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The role and place of transanal endoscopic resections in rectal cancer 经肛门内镜切除在直肠癌中的作用和地位
IF 0.1 Pub Date : 2023-03-06 DOI: 10.14739/2310-1210.2023.1.264119
R. Nikitenko, V. Zaporozhan, K. Vorotyntseva, Ye. A. Koichev
The aim of the work is to improve the algorithm of intraoperative diagnosis of rectal cancer metastasis in order to optimize surgical intervention and reduce the number of intraoperative and postoperative complications.Materials and methods. 184 operated patients with rectal cancer (RC) were divided into 2 groups: group 1 – patients with stage I RC (T1–2N0M0), and group 2 – stage II RC (T3N0M0), who underwent intraoperative detection and examination of sentinel lymph nodes. The volume and surgical approach depended on the stage and the presence of metastases (MTS).The average period of postoperative observation was 12–60 months, taking into account early (purulent-septic complications, bleeding, intestinal perforation) and late (recurrent rectal cancer) complications.Results. The patients of group 1 had no MTS lesions of the sentinel lymph nodes, the surgical intervention was limited to transanal microsurgery due to this fact. Among the complications were the following: bleeding – 2.2 %; intraoperative perforation of the intestinal wall – 5.6 %. No purulent-septic cases, no recurrences of rectal cancer were detected.In group 2, 36 (38.3 %) out of 94 patients had MTS detected intraoperatively in the sentinel lymph nodes which required a low anterior rectal resection with total mesorectumectomy. Among the complications was bleeding – 6.3 %. No intraoperative perforations of the intestinal wall and no purulent-septic complications were detected. Recurrence of rectal cancer was detected in 12 (12.8 %) patients.Conclusions. Performing transanal endoscopic resections in patients with stage I RC and especially stage II RC is possible only under the conditions of mandatory intraoperative staining and urgent histological examination of the sentinel lymph nodes. The extent of the surgical intervention is determined on the operating table based on urgent histological examination results. When MTS lesions of the mesorectal sentinel lymph nodes are detected, the operation should be continued with mandatory mesorectumectomy.
本研究旨在改进直肠癌转移的术中诊断算法,以优化手术干预,减少术中及术后并发症。材料和方法。184例直肠癌(RC)手术患者分为2组:1组- I期RC (T1-2N0M0), 2组- II期RC (T3N0M0),术中行前哨淋巴结检测和检查。体积和手术方法取决于分期和转移(MTS)的存在。考虑到早期(脓毒症、出血、肠穿孔)和晚期(直肠癌复发)并发症,术后平均观察时间为12-60个月。1组患者前哨淋巴结未见MTS病变,因此手术干预仅限于经肛门显微手术。并发症如下:出血- 2.2%;术中肠壁穿孔- 5.6%。无化脓性败血症病例,无直肠癌复发。在第2组,94例患者中有36例(38.3%)在术中前哨淋巴结发现MTS,需要低位直肠前切除术并全肠系膜切除术。并发症中出血占6.3%。术中未发现肠壁穿孔及脓毒症并发症。直肠癌复发率12例(12.8%)。只有在强制术中染色和对前哨淋巴结进行紧急组织学检查的情况下,才能对I期,特别是II期RC患者进行经肛门内镜切除。根据紧急组织学检查结果在手术台上确定手术干预的程度。当发现肠系膜前哨淋巴结的MTS病变时,应继续手术并强制肠系膜切除术。
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引用次数: 0
Personality changes in patients with schizoaffective disorder (a review) 精神分裂情感障碍患者的人格改变(综述)
IF 0.1 Pub Date : 2023-03-06 DOI: 10.14739/2310-1210.2023.1.262837
V. Chuhunov, M. Khomitskyi, V. L. Pidlubnyi
The aim of the work is to study the world experience and views on the clinic and systematics of non-psychotic manifestations in schizoaffective disorder (SAD) by analyzing modern scientific literary sources.The relevance of study on SAD is determined by the significant prevalence in the population (0.2–0.6 %) and negative socio-economic consequences of the disease. Significant problems in SAD are family and work maladjustment, suicidality and states of psychoactive substance use comorbidity.The nosological independence of the disease was put into question and it was reflected in diagnostic approaches and classifications. In the clinical practice, SAD is considered independently and as a variant of schizophrenia or affective disorders. Diagnostics and prognostic criteria regarding personality changes in SAD are still at the stage of determining.Conclusions. Understanding of definitions “prognosis”, “outcome”, and “maladjustment” in SAD is not unified. Signs of SAD in remission and intermission is the most recent aspect of the SAD clinic, which dictates the need to assess personality changes and the level of social adaptation and functioning.
本研究的目的是通过分析现代科学文献资料,研究世界上对精神分裂情感障碍(SAD)非精神病性表现的临床和系统表现的经验和看法。SAD在人群中的显著患病率(0.2 - 0.6%)和该疾病的负面社会经济后果决定了SAD研究的相关性。SAD的主要问题是家庭和工作失调、自杀倾向和精神活性物质使用共病状态。疾病的分类学独立性受到质疑,这反映在诊断方法和分类上。在临床实践中,SAD被认为是独立的,是精神分裂症或情感障碍的一种变体。关于SAD人格改变的诊断和预后标准仍处于确定阶段。对SAD中“预后”、“结局”和“适应不良”定义的理解并不统一。SAD缓解期和间歇期的症状是SAD临床研究的最新方面,这表明需要评估人格变化以及社会适应和功能水平。
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引用次数: 0
Gender, age and morphofunctional characteristics of the quality of life of patients with stable angina 性别、年龄及形态功能特征对稳定型心绞痛患者生活质量的影响
IF 0.1 Pub Date : 2023-03-06 DOI: 10.14739/2310-1210.2023.1.268081
V. Tashchuk, T. Amelina, P. R. Ivanchuk, M. A. Ivanchuk
Aim of the work is to investigate the quality of life (QoL) of patients with stable angina pectoris (SA) depending on gender, age distribution and severity of angina pectoris.Materials and methods. 78 patients with an objective diagnosis of functional classes (FC) II–III SA were examined, who formed two clinical groups: the 1st – patients with an increase in QoL (57.69 % of cases), the 2nd – patients with the absence of any changes in QoL (42.31 % of cases). All patients underwent clinical, laboratory, instrumental examinations and determination of QoL using the SF-36 questionnaire.Results. The study of the QoL in men revealed that the mental component (MHC) of health was significantly higher due to such indicators as vitality (VT) (P < 0.001), mental health (MH) (P < 0.001), social functioning (SF) (Р = 0.028), general health status (GHS) (Р < 0.001). Younger age was characterized by a higher physical component of health (PHC) due to significantly higher indicators such as physical functioning (PF) and role-based physical functioning (RBPF) (in both cases P < 0.001). In the subgroup of younger women, the PHC was higher due to significantly higher levels of PF and RBPF (P = 0.048 and P = 0.011, respectively), that could be compared with the indicators of younger men, where the PHC was also higher due to GHS (Р = 0.009), RBPF (P = 0.028) and PF (P = 0.050). In men of younger age, the indicator of VT was significantly higher (Р = 0.031).Patients with higher FC of SA were expected to have a significant limitation of QoL in the form of a lower PHC (GHS (P = 0.023), PF (P < 0.001), RBPF (P < 0.001) and pain intensity (PI) (P < 0.001)). With the progression of heart failure (HF), GHS (P = 0.003), PF (P < 0.001), RBPF (P < 0.001) and PI (P < 0.001) significantly worsened. It was confirmed that the increase of QoL did not depend on gender (women P = 0.204, men P = 0.226) and age (P = 0.143). The presence of excess body weight was characterized by limitation of physical (significantly lower indicators of PF (P = 0.010) and PI (P = 0.008)) and mental (significantly decreased indicator – P = 0.053) health.Conclusions. Positive dynamics of the quality of life is associated with a lower functional class of stable angina pectoris, lower severity of heart failure, favorable shifts in the lipid spectrum, an increase in the left ventricular ejection fraction and the threshold load of cycle ergometry. The physical component of health is decisive in the quality of life of patients with stable angina pectoris.
本研究旨在探讨稳定性心绞痛(SA)患者的生活质量(QoL)与性别、年龄分布和心绞痛严重程度的关系。材料和方法。对78例客观诊断为功能分级(FC) II-III SA的患者进行检查,分为两组:第一组患者生活质量增加(占57.69%),第二组患者生活质量无变化(占42.31%)。所有患者均接受临床、实验室、仪器检查,并采用SF-36问卷测定生活质量。男性生活质量的研究表明,健康的精神成分(MHC)由于活力(VT) (P < 0.001)、心理健康(MH) (P < 0.001)、社会功能(SF) (Р = 0.028)、一般健康状况(GHS) (Р < 0.001)等指标而显著较高。由于身体功能(PF)和基于角色的身体功能(RBPF)等指标明显较高,年龄越小,健康的身体成分(PHC)越高(两种情况下P < 0.001)。在年轻女性亚组中,由于PF和RBPF水平明显较高(P = 0.048和P = 0.011), PHC较高,这可以与年轻男性的指标进行比较,其中PHC也因GHS (Р = 0.009), RBPF (P = 0.028)和PF (P = 0.050)而较高。年轻男性VT指标明显增高(Р = 0.031)。SA FC较高的患者生活质量受到显著限制,表现为PHC较低(GHS (P = 0.023)、PF (P < 0.001)、RBPF (P < 0.001)和疼痛强度(PI) (P < 0.001))。随着心力衰竭(HF)的进展,GHS (P = 0.003)、PF (P < 0.001)、RBPF (P < 0.001)和PI (P < 0.001)均显著恶化。结果表明,生活质量的提高与性别(女性P = 0.204,男性P = 0.226)和年龄(P = 0.143)无关。体重超标的特点是身体(PF指标显著降低(P = 0.010), PI指标显著降低(P = 0.008))和精神健康(P = 0.053)受到限制。生活质量的积极动态变化与稳定性心绞痛的功能等级较低、心力衰竭的严重程度较低、脂质谱的有利变化、左心室射血分数的增加和周期几何的阈值负荷有关。健康的身体成分对稳定型心绞痛患者的生活质量起决定性作用。
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引用次数: 0
The influence of occupational environment on formation of psycho-emotional stress among remote pilots of unmanned aircraft systems 职业环境对无人机远程飞行员心理情绪应激形成的影响
IF 0.1 Pub Date : 2023-03-06 DOI: 10.14739/2310-1210.2023.1.264763
A. Shvets, V. Kalnysh, O. Maltsev
The aim of this study was to identify informative indicators and establish the level of perception of their impact on the formation of excessive psycho-emotional stress among remote pilots of unmanned aircraft systems (UASs) (class 1 “Light”) during their occupational activities.Materials and methods. 41 servicemen aged 20–35 years old, who had experience in the management of UASs (class I “Light”) and were involved in the performance of a wide range of functional duties as operators of the moving objects, were studied based on the specially developed questionnaire (100-point scale) that reflected questions about the perception of the stress factor impact during their occupational activities. Statistical analysis of data was performed by descriptive and nonparametric statistics, as well as cluster, stepwise discriminant and factor analysis using the software package STATISTICA 13.3.Results. Regarding the perceptions of “stress” factor influence, the UASs pilots (operators of moving objects) were divided into two groups: group 1 could be conventionally called “hypersusceptible”, and representatives of group 2 – “hyposusceptible”. At the same time, it was found that the resulting clustering of the data into two groups provided 99.9 % opportunity for further assignment of new operators to the designated groups using the obtained supporting discriminant model (solving rules). The hidden factors have been revealed that formed the functional state of the “hypersusceptible” UASs operators, which collectively explained 54.9 % of the data variance, and “hyposusceptible” ones, which collectively explained 62.1 % of the original data variance.Conclusions. Two groups of operators, “hypersusceptible” and “hyposusceptible” to the influence of stress factors have been distinguished. The hidden factors that formed the functional state of the “hypersusceptible” UAS operators have been highlighted (the first factor “formation of fear of death” (F1↑) had 33.2 % rate and the second hidden factor “susceptibility to sensory stimuli” (F2↑), covered 21.7 % of the analyzed data variance). Two hidden factors that formed the functional state of the “hyposusceptible” UAS operators have been identified (the first factor “concentration of attention to performance of the functional duties” (F1↓) and the second factor “increased responsibility for occupational activity results” (F2↓). It has been established that there were radically different mechanisms of their functional state regulation, and “hyposusceptible” operators were more adapted to the performance of their functional duties due to the mechanisms of harmonizing their functional state and reducing experiences from the influence of harmful stress-forming factors.
本研究的目的是确定信息指标,并确定其对无人驾驶飞机系统(UASs)(1类“轻”)远程飞行员在其职业活动中过度心理情绪压力形成的影响的感知水平。材料和方法。41名年龄在20-35岁的军人,他们有管理UASs (I类“轻”)的经验,并作为移动物体的操作员参与了广泛的功能职责的履行,基于专门开发的问卷(100分制)进行了研究,该问卷反映了他们在职业活动中对压力因素影响的感知问题。数据的统计分析采用描述性统计和非参数统计,采用STATISTICA 13.3.Results软件包进行聚类分析、逐步判别分析和因子分析。关于对"压力"因素影响的看法,将无人机飞行员(移动物体操作员)分为两组:第1组通常被称为"超敏感",第2组代表- "低敏感"。同时,发现结果将数据聚类为两组提供了99.9%的机会,可以使用获得的支持判别模型(求解规则)进一步将新算子分配到指定的组。揭示了形成“高敏感”和“低敏感”操作人员功能状态的隐性因素,它们共同解释了54.9%的数据方差,而“低敏感”操作人员共同解释了62.1%的原始数据方差。对应激因素的影响可分为“高敏感”和“低敏感”两类。形成“超敏感”无人机操作员功能状态的隐藏因素得到了突出显示(第一个隐藏因素“死亡恐惧的形成”(F1↑)占33.2%,第二个隐藏因素“对感官刺激的敏感性”(F2↑)占分析数据方差的21.7%)。确定了形成“低敏感”无人机操作员功能状态的两个隐性因素(第一个因素是“对履行职能职责的注意力集中”(F1↓),第二个因素是“对职业活动结果的责任增加”(F2↓)。他们的功能状态调节机制存在着根本不同的机制,“低易感”操作员由于协调其功能状态和减少有害应激形成因素影响的体验机制而更适应其功能职责的履行。
{"title":"The influence of occupational environment on formation of psycho-emotional stress among remote pilots of unmanned aircraft systems","authors":"A. Shvets, V. Kalnysh, O. Maltsev","doi":"10.14739/2310-1210.2023.1.264763","DOIUrl":"https://doi.org/10.14739/2310-1210.2023.1.264763","url":null,"abstract":"The aim of this study was to identify informative indicators and establish the level of perception of their impact on the formation of excessive psycho-emotional stress among remote pilots of unmanned aircraft systems (UASs) (class 1 “Light”) during their occupational activities.\u0000Materials and methods. 41 servicemen aged 20–35 years old, who had experience in the management of UASs (class I “Light”) and were involved in the performance of a wide range of functional duties as operators of the moving objects, were studied based on the specially developed questionnaire (100-point scale) that reflected questions about the perception of the stress factor impact during their occupational activities. Statistical analysis of data was performed by descriptive and nonparametric statistics, as well as cluster, stepwise discriminant and factor analysis using the software package STATISTICA 13.3.\u0000Results. Regarding the perceptions of “stress” factor influence, the UASs pilots (operators of moving objects) were divided into two groups: group 1 could be conventionally called “hypersusceptible”, and representatives of group 2 – “hyposusceptible”. At the same time, it was found that the resulting clustering of the data into two groups provided 99.9 % opportunity for further assignment of new operators to the designated groups using the obtained supporting discriminant model (solving rules). The hidden factors have been revealed that formed the functional state of the “hypersusceptible” UASs operators, which collectively explained 54.9 % of the data variance, and “hyposusceptible” ones, which collectively explained 62.1 % of the original data variance.\u0000Conclusions. Two groups of operators, “hypersusceptible” and “hyposusceptible” to the influence of stress factors have been distinguished. The hidden factors that formed the functional state of the “hypersusceptible” UAS operators have been highlighted (the first factor “formation of fear of death” (F1↑) had 33.2 % rate and the second hidden factor “susceptibility to sensory stimuli” (F2↑), covered 21.7 % of the analyzed data variance). Two hidden factors that formed the functional state of the “hyposusceptible” UAS operators have been identified (the first factor “concentration of attention to performance of the functional duties” (F1↓) and the second factor “increased responsibility for occupational activity results” (F2↓). It has been established that there were radically different mechanisms of their functional state regulation, and “hyposusceptible” operators were more adapted to the performance of their functional duties due to the mechanisms of harmonizing their functional state and reducing experiences from the influence of harmful stress-forming factors.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90550812","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}
引用次数: 1
Study of acute toxicity of new thiophene-containing derivatives of 1,2,4-triazole 新型含噻吩的1,2,4-三唑衍生物的急性毒性研究
IF 0.1 Pub Date : 2023-03-06 DOI: 10.14739/2310-1210.2023.1.266318
A. Khilkovets, I. Bilai
Acute toxicity studies are an integral part of preclinical studies of any new biologically active compound. It should be noted that it is this stage of research that is crucial regarding the possibility of further use of a pharmacologically active substance as a drug. This indicator also helps to determine the initial dose for clinical trials and establish a range of potentially safe doses. The data obtained will help determine the direction of new chemical syntheses, replenish the relevant libraries in silico, as well as reveal many other fundamentally important parameters that characterize the interaction in the compound – living organism system.The aim of this research is to study the acute toxicity of 2-((4-phenyl-5-(thiophene-3-ylmethyl)-1,2,4-triazole-3-yl)thio)sodium acetate.Materials and methods. Previously, a prediction was made using the GUSAR computer program, which helped determine the dose intervals. Acute toxicity was determined by the experimental method of Kerber in vivo using white nonlinear Wistar rats. The rats were weighed, labeled, and divided into five groups of six individuals of each.Results. After the introduction of compound moving activity decreased, drowsiness, pupil miosis, and thirst were observed. In the fifth group, with the maximum dilution, all rats died within two hours after administration of the test compound. During the death, convulsions were observed. In the fourth group five animals died, and in the third – two rats died. In the first two groups, all the rats survived. During follow-up, the animals behaved normally. Based on the results of the research, calculations were made and the LD50 indicator was determined.Conclusions. According to the results, the studied compound belonged to the V class of toxicity (almost non-toxic), and the resulting LD50 value was 1125 mg/kg. This indicator confirmed the prospects for further study of this compound.
急性毒性研究是任何新的生物活性化合物临床前研究的一个组成部分。应该指出的是,这一阶段的研究对于进一步使用药理学活性物质作为药物的可能性至关重要。该指标还有助于确定临床试验的初始剂量,并确定可能安全的剂量范围。所获得的数据将有助于确定新化学合成的方向,补充相关的计算机文库,以及揭示表征化合物-生物系统相互作用的许多其他基本重要参数。本研究的目的是研究2-((4-苯基-5-(噻吩-3-甲基)-1,2,4-三唑-3-基)硫代)乙酸钠的急性毒性。材料和方法。以前,使用GUSAR计算机程序进行了预测,这有助于确定剂量间隔。采用Kerber实验法测定其在体急性毒性,实验对象为白色非线性Wistar大鼠。这些大鼠称重,贴上标签,并分为五组,每组6只。引入复合运动活性降低后,观察到嗜睡、瞳孔缩小和口渴。在第五组,在最大稀释下,所有大鼠在给药后两小时内死亡。在死亡过程中,观察到抽搐。第四组有五只老鼠死亡,第三组有两只老鼠死亡。在前两组中,所有的老鼠都存活了下来。在随访期间,这些动物表现正常。根据研究结果进行了计算,确定了LD50指标。结果表明,所研究化合物属V类毒性(几乎无毒),LD50值为1125 mg/kg。这一指标证实了该化合物进一步研究的前景。
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引用次数: 1
The influence of systemic inflammatory markers on the development of obstetrical complications in pregnant women with chronic obstructive pulmonary disease 全身炎症标志物对慢性阻塞性肺疾病孕妇产科并发症发生的影响
IF 0.1 Pub Date : 2023-03-06 DOI: 10.14739/2310-1210.2023.1.264437
S. Heriak, O. Oleksiak
The increasing prevalence of chronic obstructive pulmonary disease (COPD) among the female half of the population is the reason for the increased interest of scientists in the course of COPD and its impact on pregnant women. At the same time, the chronic lung inflammatory process leads to the development of obstetrical and perinatal complications during pregnancy.The aim of our study is to establish the features of changes in the cytokine profile in pregnant women with COPD and their role in the development of obstetrical and perinatal complications.Materials and methods. 77 pregnant women with clinically and instrumentally verified signs of COPD were examined, who were divided into 2 subgroups depending on the degree of bronchial obstruction: IA – 43 pregnant women with FEV1 ≥80 %, IB – 34 pregnant women with FEV1 50–79 %. The control group consisted of 27 healthy pregnant women. The cytokine profile was determined and a correlational interaction with the degree of bronchial obstruction and the frequency of obstetrical and perinatal complications was established.Results. Our analysis of cytokine profile indicators in pregnant women with COPD at the stage of mild and moderate bronchoobstruction has shown a characteristic and significant increase in the level of pro-inflammatory cytokines (IL-1β, IL-6, IL-8, TNF-α) and a simultaneous decrease in the level of anti-inflammatory IL-10 (P ≤ 0.05). Dysregulation of the inflammatory response in COPD in pregnant women became the main basis for the development of obstetrical and perinatal complications. We have established that an increase in the degree of bronchoobstruction was also associated with a higher detection frequency of such pregnancy and childbirth complications as anemia by 3.1 times, the threat of preterm birth by 9 times, preeclampsia by 7 times, placental dysfunction by 3.4 times, intrauterine growth restriction by 8 times, premature birth by 3.5 times, premature rupture of membranes during labor by 4 times, and fetal distress by 3 times.Conclusions. In pregnant women with COPD, an increase in the level of pro-inflammatory cytokines – IL-1β (rI = -0.81, rII = -0.67), IL-6 (rI = -0.88, rII = -0.78), IL-8, TNF-α was found to be directly proportional to the degree of bronchial obstruction, and inversely proportional level of anti-inflammatory IL-10 (rI = 0.80, rII = 0.86), which can be an early prognostic criterion for the development of obstetrical and perinatal complications.
在占人口一半的女性中,慢性阻塞性肺疾病(COPD)的患病率越来越高,这是科学家们对COPD病程及其对孕妇影响越来越感兴趣的原因。同时,慢性肺部炎症过程导致妊娠期间产科和围产期并发症的发展。我们研究的目的是确定COPD孕妇细胞因子谱的变化特征及其在产科和围产期并发症发展中的作用。材料和方法。研究人员对77例经临床和仪器验证有COPD症状的孕妇进行了检查,根据支气管阻塞程度将其分为2个亚组:IA - 43例FEV1≥80%的孕妇,IB - 34例FEV1 50 - 79%的孕妇。对照组为27名健康孕妇。细胞因子谱被确定,并与支气管阻塞程度和产科及围产期并发症的频率建立了相关的相互作用。我们对COPD孕妇轻、中度支气管阻断期的细胞因子谱指标分析发现,促炎因子IL-1β、IL-6、IL-8、TNF-α水平显著升高,抗炎因子IL-10水平同时降低(P≤0.05)。慢性阻塞性肺病孕妇炎症反应的失调成为产科和围产期并发症发生的主要基础。我们还发现,支气管阻塞程度的增加与贫血的检出率增加3.1倍、早产的威胁增加9倍、先兆子痫的威胁增加7倍、胎盘功能障碍的威胁增加3.4倍、宫内生长受限的威胁增加8倍、早产的威胁增加3.5倍、分娩时胎膜早破的威胁增加4倍、胎儿窘迫的威胁增加3倍有关。在COPD孕妇中,促炎因子IL-1β (rI = -0.81, rII = -0.67)、IL-6 (rI = -0.88, rII = -0.78)、IL-8、TNF-α水平的升高与支气管梗阻程度成正比,抗炎因子IL-10水平的升高与支气管梗阻程度成反比(rI = 0.80, rII = 0.86),可作为产科及围产期并发症发生的早期预后标准。
{"title":"The influence of systemic inflammatory markers on the development of obstetrical complications in pregnant women with chronic obstructive pulmonary disease","authors":"S. Heriak, O. Oleksiak","doi":"10.14739/2310-1210.2023.1.264437","DOIUrl":"https://doi.org/10.14739/2310-1210.2023.1.264437","url":null,"abstract":"The increasing prevalence of chronic obstructive pulmonary disease (COPD) among the female half of the population is the reason for the increased interest of scientists in the course of COPD and its impact on pregnant women. At the same time, the chronic lung inflammatory process leads to the development of obstetrical and perinatal complications during pregnancy.\u0000The aim of our study is to establish the features of changes in the cytokine profile in pregnant women with COPD and their role in the development of obstetrical and perinatal complications.\u0000Materials and methods. 77 pregnant women with clinically and instrumentally verified signs of COPD were examined, who were divided into 2 subgroups depending on the degree of bronchial obstruction: IA – 43 pregnant women with FEV1 ≥80 %, IB – 34 pregnant women with FEV1 50–79 %. The control group consisted of 27 healthy pregnant women. The cytokine profile was determined and a correlational interaction with the degree of bronchial obstruction and the frequency of obstetrical and perinatal complications was established.\u0000Results. Our analysis of cytokine profile indicators in pregnant women with COPD at the stage of mild and moderate bronchoobstruction has shown a characteristic and significant increase in the level of pro-inflammatory cytokines (IL-1β, IL-6, IL-8, TNF-α) and a simultaneous decrease in the level of anti-inflammatory IL-10 (P ≤ 0.05). Dysregulation of the inflammatory response in COPD in pregnant women became the main basis for the development of obstetrical and perinatal complications. We have established that an increase in the degree of bronchoobstruction was also associated with a higher detection frequency of such pregnancy and childbirth complications as anemia by 3.1 times, the threat of preterm birth by 9 times, preeclampsia by 7 times, placental dysfunction by 3.4 times, intrauterine growth restriction by 8 times, premature birth by 3.5 times, premature rupture of membranes during labor by 4 times, and fetal distress by 3 times.\u0000Conclusions. In pregnant women with COPD, an increase in the level of pro-inflammatory cytokines – IL-1β (rI = -0.81, rII = -0.67), IL-6 (rI = -0.88, rII = -0.78), IL-8, TNF-α was found to be directly proportional to the degree of bronchial obstruction, and inversely proportional level of anti-inflammatory IL-10 (rI = 0.80, rII = 0.86), which can be an early prognostic criterion for the development of obstetrical and perinatal complications.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79453257","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}
引用次数: 0
Ferritin level predicts in-hospital mortality in hypertensive patients with COVID-19 铁蛋白水平预测COVID-19高血压患者住院死亡率
IF 0.1 Pub Date : 2023-03-06 DOI: 10.14739/2310-1210.2023.1.266424
O. Skakun, N. Seredyuk
Aim. This study aimed to establish the predictive ability of serum ferritin levels for severe / critical condition development, need for supplemental oxygen, and in-hospital mortality in hypertensive patients with COVID-19-associated pneumonia.Materials and methods. 135 unvaccinated patients hospitalized for COVID-19-associated pneumonia were enrolled in the study. 78.5 % of patients were hypertensive.Results. Among hypertensive patients, the median ferritin level at admission was 315.5 (169.0–396.0) ng/mL in patients with moderate condition, 374.0 (171.0–709.5) ng/mL in patients developed severe condition, and 489.0 (362.0–1128.5) ng/mL in patients developed critical condition (P = 0.03). Serum ferritin level at admission was higher in non-survivors (539.0 (440.0–1128.5) ng/mL) than that in survivors (332.5 (172.0–545.0) ng/mL, P = 0.02). Hypertensive patients who required supplemental oxygen had higher median serum ferritin level (446.0 (187.0–763.0) ng/mL) than patients without the requirement of supplemental oxygen (324.0 (165.0–401.0) ng/mL, P = 0.02). There was poor discrimination ability of ferritin level in the prediction of severe / critical conditions (AUC = 0.628, P = 0.02) and the need for supplemental oxygen (AUC = 0.629, P = 0.02). There was an acceptable discrimination ability of ferritin level in the in-hospital mortality prediction (AUC = 0.701, P = 0.03); the Youden index was 0.54, the associated criterion was >438.0 ng/mL with 83.3 % sensitivity and 70.7 % specificity. Ferritin level >438.0 ng/mL at admission was associated with a significant increase in in-hospital mortality (OR = 12.04 (2.47–58.62), P = 0.002).Conclusions. Serum ferritin level at hospital admission increases with the severity of COVID-19 in hypertensive patients. Serum ferritin level predicts in-hospital mortality in hypertensive patients. However, its predictive ability for the disease progression to severe/critical conditions and the need for supplemental oxygen is poor. A ferritin level of 438.0 ng/mL is proposed to be a cut-off value for the prediction of in-hospital mortality.
的目标。本研究旨在建立血清铁蛋白水平对高血压合并covid -19相关性肺炎患者重症/危重症发展、补充氧需求和住院死亡率的预测能力。材料和方法。135名未接种疫苗的covid -19相关肺炎住院患者参加了这项研究。78.5%的患者为高血压。高血压患者入院时铁蛋白水平中位数:中度患者315.5 (169.0 ~ 396.0)ng/mL,重度患者374.0 (171.0 ~ 709.5)ng/mL,危重患者489.0 (362.0 ~ 1128.5)ng/mL (P = 0.03)。入院时,非幸存者血清铁蛋白水平(539.0 (440.0-1128.5)ng/mL)高于幸存者(332.5 (172.0-545.0)ng/mL, P = 0.02)。需要补充氧气的高血压患者血清铁蛋白水平中位数(446.0 (187.0 ~ 763.0)ng/mL)高于不需要补充氧气的患者(324.0 (165.0 ~ 401.0)ng/mL, P = 0.02)。铁蛋白水平在预测重症/危重症(AUC = 0.628, P = 0.02)和补氧需求(AUC = 0.629, P = 0.02)方面的判别能力较差。铁蛋白水平对院内死亡率预测有可接受的判别能力(AUC = 0.701, P = 0.03);约登指数为0.54,相关标准>438.0 ng/mL,敏感性83.3%,特异性70.7%。入院时铁蛋白水平>438.0 ng/mL与住院死亡率显著升高相关(OR = 12.04 (2.47 ~ 58.62), P = 0.002)。高血压患者入院时血清铁蛋白水平随COVID-19严重程度升高。血清铁蛋白水平预测高血压患者住院死亡率。然而,它对疾病进展到严重/危重状态和需要补充氧气的预测能力较差。建议将438.0 ng/mL的铁蛋白水平作为预测住院死亡率的临界值。
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引用次数: 0
Hypoglycemia in patients with COVID-19: risk factors and prevention of complications COVID-19患者低血糖:危险因素及并发症预防
IF 0.1 Pub Date : 2023-02-15 DOI: 10.14739/2310-1210.2023.1.261797
O. Halushko, O. Protsiuk, O. Pohorila
The aim of the work is to analyze the available scientific information and generalize the main results of modern research on the causes and risk factors of hypoglycemia in patients with COVID-19.Materials and methods. A search and analysis of full-text articles was carried out in the PubMed, Web of Science, Google Scholar, and Scopus databases. The search was conducted using the key terms: COVID-19 and hypoglycemia, hypoglycemia in COVID-19 patients and treatment of COVID-19 and hypoglycemia from the beginning of the pandemic in December 2019 to July 1, 2022.Results. The analysis of literary sources made it possible to identify three groups of factors that lead to the occurrence of hypoglycemia in patients with COVID-19: peculiarities of the diabetes course in patients with COVID-19 and the influence of concomitant diseases, side effects of certain groups of drugs and methods of therapy and prevention; shortcomings in the organization of treatment and patient care. Hypoglycemia has been shown to be a risk factor for cardiovascular and total mortality in patients with diabetes, may trigger the development of a cytokine storm during COVID-19 disease, and negatively impact mortality and length of hospital stay in COVID-19.Conclusions. To prevent hypoglycemic states in patients, one should avoid sudden changes in the type and dose of hypoglycemic drugs, periodically monitor the HbA1c level, expand the reach of patients with virtual consultations and telemedicine programs. In the case of determining the program of treatment and vaccination against COVID-19 in patients with diabetes mellitus, the known and possible hypoglycemic effects of drugs and vaccines should be taken into account.
本研究的目的是分析现有的科学信息,总结新冠肺炎患者低血糖的原因和危险因素的现代研究的主要结果。材料和方法。在PubMed、Web of Science、Google Scholar和Scopus数据库中对全文文章进行了搜索和分析。检索的关键词为2019年12月至2022年7月1日期间的COVID-19和低血糖、COVID-19患者的低血糖以及COVID-19和低血糖的治疗。通过对文献资料的分析,可以确定导致COVID-19患者发生低血糖的三组因素:COVID-19患者糖尿病病程的特殊性和伴随疾病的影响,某些药物组的副作用以及治疗和预防方法;组织治疗和病人护理方面的不足。低血糖已被证明是糖尿病患者心血管和总死亡率的危险因素,可能引发COVID-19疾病期间细胞因子风暴的发展,并对COVID-19的死亡率和住院时间产生负面影响。为了防止患者出现低血糖状态,应避免突然改变降糖药的类型和剂量,定期监测HbA1c水平,通过虚拟会诊和远程医疗项目扩大患者的范围。在确定糖尿病患者的COVID-19治疗和疫苗接种方案时,应考虑药物和疫苗的已知和可能的降糖作用。
{"title":"Hypoglycemia in patients with COVID-19: risk factors and prevention of complications","authors":"O. Halushko, O. Protsiuk, O. Pohorila","doi":"10.14739/2310-1210.2023.1.261797","DOIUrl":"https://doi.org/10.14739/2310-1210.2023.1.261797","url":null,"abstract":"The aim of the work is to analyze the available scientific information and generalize the main results of modern research on the causes and risk factors of hypoglycemia in patients with COVID-19.\u0000Materials and methods. A search and analysis of full-text articles was carried out in the PubMed, Web of Science, Google Scholar, and Scopus databases. The search was conducted using the key terms: COVID-19 and hypoglycemia, hypoglycemia in COVID-19 patients and treatment of COVID-19 and hypoglycemia from the beginning of the pandemic in December 2019 to July 1, 2022.\u0000Results. The analysis of literary sources made it possible to identify three groups of factors that lead to the occurrence of hypoglycemia in patients with COVID-19: peculiarities of the diabetes course in patients with COVID-19 and the influence of concomitant diseases, side effects of certain groups of drugs and methods of therapy and prevention; shortcomings in the organization of treatment and patient care. Hypoglycemia has been shown to be a risk factor for cardiovascular and total mortality in patients with diabetes, may trigger the development of a cytokine storm during COVID-19 disease, and negatively impact mortality and length of hospital stay in COVID-19.\u0000Conclusions. To prevent hypoglycemic states in patients, one should avoid sudden changes in the type and dose of hypoglycemic drugs, periodically monitor the HbA1c level, expand the reach of patients with virtual consultations and telemedicine programs. In the case of determining the program of treatment and vaccination against COVID-19 in patients with diabetes mellitus, the known and possible hypoglycemic effects of drugs and vaccines should be taken into account.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89565961","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}
引用次数: 0
Clinical case of hemophagocytic lymphohistiocytosis: rare or undiagnosed syndrome? 噬血细胞淋巴组织细胞增多症临床病例:罕见还是未确诊综合征?
IF 0.1 Pub Date : 2023-02-15 DOI: 10.14739/2310-1210.2023.1.261972
О. B. Yaremenko, EF А. О. Sydorova A, CD О. Ya. Antoniuk A
Hemophagocytic lymphohistiocytosis (hemophagocytic syndrome, HLH) is a life-threatening hyperinflammatory condition associated with a high mortality rate; it is characterized by hyperstimulation of histiocytes and cytotoxic T-cells, which leads to cytokine storm and multisystemic injury.Aim. To present our own clinical case of the HLH development at the key aspects of pathogenic mechanisms, differential diagnosis, and therapeutic management of this syndrome.Materials and methods. This article provides information on the HLH development in a 69-year-old man with the onset of this syndrome prior to a diagnosis of the underlying disease – splenic marginal zone lymphoma. The article summarizes the current literature data on clinical manifestations, diagnosis, and treatment of HLH.Results. This article describes a case of secondary HLH from our clinical practice. The most common causes of HLH are malignant neoplasm, infectious factors and rheumatic diseases (when associated with the latest, HLH is called “macrophage activation syndrome”). The main clinical symptoms are prolonged high fever and hepatosplenomegaly, typical laboratory changes such as cytopenia, hyperferritinemia, hypertriglyceridemia, elevated liver enzymes and low fibrinogen levels.Conclusions. Despite typical clinical features, HLH is a condition that often remains unrecognized and it is characterized by a poor prognosis. Prompt prescription of adequate treatment can improve patients’ prognoses and increase the survival rate.
噬血细胞淋巴组织细胞增多症(haemophagocytic syndrome, HLH)是一种危及生命的高炎症性疾病,死亡率高;其特点是组织细胞和细胞毒性t细胞的过度刺激,导致细胞因子风暴和多系统损伤。介绍我们自己的HLH发病机制、鉴别诊断和治疗管理的关键方面的临床病例。材料和方法。本文提供了一名69岁男性在诊断为基础疾病-脾边缘区淋巴瘤之前出现这种综合征的HLH发展信息。本文综述了目前关于hlh的临床表现、诊断和治疗的文献资料。本文描述一例继发性HLH从我们的临床实践。HLH最常见的原因是恶性肿瘤、感染因素和风湿病(当与最新的HLH相关时,称为“巨噬细胞激活综合征”)。临床主要表现为长时间高热、肝脾肿大,实验室表现为细胞减少、高铁血症、高甘油三酯血症、肝酶升高、纤维蛋白原水平低。尽管有典型的临床特征,但HLH是一种经常未被识别的疾病,其特点是预后差。及时处方适当治疗可改善患者预后,提高生存率。
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引用次数: 0
Factors of QTc interval prolongation in patients with arterial hypertension 高血压病患者QTc间期延长的影响因素
IF 0.1 Pub Date : 2023-02-15 DOI: 10.14739/2310-1210.2023.1.262450
N. Y. Tselik, O. Bilchenko
The relevance of determining the factors of the prolonged QTc interval development in patients with arterial hypertension is high, as it solves the issue of preliminary diagnosis among patients from risk groups and allows adjusting the diagnostic and therapeutic tactics of managing such patients.Aim: to determine factors for the development of prolonged average daily QTc interval in patients with arterial hypertension.Materials and methods. The study included 195 patients with arterial hypertension, who were divided into 2 subgroups: 175 individuals with a normal average daily duration of the QTc interval and 20 patients with a prolonged average daily duration of the QTc interval. All the patients underwent 24-hour heart rate monitoring and determination of blood pressure variability. At the stage of involving patients in the study, the following were performed: anamnesis collection and determination of physical data (estimation of systolic and diastolic blood pressure).Results. The study has revealed risk factors of daily QTc interval prolongation in hypertensive patients with further developing a prognostic model with high sensitivity (88.9 %) and specificity (70.6 %). Prolongation of QTc in patients with hypertension was associated with such parameters: male sex (OR = 4.292 [95.0 % CI 1.337–13.779], Р = 0.014), body mass index (OR = 1.107 [95.0 % CI 0.987–1.243], Р = 0.083), mean 24-hour diastolic (OR = 1.076 [95.0 % CI 1.017–1.139], Р = 0.011) and pulse blood pressure (OR = 1.075 [95.0 % CІ 1.012–1.141], Р = 0.018), time since hypertension was diagnosed (OR = 1.093 [95.0 % CI 0.997–1.197], Р = 0.057) and office pulse blood pressure (OR = 0.948 [95.0 % CІ 0.900–0.999], Р = 0.046).Conclusions. The study has determined risk factors of developing a prolonged average daily QTc interval in patients with hypertension, which will allow correcting diagnostic and treatment tactics of management for patients from risk groups.
确定动脉性高血压患者QTc间期延长发展的相关因素,解决了高危人群患者的初步诊断问题,调整了该类患者的诊治策略,具有较高的相关性。目的:探讨高血压患者平均每日QTc间期延长的影响因素。材料和方法。该研究纳入195例动脉高血压患者,将其分为2个亚组:175例QTc间期平均日持续时间正常的患者和20例QTc间期平均日持续时间延长的患者。所有患者均接受24小时心率监测和血压变异性测定。在患者参与研究的阶段,进行了以下工作:收集记忆和确定物理数据(估计收缩压和舒张压)。本研究揭示了高血压患者每日QTc间期延长的危险因素,并进一步建立了敏感性(88.9%)和特异性(70.6%)较高的预后模型。高血压患者QTc的延长与以下参数相关:男性(或= 4.292 (95.0% CI 1.337 - -13.779),Р= 0.014),身体质量指数(或= 1.107 (95.0% CI 0.987 - -1.243),Р= 0.083),意思是24小时舒张压(或= 1.076 (95.0% CI 1.017 - -1.139),Р= 0.011)和脉搏血压(或= 1.075 (95.0% CІ1.012 - -1.141),Р= 0.018),以来被诊断为高血压(或= 1.093 (95.0% CI 0.997 - -1.197),Р= 0.057)和办公室血压脉搏(或= 0.948 (95.0% CІ0.900 - -0.999),Р= 0.046).Conclusions。本研究确定了高血压患者平均每日QTc间隔延长的危险因素,为高危人群患者的诊断和治疗策略的调整提供了依据。
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引用次数: 0
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