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ST-segment elevation myocardial infarction and the clinical significance of differentiated electrocardiogram st段抬高型心肌梗死及鉴别心电图的临床意义
IF 0.1 Pub Date : 2023-05-31 DOI: 10.14739/2310-1210.2023.3.267269
V. Tashchuk, O. Malinevska-Biliichuk, P. Ivanchuk, O. S. Polianska
Aim. To evaluate the markers of changing dynamics recorded by digital processing of routine ECG using own diagnostic complex software “Smart-ECG” in patients with ST-segment elevation myocardial infarction (STEMI) based on the results of a 40-day follow-up.Materials and methods. The main group consisted of 20 patients with STEMI according to the ESC guidelines (2017) (mean age of males 56.11 ± 11.62, n = 10; mean age of females 58.22 ± 13.11, n = 10). ECG were analyzed using own developed diagnostic complex software “Smart-ECG” on the 1st, 10th, 40th day after STEMI. The first derivative of T wave – ratio of maximum velocity (MVR), inclination angle (β) and inclination height (H) of ST segment was calculated. The control group – 20 apparently healthy people.Results. MVR indicators decreased by 61.90 %, 68.20 % and 51.48 % on the 1st, 10th and 40th day, respectively, after STEMI as compared to those of the control group (p < 0.01). At the moment of the maximum ST segment elevation, the height (H) of ST inclination was 347.7 % increased (p < 0.01); on the 40th day, H was 25 % increased, close to control indicators, with ST segment shift to isoline (р > 0.05). During the acutest period, the angle β increased by 172.2 % (p < 0.01) and then decreased by 15.8 % at the recovery phase, but insignificantly.Conclusions. Self-developed medical software “Smart-ECG” for qualitative evaluation of ECG is an effective tool to diagnose pathological changes in the myocardium, makes it possible to improve the specificity, sensitivity and prognostic significance of ECG in STEMI. The significant decrease in MVR has been detected at all stages of STEMI, which was associated with a violation of electrogenesis in the repolarization phase; the critical increase in ST slope indicators (angle β and height H) on the 1st day has been found as a characteristic of ST elevation, as well as its decrease on the 40th day as a sign of reduced potential difference between healthy and damaged areas of the myocardium during the recovery stage.
的目标。目的:评价st段抬高型心肌梗死(STEMI)患者40 d随访结果,采用自行开发的复杂诊断软件“Smart-ECG”对常规心电图进行数字化处理所记录的动态变化指标。材料和方法。根据ESC指南(2017),主要组包括20例STEMI患者(男性平均年龄56.11±11.62,n = 10;女性平均年龄58.22±13.11,n = 10)。STEMI后第1天、第10天、第40天,采用自行开发的综合诊断软件Smart-ECG进行心电图分析。计算了T波的一阶导数- ST段最大速度(MVR)、倾角(β)和倾角高度(H)之比。对照组——20名表面健康的人。STEMI后第1天、第10天、第40天MVR指标较对照组分别下降61.90%、68.20%、51.48% (p < 0.01)。在ST段高程最大时刻,ST段倾斜高度(H)增加了347.7% (p < 0.01);第40天,H升高25%,接近对照指标,ST段向等值线移动(0.05)。急性期β角升高172.2% (p < 0.01),恢复期β角下降15.8%,但差异不显著。自主开发的心电图定性评价医学软件“Smart-ECG”是诊断心肌病理变化的有效工具,可提高STEMI患者心电图的特异性、敏感性和预后意义。在STEMI的所有阶段都检测到MVR的显著下降,这与复极化阶段的电生成破坏有关;ST斜率指标(角度β和高度H)在第1天的临界增加被发现是ST抬高的特征,而在第40天它的下降是恢复阶段心肌健康区和受损区电位差减小的标志。
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引用次数: 0
Personality profile characteristics of patients with somatoform and anxiety-phobic disorders with phenomena of reduced criticality 躯体型和焦虑型恐惧症患者的人格特征及临界性降低现象
IF 0.1 Pub Date : 2023-05-31 DOI: 10.14739/2310-1210.2023.3.265368
M. Khomitskyi, M. Kondratenko
The aim: to study the personality characteristics and their relationship with reduced criticality manifestations by examining the personality profile of patients with somatoform and anxiety-phobic disorders.Materials and methods. A prospective clinical study involved 102 patients: 54 patients with somatoform disorder and 48 patients with anxiety-phobic disorder. Research methods: clinical-psychopathological, clinical-anamnestic, clinical-catamnestic, clinical-psychophenomenological and medical statistical analysis.Results. As the study result, the peculiarities of the personal characteristics of patients with somatoform and anxiety-phobic disorders and their connection with reduced criticality manifestations have been established. The most common clinical types of accentuations in patients with somatoform disorder have been revealed (“sticking-demonstrative” (16.67 % of the group), “sticking-exalted” (11.11 %), “anxious-demonstrative” (9.26 %) and “demonstrative” (9.26 %) as well as a characteristic pronounced (p < 0.05) reduction in criticality (mainly due to the phenomenon of alexithymia). The prevailing types of accentuation among the contingent with anxiety-phobic disorder (“anxious” (14.58 %) and “anxious-pedantic” (12.50 %)) had a connection (p < 0.01) with a mild degree of reduced criticality.Conclusions. Based on the differences found in the personality characteristics of patients with somatoform and anxiety-phobic disorders, variations in the degree of severity and pathogenetic mechanisms of reduced criticality have been revealed. The obtained results offer the potential to develop a personalized system for correction of reduced criticality, the use of which would improve the treatment results in patients with somatoform and anxiety-phobic disorders. 
目的:通过对躯体型和焦虑型恐惧症患者的人格特征分析,探讨人格特征及其与降低临界症状的关系。材料和方法。一项前瞻性临床研究涉及102例患者:54例躯体形式障碍患者和48例焦虑恐惧症患者。研究方法:临床-精神病理学、临床-遗忘学、临床-灾变学、临床-精神现象学和医学统计分析。作为研究结果,躯体形式和焦虑恐惧症患者的个人特征的特殊性及其与降低临界性表现的联系已经建立。躯体形式障碍患者最常见的临床加重类型为“粘-示”型(16.67%)、“粘-兴奋”型(11.11%)、“焦虑-示”型(9.26%)和“示”型(9.26%),且危重程度显著降低(p < 0.05)(主要是由于述情障碍现象)。焦虑恐惧症患者中常见的加重类型(“焦虑型”(14.58%)和“焦虑型-学文型”(12.50%))与轻度危重程度降低有关联(p < 0.01)。基于躯体型和焦虑-恐惧障碍患者人格特征的差异,揭示了其严重程度的差异和临界性降低的发病机制。所获得的结果为开发一种个性化的系统来纠正降低的临界状态提供了潜力,这种系统的使用将改善患有躯体形式和焦虑恐惧症患者的治疗结果。
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引用次数: 0
The role of metabolic syndrome in the development of polycystic ovary syndrome in adolescence 代谢综合征在青春期多囊卵巢综合征发展中的作用
IF 0.1 Pub Date : 2023-05-31 DOI: 10.14739/2310-1210.2023.3.251479
N. Avramenko, O. Kabachenko, D. Y. Barkovskyi, К. Sierykh
The review article presents an analysis of the metabolic syndrome problem in children and adolescents, its role in the development of polycystic ovary syndrome (PCOS) in accordance with the latest International guidelines and modern literature. The urgency of the problem lies in the rapid spread of overweight among children in the world and, consequently, the growth of alimentary-dependent pathology. One of the major consequences of weight problems is metabolic syndrome (MS).There are still no clear MS criteria for children and adolescents. IDF suggests using IDF criteria for adults. Priority in the pathogenesis of MS is given to insulin resistance (IR), which is associated with puberty. The problem of IR assessment remains. HOMA-IR and QUICKI methods are not considered reliable tests to determine IR, so the assessment is based on clinical signs (hyperglycemia, dyslipidemia, abdominal obesity, hypertension).Obesity and IR can be predictors of PCOS, which can often be associated with puberty. Pathological signs of the syndrome typical for adults in adolescence may be a manifestation of the physiological course of puberty. Obligative criteria for the diagnosis of PCOS in adolescence are irregular menstruation/oligomenorrhea, proven biochemically and clinically hyperandrogenemia).First-line therapy for PCOS in adolescents with MS is weight loss and dosed exercise, which helps to normalize a hormonal balance. Drug treatment may include insulin-sensitizing drugs (metformin), antiandrogens (spironlactone, flutamide, cyproterone acetate), 5-alpha-reductase inhibitors (finasteride), combined oral contraceptives, inositol. Prevention of overweight, obesity in children can prevent the development of IR and, accordingly, associated MS and PCOS, reproductive health disorders. Prevention measures are aimed at avoiding maternal obesity, gestational diabetes, malnutrition and smoking during pregnancy, promoting breastfeeding and physical activity.
本文根据最新的国际指南和现代文献,综述了儿童和青少年代谢综合征问题及其在多囊卵巢综合征(PCOS)发展中的作用。问题的紧迫性在于超重在世界儿童中迅速蔓延,从而导致了食物依赖病理的增长。体重问题的主要后果之一是代谢综合征(MS)。目前还没有明确的儿童和青少年多发性硬化症标准。IDF建议对成人使用IDF标准。多发性硬化症的发病机制优先考虑胰岛素抵抗(IR),这与青春期有关。IR评估的问题仍然存在。HOMA-IR和QUICKI方法不被认为是确定IR的可靠方法,因此评估是基于临床症状(高血糖、血脂异常、腹部肥胖、高血压)。肥胖和IR可能是多囊卵巢综合征的预测因子,多囊卵巢综合征通常与青春期有关。青春期成人典型综合征的病理体征可能是青春期生理过程的一种表现。青春期PCOS的强制性诊断标准是月经不调/月经少,经生化证实和临床高雄激素血症)。多发性硬化症青少年多囊卵巢综合征的一线治疗方法是减肥和大剂量运动,这有助于使激素平衡正常化。药物治疗可能包括胰岛素增敏药物(二甲双胍)、抗雄激素(螺内酯、氟他胺、醋酸环丙孕酮)、5- α -还原酶抑制剂(非那雄胺)、联合口服避孕药、肌醇。预防儿童超重、肥胖可以预防IR的发展,从而预防相关的多发性硬化症和多囊卵巢综合征以及生殖健康障碍。预防措施的目的是避免产妇肥胖、妊娠期糖尿病、营养不良和怀孕期间吸烟,促进母乳喂养和体育活动。
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引用次数: 0
Stem cells in the context of colon carcinogenesis (a literature review) 干细胞在结肠癌发生中的作用(文献综述)
IF 0.1 Pub Date : 2023-03-28 DOI: 10.14739/2310-1210.2023.2.272160
M. Shyshkin
Aim. To analyze the latest literature data on stem cells in general, intestinal stem cells in particular, as well as cancer stem cells in the context of colon carcinogenesis.Over the past decade, a significant amount of data confirming the existence of cancer stem cells, their importance in cancer progression, resistance to current treatment regimens, and the occurrence of relapses has been accumulated. These cells are a small fraction of cancer cells that initiate tumor growth and provide tumor tissue heterogeneity. In addition, these cells are distinguished by a significant resistance to effects of various cytotoxic factors. Therefore, the possibility of isolating cancer stem cells and further targeted action are highly important for enabling a complete tumor eradication.A study on intestinal stem cells has always been in the focus of stem cell biology researchers’ attention because intestinal stem cells are an example of an active cell population that provides regular rapid renewal of the epithelium, which is constantly exposed to toxic, bacterial, and other aggressive factors. Accordingly, colon carcinogenesis is a convenient model for studying the role of stem cells in tumorigenesis.At the same time, there are two main current schemes of colon carcinogenesis, which are acknowledged – these are so-called “bottom-up” and “top-down” modes of transformed cell spreading. The “bottom-up” scheme was substantiated first, proving to be in good agreement with modern ideas about the structure of intestinal crypts. However, a little later, reports about the possibility of the “top-down” direction began to appear: differentiated cells located in the superficial parts of the intestinal crypts, undergoing mutations, could dedifferentiate and return to the basal parts; a pathological increase in the surface epithelial cells proliferation level was possible as well, leading to an increase in the luminal surface area, formation of grooves mimicking the intestinal crypts.This review provides the latest data on stem cells in general, in particular on intestinal stem cells, as well as on cancer stem cells in the context of colon carcinogenesis. We also analyze the latest literature data on the possibility of isolating cancer stem cells in colon carcinomas using molecular markers, difficulties associated with this process, and issues that are still unresolved.Conclusions. Today, there is no doubt about the existence and importance of cancer stem cells in carcinomas. Quite a lot of molecular markers of cancer stem cells have been identified and studied. It is worth noting that certain aspects of cancer stem cells can not be studied one-sidedly but require a multidimensional analysis.
的目标。分析干细胞的最新文献资料,特别是肠道干细胞,以及结肠癌发生背景下的癌症干细胞。在过去的十年中,已经积累了大量的数据,证实了癌症干细胞的存在,它们在癌症进展、对当前治疗方案的耐药性和复发发生中的重要性。这些细胞是癌细胞的一小部分,它们启动肿瘤生长并提供肿瘤组织异质性。此外,这些细胞的特点是对各种细胞毒性因子的作用具有显著的抵抗力。因此,分离癌症干细胞的可能性和进一步的靶向作用对于完全根除肿瘤是非常重要的。肠道干细胞的研究一直是干细胞生物学研究人员关注的焦点,因为肠道干细胞是一种活跃的细胞群体,它提供了定期快速更新的上皮,不断暴露于有毒、细菌和其他侵袭性因素。因此,结肠癌的发生是研究干细胞在肿瘤发生中的作用的一个方便的模型。与此同时,目前有两种公认的结肠癌发生机制,即所谓的转化细胞扩散的“自下而上”和“自上而下”模式。“自下而上”的方案首先得到证实,证明与现代关于肠隐窝结构的观点非常吻合。然而,不久之后,关于“自上而下”方向的可能性的报道开始出现:位于肠隐窝浅部的分化细胞在发生突变后可以去分化并返回到基底部;表面上皮细胞增殖水平的病理增加也是可能的,导致管腔表面积增加,形成模仿肠隐窝的沟槽。这篇综述提供了干细胞的最新数据,特别是肠道干细胞,以及结肠癌发生背景下的癌症干细胞。我们还分析了利用分子标记分离结肠癌干细胞的可能性的最新文献资料,这一过程中存在的困难,以及尚未解决的问题。今天,癌症干细胞在癌症中的存在和重要性是毋庸置疑的。许多肿瘤干细胞的分子标记已被发现和研究。值得注意的是,癌症干细胞的某些方面不能片面研究,而需要多维分析。
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引用次数: 0
Factors of lumbosacral radiculopathy chronicity 腰骶神经根病的慢性因素
IF 0.1 Pub Date : 2023-03-28 DOI: 10.14739/2310-1210.2023.2.273614
L. A. Dziak, O. Shulha, V. Suk
Assessment of chronic factors of acute lumbosacral radiculopathy is an urgent problem due to the disease impact on the quality of life of patients, possible loss of work capacity and disability.The aim of the work is to identify chronicity factors of acute compressive lumbosacral radiculopathy depending on the severity of degenerative-dystrophic changes in the spine and pathomorphological changes in the zone of disc-radicular conflict based on complex clinical-neurological, neuro-orthopedic, neuroimaging, neurophysiological and statistical methods of examination.Materials and methods. 100 patients with acute lumbosacral radiculopathy were examined. The patients were divided into two groups: 45 patients with radiculopathy and both discogenic pathology and stenotic process in the spinal canal and/or lateral openings, and 55 patients with radiculopathy developed secondary to a pathology between the vertebral disc at the level of one vertebromotor segment. All the patients underwent neurological, neuroorthopedic, neurophysiological examinations. The study was conducted in two stages – 3–7 days and one months after the disease onset.Results. On the basis of comprehensive clinical, neuroimaging, neurophysiological examinations and statistical processing of the obtained data, factors affecting the chronicity of acute compressive lumbosacral radiculopathy were identified: age (rs = 0.25, P = 0.012), sex (rs = 0.25, P = 0.012), pain syndrome severity according to the VAS (rs = 0.25, P = 0.011), the presence of a neuropathic component of pain according to the PainDETECT questionnaire (rs = 0.74, P < 0.001), biomechanical disorders of the spine during the Schober test (rs = -0.41, P < 0.001), lateroflexion (rs = -0.30, P = 0.003), extension (rs = 0.28, p = 0.004), damage to Aβ fibers (rs = -0.36, P = 0.009), Aδ-fibers (rs = -0.38, P = 0.006), C-fibers (rs = -0.37, P = 0.008), allodynia (rs = 0.38, P < 0.001), hyperalgesia (rs = -0.24, p = 0.014), muscular-tonic syndrome index (rs = 0.26, p = 0.008), the presence of lumbar canal stenosis (rs = 0.42, P < 0.001), spondyloarthrosis (rs = 0.22, P = 0.028), spondylolisthesis (rs = 0.20, P = 0.047).Conclusions. The conducted study has revealed the main factors contributing to the development of acute lumbosacral radiculopathy chronicity. The presence of a neuropathic component of pain in the mechanism of pain syndrome development in the acute period of the disease and the involvement of C-fibers in the pathological process in the late stages of the disease are among the important markers contributing to the disease prolongation. Assessment of the factors that determine the chronicity of the course in the acute period of the disease allows to prescribe complex differential therapy at the early stage of the disease.
急性腰骶神经根病的慢性因素评估是一个迫切的问题,因为疾病影响患者的生活质量,可能丧失工作能力和残疾。这项工作的目的是基于复杂的临床-神经学、神经矫形学、神经影像学、神经生理学和统计学检查方法,根据脊柱退行性营养不良变化的严重程度和椎间盘-神经根冲突区病理形态学变化,确定急性腰骶神经根病的慢性因素。材料和方法。对100例急性腰骶神经根病患者进行了检查。患者被分为两组:45例神经根病患者同时伴有椎间盘源性病理和椎管和/或外侧开口狭窄过程,55例神经根病患者继发于椎间盘间一个椎体运动节段的病理。所有患者均行神经学、神经矫形学、神经生理学检查。该研究分两个阶段进行——发病后3-7天和1个月。在综合临床、神经影像学、神经生理检查及对所得资料进行统计处理的基础上,确定了急性压缩性腰骶神经根病的慢性影响因素:年龄(r = 0.25, P = 0.012),性别(r = 0.25, P = 0.012),根据血管疼痛综合征严重程度(r = 0.25, P = 0.011),神经性疼痛的的存在根据PainDETECT问卷(r = 0.74, P < 0.001),脊柱的生物力学紊乱在Schober测试(r = -0.41, P < 0.001),侧屈(r = -0.30, P = 0.003),扩展(r = 0.28, P = 0.004),破坏β纤维(r = -0.36, P = 0.009),一个δ纤维(r = -0.38, P = 0.006), c fibers (r = -0.37,P = 0.008)、异常性疼痛(rs = 0.38, P < 0.001)、痛觉过敏(rs = -0.24, P = 0.014)、肌肉紧张性综合征指数(rs = 0.26, P = 0.008)、腰椎管狭窄(rs = 0.42, P < 0.001)、腰椎关节病(rs = 0.22, P = 0.028)、腰椎滑脱(rs = 0.20, P = 0.047)。本研究揭示了急性腰骶神经根病慢性发展的主要因素。疼痛的神经性成分在疾病急性期疼痛综合征发生机制中的存在,以及c -纤维在疾病晚期病理过程中的参与是导致疾病延长的重要标志之一。在疾病的急性期对决定病程慢性的因素进行评估,可以在疾病的早期阶段开出复杂的鉴别治疗处方。
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引用次数: 0
The debut of Schamberg disease (a clinical case) Schamberg病的首次登场(一例临床病例)
IF 0.1 Pub Date : 2023-03-28 DOI: 10.14739/2310-1210.2023.2.273497
S. Matviienko
A group of pigmented purpuric dermatoses includes a list of skin diseases characterized by multiple petechial hemorrhages, purpura, and increased skin pigmentation (yellow, brown, or red patchy).Schamberg disease is the most common representative of this group with a benign, chronic and recurrent course of idiopathic origin. The lesions are often asymptomatic or associated with mild pruritus, usually occurring on the lower extremities. The diagnosis is not a dilemma, as it is made based on clinical examinations and identification of the classical rash morphology, but is also emphasizing the role of a wide range of specialists in the evaluation and treatment of this pathological condition.The aim of the study. To analyze a clinical case of the debut of Schamberg disease.Results. Considering the sporadic nature and rarity of the disease, the clinical case of Schamberg disease diagnosed in a 53-year-old man who visited a pediatrician concerning his child’s illness is presented. The probable cause of the disease debut was a complex trigger effect (a long-term use of diclofenac sodium, drinking alcohol on the eve).Conclusions. The report is aimed at drawing attention to Schamberg disease (Schamberg purpura) as a diagnostic and therapeutic challenge not only for general practitioners, internal medicine specialists but also for dermatologists, phlebologists, hematologists in particular.
一组色素性紫癜性皮肤病包括一系列皮肤病,其特征是多发点状出血、紫癜和皮肤色素沉着增加(黄色、棕色或红色斑块)。Schamberg病是本组最常见的代表,具有良性、慢性和复发的特发性起源病程。病变通常无症状或伴有轻度瘙痒,通常发生在下肢。诊断不是一个困境,因为它是基于临床检查和经典皮疹形态的识别,但也强调了广泛的专家在评估和治疗这种病理状况中的作用。研究的目的。目的:分析1例尚伯格病的临床表现。考虑到该病的散发性和罕见性,我们在一名53岁的男性中诊断出Schamberg病,他因为孩子的疾病而去儿科医生那里就诊。发病的可能原因是复杂的触发效应(长期使用双氯芬酸钠,前夜饮酒)。该报告旨在引起人们对Schamberg病(Schamberg purpura)的关注,不仅对全科医生、内科专家,而且对皮肤科医生、血液学家、特别是血液学家来说,这是一种诊断和治疗上的挑战。
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引用次数: 0
Whether exercises and testosterone replacement therapy support a treatment for cardiovascular and atherosclerotic patients with iliac artery stenosis and low total testosterone and high-density lipoprotein cholesterol after endovascular procedure? 运动和睾酮替代疗法是否支持血管内手术后伴有髂动脉狭窄、总睾酮和高密度脂蛋白胆固醇低的心血管和动脉粥样硬化患者的治疗?
IF 0.1 Pub Date : 2023-03-28 DOI: 10.14739/2310-1210.2023.2.268513
S. Solaković, Nina Solaković, A. Jogunčić, H. Spahović, Fedja Hajrulahović, R. Pavlović, Mensur Vrcić, E. Solaković, Amina Godinjak, I. Skrypchenko, O. Dorofieieva, K. Yarymbash
Serum levels of testosterone (ST) and high-density lipoprotein (HDL) are generally associated with atherosclerosis in male patients over 50 years with critic iliac stenosis (TASC II A and B) and cardiovascular disease with significant changes in HDL and low-density lipoprotein (LDL). In addition to the standard therapy, combined medicamentous therapy and adequate model of exercise are also important factors as medicines can improve HDL levels and primary bypass and endovascular potency impacting positively on improvement of ST or it can be the following testosterone replacement therapy (TRT) comprising cardiovascular disease prevention and vascular treatment as adjunct therapy options after endovascular and vascular surgical procedures.The aim of the study is to identify the association between HDL and ST after surgical and endovascular intervention on the iliac segment (TASCII A and B), as well as cardiovascular risk factors with modified medium activity (MET) <6 with short interval increase over >6 (MET), with total duration of 30–60 minutes. It also attempts to remodel a patient behavioral pattern, optimize ST levels and link them to outcomes and patency of vascular procedures on the iliac segment.Materials and methods. 108 selected male patients with cardiovascular disease combined with metabolic syndrome and critical iliac artery stenosis (TASC II A and B) were examined during 2014–2018, 4 years after invasive and minimal invasive treatment (54 patients were treated with surgical Dacron reconstruction and 54 patients – with endovascular treatment on short segment of critical iliac artery stenosis (TASC II A and B).Results. In the total population, no difference was observed in changes of constraint-induced movement therapy between the standard exercise group and the control one after 4 years from baseline. However, there was no significant interaction between the effect of exercise trainings and primary bypass potency within 4 years.Conclusions. Primary effects of endovascular procedure and Dacron bypass revascularization raise the risk of elevated testosterone levels after 4 years of group training but does not provide adequate answers to questions as to whether higher levels of ST have any major influence on primary bypass potency preventing further progression of cardiovascular disease and general symptomatic and asymptomatic atherosclerosis. However, exercise and TRT can be potential adjunctive therapeutic options for a future supporting postsurgical and endovascular illiac treatment in cardiovascular patients with low testosterone levels.
血清睾酮(ST)和高密度脂蛋白(HDL)水平通常与50岁以上伴有严重髂狭窄(TASC II A和B)和心血管疾病的男性患者动脉粥样硬化相关,HDL和低密度脂蛋白(LDL)水平发生显著变化。除了标准治疗外,药物联合治疗和适当的运动模式也是重要的因素,因为药物可以改善HDL水平和初级旁路和血管内效力,对ST的改善有积极的影响,或者可以在血管内和血管外科手术后进行包括心血管疾病预防和血管治疗在内的睾酮替代治疗(TRT)作为辅助治疗选择。该研究的目的是确定手术和髂段血管内干预(TASCII A和B)后HDL与ST之间的关系,以及总持续时间为30-60分钟的改良中等活性(MET) 6 (MET)心血管危险因素。它还试图重塑患者的行为模式,优化ST水平,并将其与髂段血管手术的结果和通畅联系起来。材料和方法。选取2014-2018年有创和微创治疗后4年的108例男性心血管疾病合并代谢综合征和临界髂动脉狭窄(TASC II A和B)患者,其中54例接受手术涤纶重建,54例接受血管内治疗。从总体上看,标准运动组和对照组在基线后4年的限制性运动治疗变化无差异。然而,在4年内,运动训练的效果与初级旁路效价之间没有显著的相互作用。血管内手术和涤纶搭桥血运重建术的主要作用增加了4年组训练后睾酮水平升高的风险,但对于ST水平升高是否对预防心血管疾病进一步进展和一般有症状和无症状动脉粥样硬化的初级搭桥效力有任何重大影响,并没有提供足够的答案。然而,运动和TRT可以作为潜在的辅助治疗选择,用于未来支持低睾酮水平心血管患者的术后和血管内髂治疗。
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引用次数: 0
Characteristics of the personal profile of active servicemen with dissomnic manifestations 有失忆表现的现役军人的个人特征
IF 0.1 Pub Date : 2023-03-28 DOI: 10.14739/2310-1210.2023.2.263865
G. V. Guk
Aim: to study specifics of psychopathogenesis and the influence of personal characteristics on the pathopsychological content of dissomnic manifestations in active servicemen of the Armed Forces of Ukraine by examining the personal profile.Materials and methods. In total, 64 active servicemen of the Armed Forces of Ukraine with inorganic sleep disorders were included in a prospective clinical study on the basis of Military Hospital of Military Unit 3309 (Zaporizhzhia) and served as the study group; the comparison group included 40 patients who were treated at the Department of Borderline Conditions of “Regional Clinical Institution for the Provision of Psychiatric Care” of Zaporizhzhia Regional Council and had sleep disorders within neurotic mental disorders. To achieve the aim of the study, anamnestic, clinical-psychopathological, psychodiagnostic, clinical-psychophenomenological and clinical-statistical methods were used. As a psychodiagnostic tool, the Methodology for studying personality accentuations of K. Leonhard and G. Shmishek was chosen.Results. The most common types of accentuation in active servicemen with dyssomnic manifestations were sticking (18.75 % of the contingent), dysthymic (17.19 %) and hyperthymic (9.38 %). The most frequent combined clinical types of accentuations were “dysthymic-sticking” (9.38 %), “anxious-dysthymic” (4.69 %) and “hyperthymic-demonstrative” (3.13 %).Conclusions. As a result of the study, the characteristics of the personal profile and their influence on the pathopsychological content of dissomnic manifestations in active servicemen of the Armed Forces of Ukraine have been determined. The data obtained on the relationship between the personal profile characteristics and clinical types of dyssomnia would provide an opportunity to optimize measures for the detection and psychotherapeutic correction of dissomnic manifestations in active servicemen of the Armed Forces.
目的:通过对乌克兰现役军人个人资料的调查,研究其心理发病特点及个人特征对其失忆表现病理心理内容的影响。材料和方法。以3309部队军队医院为基础,将64名乌克兰武装部队现役无机性睡眠障碍军人纳入前瞻性临床研究,作为研究组;对照组为40例在“区域精神科临床护理机构”边缘性疾病科接受治疗的神经性精神障碍中存在睡眠障碍的患者。为了达到研究目的,使用了记忆学、临床-精神病理学、精神诊断、临床-精神现象学和临床-统计学方法。作为一种心理诊断工具,本文选择了K. Leonhard和G. Shmishek的人格重音研究方法。在有运动障碍表现的现役军人中,最常见的加重类型是粘滞(占18.75%)、情绪不良(17.19%)和情绪亢进(9.38%)。最常见的合并临床加重类型为“情绪不良-粘滞型”(9.38%)、“焦虑-情绪不良型”(4.69%)和“情绪亢进-示范性”(3.13%)。通过这项研究,确定了乌克兰武装部队现役军人的个人特征及其对失忆表现的病理心理内容的影响。所得的个人特征特征与睡眠障碍临床类型之间的关系数据将为优化现役军人睡眠障碍表现的检测和心理治疗纠正措施提供机会。
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引用次数: 0
Epidemiology of Alzheimer’s disease in the Odesa region 敖德萨地区阿尔茨海默病的流行病学
IF 0.1 Pub Date : 2023-03-28 DOI: 10.14739/2310-1210.2023.2.270277
I. Khubetova, D. A. Voloshchuk, К. А. Kosenko, Y. Vorokhta
The aim of the work was to study the epidemiology of Alzheimer’s disease in the Odesa region.Materials and methods. The study was carried out on the basis of the Regional Mental Health Center (Odesa) in 2016–2021. The data of the primary referral of patients with a verified diagnosis of Alzheimer’s disease were analyzed. Statistical processing of the obtained data was performed by frequency analysis methods using standard MS Excel packages (Microsoft Inc., USA). The population of the Odesa region was determined according to the State Statistics Service of Ukraine.Results. According to the retrospective analysis over the past 5 years, there was a constant increase in the number of identified patients with Alzheimer’s disease, from 4.9 cases per 100,000 population in 2016 to 6.0 cases in 2020 with a slight predominance of women in the structure of cases. Brain MRI was performed only in 29 (4.6 %) patients, EEG in 41 (6.5 %) patients. There were no cases of familial Alzheimer’s disease or early-onset Alzheimer’s disease. In 2020, Alzheimer’s and dementia deaths reached 14,196 or 2.54 % of total mortality in Ukraine.Conclusions. The prevalence of Alzheimer’s disease was 6.0 cases per 100,000 in the population of the Odesa region at the end of 2021, which was an order of magnitude less than the global average. The mean score on the MMSE scale was 18.6 ± 0.5. The analysis on subscales has shown the prevalence of memory, spatial orientation and verbal disorders. The Ukrainian population is characterized by the small number of patients of the older age group (3.3 %) and the predominance of female patients (59.4 %).
这项工作的目的是研究敖德萨地区阿尔茨海默病的流行病学。材料和方法。该研究是2016-2021年在敖德萨地区精神卫生中心的基础上进行的。对经证实诊断为阿尔茨海默病的患者的初级转诊数据进行分析。使用标准MS Excel软件包(Microsoft Inc., USA),采用频率分析方法对所得数据进行统计处理。敖德萨地区的人口是根据乌克兰国家统计局确定的。根据过去5年的回顾性分析,阿尔茨海默病确诊患者的数量不断增加,从2016年的每10万人4.9例增加到2020年的6.0例,病例结构中女性略有优势。29例(4.6%)患者行脑MRI检查,41例(6.5%)患者行脑电图检查。没有家族性阿尔茨海默病或早发性阿尔茨海默病的病例。2020年,乌克兰阿尔茨海默病和痴呆症死亡人数达到14,196人,占总死亡率的2.54%。截至2021年底,敖德萨地区阿尔茨海默病的患病率为每10万人6.0例,比全球平均水平低一个数量级。MMSE平均得分为18.6±0.5分。亚量表分析显示,记忆、空间定向和语言障碍普遍存在。乌克兰人口的特点是老年患者人数较少(3.3%),女性患者占多数(59.4%)。
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引用次数: 0
Purine metabolism state in patients with type 1 diabetes mellitus 1型糖尿病患者嘌呤代谢状态的研究
IF 0.1 Pub Date : 2023-03-28 DOI: 10.14739/2310-1210.2023.2.273721
А. О. Черняєва, B. А, CD Ю. І. Караченцев A, C. A, C. Л. Ю. С. B, A. Cherniaieva, M. R. Mykytiuk, Y. Karachentsev, O. Pliekhova, L. Y. Serhiienko
The aim of the study. To carry out a comprehensive analysis of the purine metabolism (PM) state and assess its features in patients with type 1 diabetes mellitus (DM).Materials and methods. 181 patients with type 1 DM were examined (94 women and 87 men) aged 42.5 ± 12.1 years. Indicators of the carbohydrate metabolism state, creatinine (Cr) concentration by the method of Popper, purine bases (PBs) and the activity of xanthine oxidase (XO) by a photometric method, uric acid (UA) by a colorimetric method were determined in fasting venous blood. UA excretion was detected by the colorimetric method, Cr by an enzymatic method.Renal UA clearance (RCUA), fractional UA clearance (FCUA), total UA tubular reabsorption (TTRUA) and hypoxanthine-guanine-phosphoribosyltransferase (HGPRT) activity were calculated. The comparison group, representative in terms of age and sex, included 25 healthy volunteers.Results. PM changes in patients with type 1 DM were orientated towards an excessively increased catabolism and insufficient reutilization of PBs. The structure of the detected disorders was as follows: hyperuricemia (HU) (13.8 %), enhanced RCUA (42.8 %), increased XO activity (35.6 %) and inhibition of HGPRT activity (53.3 %). In about 56 % of the subjects, high concentrations of PBs were found, and HU was diagnosed only in every seventh subject.It was identified that PB concentrations were negatively correlated with the level of XO activity. RCUA and XO activity levels were revealed to be of the greatest informational value for assessing the PM state in patients with type 1 DM. RCUA was significantly associated with the level of UA excretion and HGPRT activity. Relationships of RCUA and FCUA with HbAc1 levels were established. The higher the level of HbAc1, the greater the clearance of RCUA was, especially FCUA, which led to a significant decrease in TTRUA.Conclusions. PM in type 1 DM is characterized by a high intensity, which is realized due to a decrease in anabolism, increased oxidation and suppression of PB reutilization. Uricemia inadequately reflects the level of UA production in patients with type 1 DM. The severity of PM disorders in type 1 DM patients is associated with the carbohydrate metabolism compensation state.
研究的目的。对1型糖尿病(DM)患者的嘌呤代谢(PM)状态进行综合分析并评价其特征。材料和方法。181例1型糖尿病患者(女性94例,男性87例),年龄42.5±12.1岁。测定空腹静脉血碳水化合物代谢状态、肌酐(Cr)浓度、嘌呤碱(PBs)和黄嘌呤氧化酶(XO)活性、尿酸(UA)含量。UA排泄用比色法测定,Cr排泄用酶法测定。计算肾脏UA清除率(RCUA)、部分UA清除率(FCUA)、总UA小管重吸收(TTRUA)和次黄嘌呤-鸟嘌呤-磷酸基转移酶(HGPRT)活性。对照组在年龄和性别方面具有代表性,包括25名健康志愿者。1型糖尿病患者的PM变化倾向于过度增加的分解代谢和PBs的再利用不足。检测到的疾病结构如下:高尿酸血症(HU) (13.8%), RCUA增强(42.8%),XO活性增加(35.6%)和HGPRT活性抑制(53.3%)。在约56%的受试者中发现了高浓度的PBs,并且仅在七分之一的受试者中诊断为HU。结果表明,PB浓度与XO活性水平呈负相关。RCUA和XO活性水平对于评估1型糖尿病患者的PM状态具有最大的信息价值。RCUA与UA排泄水平和HGPRT活性显著相关。建立RCUA、FCUA与HbAc1水平的关系。HbAc1水平越高,RCUA的清除率越大,尤其是FCUA,导致ttrua显著降低。1型DM的PM具有高强度的特征,这是由于合成代谢减少、氧化增加和PB再利用受到抑制而实现的。尿毒症不能充分反映1型糖尿病患者的UA生成水平。1型糖尿病患者PM紊乱的严重程度与碳水化合物代谢代偿状态相关。
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引用次数: 1
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Zaporozhye Medical Journal
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