiology of irritable bowel syndrome in children.\u0000 ","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87856098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-22DOI: 10.14739/2310-1210.2022.5.258677
L. Stryzhak, I. Anikin
Detection of new markers of renal hypoperfusion in full-term infants during therapeutic cooling in moderate or severe hypoxic-ischemic encephalopathy to prevent the progression of acute kidney injury (AKI). Aim. To evaluate the significance of using continuous peripheral NIRS monitoring in full-term infants with hypoxic-ischemic encephalopathy for early detection of renal hypoperfusion against the background of prophylactic use of methylxanthines. Materials and methods. A prospective randomized controlled trial was conducted from 2019 to 2022 on the basis of the Neonatal Intensive Care Department of the Zaporizhzhia Regional Clinical Children’s Hospital. We included 50 full-term infants who underwent a program of total therapeutic hypothermia for moderate or severe hypoxic-ischemic encephalopathy. The infants were divided into 2 groups, each receiving methylxanthine to prevent the progression of AKI. Continuous NIRS monitoring of renal and brain tissues was performed throughout the cooling phase and until the end of the warming period. The relationship between NIRS and the development of AKI, which was determined according to the modified neonatal scale KDIGO (2012) by increasing serum creatinine and decreasing urine output during the first 5 days, was studied. Results. NIRS monitoring revealed that changes in cerebral CrSO2 were observed somewhat earlier than renal RrSO2, as the kidneys were less susceptible to autoregulation and perfusion changes than the brain. The level of CrSO2 was identical in 2 groups and did not change after the administration of caffeine citrate or theophylline. The average peripheral renal saturation rates were slightly higher than CrSO2 and tended to increase during the observation period due to the development of renal reperfusion after hypoxia. While the level of renal oxygen extraction decreased. The results obtained indicated that the warming period was characterized by normalization of perfusion, increase in regional renal saturation and decrease in renal oxygen excretion. In general, acute kidney injury in stage I developed in 4 (8.00 %) newborns, and stage II – in 1 (2.00 %), which was equivalent in both study groups (P = 0.8009; U = 299.00). Instead, the other children had stage 0 – 45 (90.00 %). None of the neonates had stage III according to KDIGO (2012) and required renal replacement therapy. Conclusions. The combined use of methylxanthines and the maintenance of optimal postnatal hemodynamics through NIRS diagnostics are vital for the prevention and treatment of acute kidney injury in neonates with moderate or severe hypoxic-ischemic encephalopathy.
{"title":"The use of near-infrared spectroscopy in the acute phase of hypoxic-ischemic encephalopathy in newborns","authors":"L. Stryzhak, I. Anikin","doi":"10.14739/2310-1210.2022.5.258677","DOIUrl":"https://doi.org/10.14739/2310-1210.2022.5.258677","url":null,"abstract":"Detection of new markers of renal hypoperfusion in full-term infants during therapeutic cooling in moderate or severe hypoxic-ischemic encephalopathy to prevent the progression of acute kidney injury (AKI).\u0000Aim. To evaluate the significance of using continuous peripheral NIRS monitoring in full-term infants with hypoxic-ischemic encephalopathy for early detection of renal hypoperfusion against the background of prophylactic use of methylxanthines.\u0000Materials and methods. A prospective randomized controlled trial was conducted from 2019 to 2022 on the basis of the Neonatal Intensive Care Department of the Zaporizhzhia Regional Clinical Children’s Hospital. We included 50 full-term infants who underwent a program of total therapeutic hypothermia for moderate or severe hypoxic-ischemic encephalopathy. The infants were divided into 2 groups, each receiving methylxanthine to prevent the progression of AKI. Continuous NIRS monitoring of renal and brain tissues was performed throughout the cooling phase and until the end of the warming period. The relationship between NIRS and the development of AKI, which was determined according to the modified neonatal scale KDIGO (2012) by increasing serum creatinine and decreasing urine output during the first 5 days, was studied.\u0000Results. NIRS monitoring revealed that changes in cerebral CrSO2 were observed somewhat earlier than renal RrSO2, as the kidneys were less susceptible to autoregulation and perfusion changes than the brain. The level of CrSO2 was identical in 2 groups and did not change after the administration of caffeine citrate or theophylline. The average peripheral renal saturation rates were slightly higher than CrSO2 and tended to increase during the observation period due to the development of renal reperfusion after hypoxia. While the level of renal oxygen extraction decreased. The results obtained indicated that the warming period was characterized by normalization of perfusion, increase in regional renal saturation and decrease in renal oxygen excretion. In general, acute kidney injury in stage I developed in 4 (8.00 %) newborns, and stage II – in 1 (2.00 %), which was equivalent in both study groups (P = 0.8009; U = 299.00). Instead, the other children had stage 0 – 45 (90.00 %). None of the neonates had stage III according to KDIGO (2012) and required renal replacement therapy.\u0000Conclusions. The combined use of methylxanthines and the maintenance of optimal postnatal hemodynamics through NIRS diagnostics are vital for the prevention and treatment of acute kidney injury in neonates with moderate or severe hypoxic-ischemic encephalopathy.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78901978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-22DOI: 10.14739/2310-1210.2022.5.252474
ВF Л. Л О. П. Шматенко А, F. Т. В. Давтян А, EF О. Ф Приходько C, B. Кучмістова A, Тарасенко, DF Н. О. Козіко C, Д. В. В. B, В. В. Осьодло, O. P. Shmatenko, L. Davtian, T. Prykhodko, O. F. Kuchmistova, V. Tarasenko, N. O. Коziko, D. Voronenko, V. V. Osodlo
The review provides information concerning the assortment of modern wound dressings (bandages) which are presented on the pharmaceutical market. The studied group of dressings varies widely in chemical composition and active pharmaceutical ingredients. It has been determined that the development of modern wound dressings provides for the realization of a complex effect on the wound process, which is achieved by the multi-layer structure of the dressing (bandages) with clearly defined functions of each component – the contact layer reduces adhesion to the wound surface; sorption layer provides irreversible sorption, retention and inactivation of wound exudate; pharmacologically active layer influences the main factors of wound process pathogenesis; outer isolating membrane generates wound occlusion. Conclusions. The events of recent years which related to the Anti-terrorist operation / the Joint Forces Operation in Ukraine indicate the unresolved problem of combat surgical trauma treatment. This is an important issue for the Medical services of the Armed Forces and the health care system of Ukraine. This necessitates expanding the range of wound dressing (bandages) with combined action for military medicine. It has been determined that the treatment in the purulent-necrotic phase of the wound process, it is advisable to use wound dressings with strong osmotic and antibacterial activity and low adhesion to the wound surface. In the second phase of the wound process, it is advisable to use wound dressings with moderate osmotic activity and a combination of antibacterial and reparative properties. In the final phase of the wound process, wound dressings should prevent drying of the wound surface as well as protect and stimulate the growth of granulations.
{"title":"Current aspects of the wound process treatment using dressings (bandages)","authors":"ВF Л. Л О. П. Шматенко А, F. Т. В. Давтян А, EF О. Ф Приходько C, B. Кучмістова A, Тарасенко, DF Н. О. Козіко C, Д. В. В. B, В. В. Осьодло, O. P. Shmatenko, L. Davtian, T. Prykhodko, O. F. Kuchmistova, V. Tarasenko, N. O. Коziko, D. Voronenko, V. V. Osodlo","doi":"10.14739/2310-1210.2022.5.252474","DOIUrl":"https://doi.org/10.14739/2310-1210.2022.5.252474","url":null,"abstract":"The review provides information concerning the assortment of modern wound dressings (bandages) which are presented on the pharmaceutical market. The studied group of dressings varies widely in chemical composition and active pharmaceutical ingredients. It has been determined that the development of modern wound dressings provides for the realization of a complex effect on the wound process, which is achieved by the multi-layer structure of the dressing (bandages) with clearly defined functions of each component – the contact layer reduces adhesion to the wound surface; sorption layer provides irreversible sorption, retention and inactivation of wound exudate; pharmacologically active layer influences the main factors of wound process pathogenesis; outer isolating membrane generates wound occlusion.\u0000Conclusions. The events of recent years which related to the Anti-terrorist operation / the Joint Forces Operation in Ukraine indicate the unresolved problem of combat surgical trauma treatment. This is an important issue for the Medical services of the Armed Forces and the health care system of Ukraine. This necessitates expanding the range of wound dressing (bandages) with combined action for military medicine. It has been determined that the treatment in the purulent-necrotic phase of the wound process, it is advisable to use wound dressings with strong osmotic and antibacterial activity and low adhesion to the wound surface. In the second phase of the wound process, it is advisable to use wound dressings with moderate osmotic activity and a combination of antibacterial and reparative properties. In the final phase of the wound process, wound dressings should prevent drying of the wound surface as well as protect and stimulate the growth of granulations.\u0000 ","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82910310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-22DOI: 10.14739/2310-1210.2022.5.259489
A. V. Yakushev, O. Paratsii
Catheter ablation occupies the first place in the treatment of atrial macro reentry arrhythmias. The main controllable parameters in ablations are energy, duration of exposure and use of catheter tip cooling. With traditional ablation techniques, there is a high risk of insufficient tissue damage due to electrode instability. Regarding the issue of stability, a new technique was proposed – reducing the application time with increasing the energy. The aim of this work was to compare the results of radiofrequency catheter ablation (RFA) using an 8 mm uncooled electrode to a 4 mm cooled electrode and a 4 mm cooled electrode with increased energy. Materials and methods. The work is based on a retrospective analysis of the results of catheter ablations in patients with atrial flutter. Patients were divided into 3 groups depending on the parameters of the used radio frequency energy and the type of ablation electrode. Results. It was found that in the group with increased energy, there were the shortest time from the start of RFA to the achievement of success criteria and the lowest radiation exposure. The obtained differences were statistically significant in comparison with two groups of patients who underwent traditional methods. Such differences were associated both with a reduction in the time of the application itself due to the use of high energy as well as the need to apply a smaller number of applications owing to a lower probability of the electrode displacement from the target area. Conclusions. The use of a high-energy protocol allows to success criteria for cavo-tricuspid isthmus ablation more quickly compared to traditional techniques (by 30 % and 22 %, respectively) with less radiation exposure (by 27 % and 24 %, respectively). The use of the high-energy protocol does not lead to an increase in the frequency of complications and can be considered safe for clinical use.
{"title":"Comparative characteristics of different methods of radiofrequency catheter ablation in atrial flutter","authors":"A. V. Yakushev, O. Paratsii","doi":"10.14739/2310-1210.2022.5.259489","DOIUrl":"https://doi.org/10.14739/2310-1210.2022.5.259489","url":null,"abstract":"Catheter ablation occupies the first place in the treatment of atrial macro reentry arrhythmias. The main controllable parameters in ablations are energy, duration of exposure and use of catheter tip cooling. With traditional ablation techniques, there is a high risk of insufficient tissue damage due to electrode instability. Regarding the issue of stability, a new technique was proposed – reducing the application time with increasing the energy.\u0000The aim of this work was to compare the results of radiofrequency catheter ablation (RFA) using an 8 mm uncooled electrode to a 4 mm cooled electrode and a 4 mm cooled electrode with increased energy.\u0000Materials and methods. The work is based on a retrospective analysis of the results of catheter ablations in patients with atrial flutter. Patients were divided into 3 groups depending on the parameters of the used radio frequency energy and the type of ablation electrode.\u0000Results. It was found that in the group with increased energy, there were the shortest time from the start of RFA to the achievement of success criteria and the lowest radiation exposure. The obtained differences were statistically significant in comparison with two groups of patients who underwent traditional methods. Such differences were associated both with a reduction in the time of the application itself due to the use of high energy as well as the need to apply a smaller number of applications owing to a lower probability of the electrode displacement from the target area.\u0000Conclusions. The use of a high-energy protocol allows to success criteria for cavo-tricuspid isthmus ablation more quickly compared to traditional techniques (by 30 % and 22 %, respectively) with less radiation exposure (by 27 % and 24 %, respectively). The use of the high-energy protocol does not lead to an increase in the frequency of complications and can be considered safe for clinical use.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79712327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-22DOI: 10.14739/2310-1210.2022.5.257288
Y. Stepanov, N. Zavhorodnia, O. Tatarchuk, I. Klenina, I. S. Konenko, O. Petishko
The hypothesis of primacy between insulin resistance (IR) and non-alcoholic fatty liver disease (NAFLD) remains debatable, which requires additional research. Aim. To examine the differences between cytokine profile and IR markers in children with NAFLD depending on liver damage degree compared to children with normal weight and obesity without NAFLD and to study their association with anthropometric and instrumental parameters. Materials and methods. 170 patients aged 6–17 years (mean 12.15 ± 2.51 years) were included. Hepatic steatosis was determined by transient elastography. Patients were divided into 4 groups according to the presence of hepatic steatosis, non-alcoholic steatohepatitis (NASH) and obesity: group 1 – 37 obese patients with NASH; group 2 – 53 obese patients with simple steatosis; group 3 – 65 obese patients without NAFLD; group 4 (control) – 15 patients with normal weight without NAFLD. Anthropometric parameters, carbohydrate metabolism with the HOMA-IR calculation, and cytokine profile were examined. Results. An increase in serum IL-6 and TNFα levels in NAFLD children compared to the control group (P ˂ 0.05), a decrease in IL-10 level in NAFLD children (P ˂ 0.05), and an increase in TNFα/IL-10 ratio (P ˂ 0.05) in NASH children compared to obese children without steatosis were demonstrated. In NAFLD children, a progressive increase in HOMA-IR was found compared to the control group and obese children without steatosis (P ˂ 0.05). The serum IL-6, TNFα levels, TNFα/IL-10 ratio, and HOMA-IR were positively correlated with obesity degree, adipose tissue distribution parameters, hepatic steatosis degree, CAP, while IL-10 level was negatively correlated with the hepatic steatosis degree. Conclusions. In obese NAFLD children, a significant increase in HOMA-IR, IL-6, TNFα is correlated with excessive fat accumulation, adipose tissue distribution parameters, hepatic steatosis degree, and CAP that may be useful for early diagnosis of NAFLD in children. A significant increase in the TNFα/IL-10 ratio in NASH children allows to consider this indicator as a probable marker for diagnosis of different NAFLD forms in pediatric clinical practice.
{"title":"Pathogenetic role of inflammation and insulin resistance in non-alcoholic fatty liver disease in obese children","authors":"Y. Stepanov, N. Zavhorodnia, O. Tatarchuk, I. Klenina, I. S. Konenko, O. Petishko","doi":"10.14739/2310-1210.2022.5.257288","DOIUrl":"https://doi.org/10.14739/2310-1210.2022.5.257288","url":null,"abstract":"The hypothesis of primacy between insulin resistance (IR) and non-alcoholic fatty liver disease (NAFLD) remains debatable, which requires additional research.\u0000Aim. To examine the differences between cytokine profile and IR markers in children with NAFLD depending on liver damage degree compared to children with normal weight and obesity without NAFLD and to study their association with anthropometric and instrumental parameters.\u0000Materials and methods. 170 patients aged 6–17 years (mean 12.15 ± 2.51 years) were included. Hepatic steatosis was determined by transient elastography. Patients were divided into 4 groups according to the presence of hepatic steatosis, non-alcoholic steatohepatitis (NASH) and obesity: group 1 – 37 obese patients with NASH; group 2 – 53 obese patients with simple steatosis; group 3 – 65 obese patients without NAFLD; group 4 (control) – 15 patients with normal weight without NAFLD. Anthropometric parameters, carbohydrate metabolism with the HOMA-IR calculation, and cytokine profile were examined.\u0000Results. An increase in serum IL-6 and TNFα levels in NAFLD children compared to the control group (P ˂ 0.05), a decrease in IL-10 level in NAFLD children (P ˂ 0.05), and an increase in TNFα/IL-10 ratio (P ˂ 0.05) in NASH children compared to obese children without steatosis were demonstrated. In NAFLD children, a progressive increase in HOMA-IR was found compared to the control group and obese children without steatosis (P ˂ 0.05). The serum IL-6, TNFα levels, TNFα/IL-10 ratio, and HOMA-IR were positively correlated with obesity degree, adipose tissue distribution parameters, hepatic steatosis degree, CAP, while IL-10 level was negatively correlated with the hepatic steatosis degree.\u0000Conclusions. In obese NAFLD children, a significant increase in HOMA-IR, IL-6, TNFα is correlated with excessive fat accumulation, adipose tissue distribution parameters, hepatic steatosis degree, and CAP that may be useful for early diagnosis of NAFLD in children. A significant increase in the TNFα/IL-10 ratio in NASH children allows to consider this indicator as a probable marker for diagnosis of different NAFLD forms in pediatric clinical practice.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79076078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-22DOI: 10.14739/2310-1210.2022.5.257413
S. Serik, N. Mavrycheva, T. Bondar
The aim of the study was to investigate circulating microRNA-126-3p levels and its relationships with glucometabolic indices in patients with ischemic heart disease (IHD) and type 2 diabetes mellitus (Т2DM). Materials and methods. The study included 68 patients with stable coronary artery disease (CAD) and T2DM, 25 CAD patients without diabetes and 18 healthy individuals as a control. MiRNA126-3p was determined in blood plasma by real time polymerase chain reaction. Small nuclear RNA U6 was used as an endogenous control. Results. Circulating miRNA-126-3p levels in CAD patients both with T2DM (50.32 [19.54; 93.82]) and without diabetes (109.46 [49.52; 211.11]) were higher than in the controls (17.95 [13.74; 35.01]) (P = 0.018 and P < 0.001). But in patients with T2DM, miRNA126-3p level was decreased in comparison with patients without diabetes (P < 0.001). In patients with T2DM, miRNA-126-3p displayed a significant negative correlation with blood glucose level (R = -0.259, P = 0.037) and was correlated negatively with glycosylated hemoglobin (R = -0.246, Р = 0.056) and insulin resistance index HOMA-IR (R = -0.229, P = 0.082) reaching boundary level of statistical significance. In diabetic patients, lower miRNA-126-3p level (the 1st tertile) was associated with a significant increase in blood glucose level and HOMA-IR in comparison with the 3rd tertile (P = 0.011 and P = 0.041). According to the ROC-analysis, the decrease in miRNA-126-3p levels was significantly associated with the presence of T2DM in patients with САD: AUC was 0.734 (95 % CI: 0.631–0.822, P < 0.001). Conclusions. Circulating miRNA-126-3p levels in CAD patients both with and without T2DM were increased compared to the controls, possibly due to compensatory mechanisms. However, in patients with T2DM, miRNA-126-3p expression was significantly lower than in patients without T2DM. The lowest miRNA-126-3p level in CAD patients with T2DM was associated with the significant elevation of blood glucose level and the increase in insulin resistance. MiRNA-126-3p may serve as potential biomarker for predicting and early diagnosis of T2DM in patients with CAD.
本研究旨在探讨缺血性心脏病(IHD)和2型糖尿病患者血液中microRNA-126-3p水平及其与糖代谢指标的关系(Т2DM)。材料和方法。该研究包括68例稳定型冠心病(CAD)和T2DM患者，25例无糖尿病的冠心病患者和18名健康个体作为对照。实时聚合酶链反应测定血浆中MiRNA126-3p。以核小RNA U6作为内源性对照。冠心病合并T2DM患者循环miRNA-126-3p水平(50.32 [19.54;93.82])，无糖尿病(109.46 [49.52;21.11])高于对照组(17.95 [13.74;35.01]) (P = 0.018, P < 0.001)。但在T2DM患者中，miRNA126-3p水平较非糖尿病患者降低(P < 0.001)。在T2DM患者中，miRNA-126-3p与血糖水平呈显著负相关(R = -0.259, P = 0.037)，与糖化血红蛋白呈显著负相关(R = -0.246， Р = 0.056)，与胰岛素抵抗指数HOMA-IR呈显著负相关(R = -0.229, P = 0.082)，达到有统计学意义的边界水平。在糖尿病患者中，较低的miRNA-126-3p水平(第1分位)与血糖水平和HOMA-IR较3分位显著升高相关(P = 0.011和P = 0.041)。roc分析显示，miRNA-126-3p水平的降低与САD患者的T2DM存在显著相关:AUC为0.734 (95% CI: 0.631-0.822, P < 0.001)。与对照组相比，伴有或不伴有2型糖尿病的冠心病患者循环miRNA-126-3p水平升高，可能是由于代偿机制。然而，在T2DM患者中，miRNA-126-3p的表达明显低于非T2DM患者。冠心病合并T2DM患者miRNA-126-3p水平最低与血糖水平显著升高和胰岛素抵抗增加相关。MiRNA-126-3p可能作为预测和早期诊断冠心病患者T2DM的潜在生物标志物。
{"title":"Circulating microRNA-126 in patients with ischemic heart disease with type 2 diabetes mellitus and its relationship with glucometabolic disorders","authors":"S. Serik, N. Mavrycheva, T. Bondar","doi":"10.14739/2310-1210.2022.5.257413","DOIUrl":"https://doi.org/10.14739/2310-1210.2022.5.257413","url":null,"abstract":"The aim of the study was to investigate circulating microRNA-126-3p levels and its relationships with glucometabolic indices in patients with ischemic heart disease (IHD) and type 2 diabetes mellitus (Т2DM).\u0000Materials and methods. The study included 68 patients with stable coronary artery disease (CAD) and T2DM, 25 CAD patients without diabetes and 18 healthy individuals as a control. MiRNA126-3p was determined in blood plasma by real time polymerase chain reaction. Small nuclear RNA U6 was used as an endogenous control.\u0000Results. Circulating miRNA-126-3p levels in CAD patients both with T2DM (50.32 [19.54; 93.82]) and without diabetes (109.46 [49.52; 211.11]) were higher than in the controls (17.95 [13.74; 35.01]) (P = 0.018 and P < 0.001). But in patients with T2DM, miRNA126-3p level was decreased in comparison with patients without diabetes (P < 0.001).\u0000In patients with T2DM, miRNA-126-3p displayed a significant negative correlation with blood glucose level (R = -0.259, P = 0.037) and was correlated negatively with glycosylated hemoglobin (R = -0.246, Р = 0.056) and insulin resistance index HOMA-IR (R = -0.229, P = 0.082) reaching boundary level of statistical significance. In diabetic patients, lower miRNA-126-3p level (the 1st tertile) was associated with a significant increase in blood glucose level and HOMA-IR in comparison with the 3rd tertile (P = 0.011 and P = 0.041).\u0000According to the ROC-analysis, the decrease in miRNA-126-3p levels was significantly associated with the presence of T2DM in patients with САD: AUC was 0.734 (95 % CI: 0.631–0.822, P < 0.001).\u0000Conclusions. Circulating miRNA-126-3p levels in CAD patients both with and without T2DM were increased compared to the controls, possibly due to compensatory mechanisms. However, in patients with T2DM, miRNA-126-3p expression was significantly lower than in patients without T2DM.\u0000The lowest miRNA-126-3p level in CAD patients with T2DM was associated with the significant elevation of blood glucose level and the increase in insulin resistance. MiRNA-126-3p may serve as potential biomarker for predicting and early diagnosis of T2DM in patients with CAD.\u0000 ","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75292248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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