Pub Date : 2022-09-30DOI: 10.32345/2664-4738.3.2022.01
T. Pochuiеva, A. Filatova, S. Samusenko, I. Filatova, A.B. Bobrus
Relevance. Relevance of the research is caused by the clinical necessity to increase efficiency of diagnostics and treatment of acute otitis media (AOM) from the modern positions personalized medicine and the feasibility of statistical verification of the validity of the hypothesis about the influence of glucose metabolism disorders on the formation of clinical and pathogenetic features of acute otitis media in adults. Objective. To carry out statistical verification of the hypothesis about the influence of carbohydrate metabolism disorders on the complicated course of AOM on the basis of cluster analysis and to determine its informativity. Materials and methods. The cluster analysis included 73 with AOM. The 1 group (n=17) - patients with AOM; 2 group (n=15) - patients with AOM with presence of the sinus pathology; 3 group (n=20) - patients with AOM due to type 2 diabetes mellitus (DM2); 4 group (n=21) - patients with AOM due to transient glucose metabolism disorders. Apart from the clinical examination, all patients were tested for HbAlc, parathormone, osteocalcin, total calcium, IL-4, IL-6, FNP-α, and low-density lipoproteins (LDL). Cluster analysis on the basis of laboratory indicators was performed by the hierarchical method using the iterative algorithm of k-means and prior standardization of the data. Result. The hypothesis was tested at the level of stratification of patients into 4 and 2 clusters. In the first case, 28.8 %, 31.5 %, 15.6 %, and 24.6 % of the total number of patients were included in clusters I, II, III, and IV. Patients with AOM due to impaired glucose metabolism were predominantly in clusters I and II, comprising 51.2 % and 69.5 % of the cluster contingent respectively, while DM2 prevailed in cluster I and transient glucose metabolism disorders in cluster II (61.9 % and 62.5 % accordingly), 72.7 % and 94.4 % of patients with AOM without impaired glucose metabolism were stratified in clusters III and IV. The analysis of laboratory indicators using the k-means algorithm showed a general tendency for the increase in glucose, HbAlc, parathormone, TNF-α and LDL in patients with AOM in clusters I and II with increased levels of osteocalcin, calcium and IL-4 in patients in clusters III and IV with the presence of a significant difference (p˂0.05). At the level of patients' grouping into two clusters, cluster I included 41.9 % of the total number of patients due to the presence of all glucose metabolism disorders (of these, DM2 occurred in 57.6 % and transient glucose metabolism disorders in 43.3 %). The II cluster (58.9 % of patients) included all patients with AOM without impaired glucose metabolism, accounting for 74.4 % of its structure, and 25.6 % of patients with impaired glucose metabolism (6.97 % for DM2 and 18.6 % for transient impairments). The k-means algorithm revealed a clear and reliable distribution of clusters for all 9 studied indicators, which resulted in an increase in glucose content, HbAlc, levels of p
{"title":"CLUSTER ANALYSIS AS A METHOD FOR TESTING THE HYPOTHESIS ABOUT THE INFLUENCE OF GLUCOSE METABOLISM DISORDERS ON THE COURSE OF ACUTE OTITIS MEDIA IN ADULTS","authors":"T. Pochuiеva, A. Filatova, S. Samusenko, I. Filatova, A.B. Bobrus","doi":"10.32345/2664-4738.3.2022.01","DOIUrl":"https://doi.org/10.32345/2664-4738.3.2022.01","url":null,"abstract":"Relevance. Relevance of the research is caused by the clinical necessity to increase efficiency of diagnostics and treatment of acute otitis media (AOM) from the modern positions personalized medicine and the feasibility of statistical verification of the validity of the hypothesis about the influence of glucose metabolism disorders on the formation of clinical and pathogenetic features of acute otitis media in adults. \u0000Objective. To carry out statistical verification of the hypothesis about the influence of carbohydrate metabolism disorders on the complicated course of AOM on the basis of cluster analysis and to determine its informativity. \u0000Materials and methods. The cluster analysis included 73 with AOM. The 1 group (n=17) - patients with AOM; 2 group (n=15) - patients with AOM with presence of the sinus pathology; 3 group (n=20) - patients with AOM due to type 2 diabetes mellitus (DM2); 4 group (n=21) - patients with AOM due to transient glucose metabolism disorders. Apart from the clinical examination, all patients were tested for HbAlc, parathormone, osteocalcin, total calcium, IL-4, IL-6, FNP-α, and low-density lipoproteins (LDL). Cluster analysis on the basis of laboratory indicators was performed by the hierarchical method using the iterative algorithm of k-means and prior standardization of the data. \u0000Result. The hypothesis was tested at the level of stratification of patients into 4 and 2 clusters. In the first case, 28.8 %, 31.5 %, 15.6 %, and 24.6 % of the total number of patients were included in clusters I, II, III, and IV. Patients with AOM due to impaired glucose metabolism were predominantly in clusters I and II, comprising 51.2 % and 69.5 % of the cluster contingent respectively, while DM2 prevailed in cluster I and transient glucose metabolism disorders in cluster II (61.9 % and 62.5 % accordingly), 72.7 % and 94.4 % of patients with AOM without impaired glucose metabolism were stratified in clusters III and IV. \u0000The analysis of laboratory indicators using the k-means algorithm showed a general tendency for the increase in glucose, HbAlc, parathormone, TNF-α and LDL in patients with AOM in clusters I and II with increased levels of osteocalcin, calcium and IL-4 in patients in clusters III and IV with the presence of a significant difference (p˂0.05). \u0000At the level of patients' grouping into two clusters, cluster I included 41.9 % of the total number of patients due to the presence of all glucose metabolism disorders (of these, DM2 occurred in 57.6 % and transient glucose metabolism disorders in 43.3 %). The II cluster (58.9 % of patients) included all patients with AOM without impaired glucose metabolism, accounting for 74.4 % of its structure, and 25.6 % of patients with impaired glucose metabolism (6.97 % for DM2 and 18.6 % for transient impairments). \u0000The k-means algorithm revealed a clear and reliable distribution of clusters for all 9 studied indicators, which resulted in an increase in glucose content, HbAlc, levels of p","PeriodicalId":52737,"journal":{"name":"Medichna nauka Ukrayini","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43110277","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 : 2022-06-30DOI: 10.32345/2664-4738.2.2022.01
I.V. Koshurba, F. Hladkykh, M. Chyzh
Relevance. Gastric and duodenal ulcers occur in 6-10% of the adult population, and mortality from peptic ulcers ranges from 5 to 15%. Conservative treatment of this disease almost always involves the use of antisecretory and antibacterial drugs. Existing treatment regimens for peptic ulcer disease, focused on key pathogenetic mechanisms, do not take into account the individual adaptive and trophological characteristics of patients. As a potential antiulcer agent, our attention was drawn to the cryopreserved placenta extract ("Cryocell-cryoextract placenta"). It eliminates the ulcerogenic effect of anti-inflammatory drugs of non-steroidal nature, without affecting their therapeutic efficacy. Objective: to characterize the anti-ulcerogenic effect of therapeutic and prophylactic use of cryopreserved placenta extract in the model of alcohol-prednisolone gastric lesions in rats. Methods. The study was performed on 28 male rats weighing 200-220 g. they were randomized into four groups: I (n = 7) – intact rats, II (n = 7) – control – rats with model pathology (alcohol-prednisolone gastric lesion) without treatment, III (n = 7) – rats with alcohol-prednisolone gastric lesions, which were injected with cryoextract placenta (0.16 ml / kg body weight, intramuscularly), IV (n = 7) – rats with alcohol-prednisolone gastric lesions, which were administered the reference drug esomeprazole, proton pump inhibitor (50 mg / kg , intragastric). Gastric lesions in rats were simulated by intragastric single administration of prednisolone (20 mg/kg) dissolved in 80.0% ethanol (0.6 ml/100 g body weight). Cryoextracts of the placenta were administered intravenously in a prophylactic mode – 1 time per day for 4 days before and 1 time 60 minutes after the introduction of ethanol-prednisolone mixture. In 24 h. after administration of the mixture, rats were removed from the experiment and the size of the stomach (bloating) and the presence of adhesions with adjacent organs were evaluated macroscopically by the following criteria: erosions and hemographies, hyperemia, edema and mucosal fold disorders. For each group, the percentage of experimental animals was calculated according to these characteristics and the average value of their severity. The values of the ulcer index were calculated for each group. Results. The study showed that the introduction of placental cryoexact as well as the reference drug esomeprazole led to a statistically significant (p<0.05) reduction of three times the prevalence of gastric ulcers in rats after administration of alcohol-prednisolone mixture. The use of placental cryoextract in the treatment-and-prophylactic regimen led to a statistically significant (p<0.05) decrease in the value of the ulcer index in 13 times relative to the control rats, and the average score of macroscopic assessment of gastric mucosa was 3.5 times lower and was 1.1±0.24 and 3.9±0.26, respectively. In animals treated with esomeprazole 2 times more moderate (2 [0.5;
{"title":"EVALUATION OF ANTIULCEROGENIC EFFECT OF CRYOCONSERVATED PLACENTA EXTRACT ON THE MODEL OF ETHANOL-PREDISONOLIC LESIONS OF THE GASTRIC MUCOSA","authors":"I.V. Koshurba, F. Hladkykh, M. Chyzh","doi":"10.32345/2664-4738.2.2022.01","DOIUrl":"https://doi.org/10.32345/2664-4738.2.2022.01","url":null,"abstract":"Relevance. Gastric and duodenal ulcers occur in 6-10% of the adult population, and mortality from peptic ulcers ranges from 5 to 15%. Conservative treatment of this disease almost always involves the use of antisecretory and antibacterial drugs. Existing treatment regimens for peptic ulcer disease, focused on key pathogenetic mechanisms, do not take into account the individual adaptive and trophological characteristics of patients. As a potential antiulcer agent, our attention was drawn to the cryopreserved placenta extract (\"Cryocell-cryoextract placenta\"). It eliminates the ulcerogenic effect of anti-inflammatory drugs of non-steroidal nature, without affecting their therapeutic efficacy. \u0000Objective: to characterize the anti-ulcerogenic effect of therapeutic and prophylactic use of cryopreserved placenta extract in the model of alcohol-prednisolone gastric lesions in rats. \u0000Methods. The study was performed on 28 male rats weighing 200-220 g. they were randomized into four groups: I (n = 7) – intact rats, II (n = 7) – control – rats with model pathology (alcohol-prednisolone gastric lesion) without treatment, III (n = 7) – rats with alcohol-prednisolone gastric lesions, which were injected with cryoextract placenta (0.16 ml / kg body weight, intramuscularly), IV (n = 7) – rats with alcohol-prednisolone gastric lesions, which were administered the reference drug esomeprazole, proton pump inhibitor (50 mg / kg , intragastric). Gastric lesions in rats were simulated by intragastric single administration of prednisolone (20 mg/kg) dissolved in 80.0% ethanol (0.6 ml/100 g body weight). Cryoextracts of the placenta were administered intravenously in a prophylactic mode – 1 time per day for 4 days before and 1 time 60 minutes after the introduction of ethanol-prednisolone mixture. In 24 h. after administration of the mixture, rats were removed from the experiment and the size of the stomach (bloating) and the presence of adhesions with adjacent organs were evaluated macroscopically by the following criteria: erosions and hemographies, hyperemia, edema and mucosal fold disorders. For each group, the percentage of experimental animals was calculated according to these characteristics and the average value of their severity. The values of the ulcer index were calculated for each group. \u0000Results. The study showed that the introduction of placental cryoexact as well as the reference drug esomeprazole led to a statistically significant (p<0.05) reduction of three times the prevalence of gastric ulcers in rats after administration of alcohol-prednisolone mixture. The use of placental cryoextract in the treatment-and-prophylactic regimen led to a statistically significant (p<0.05) decrease in the value of the ulcer index in 13 times relative to the control rats, and the average score of macroscopic assessment of gastric mucosa was 3.5 times lower and was 1.1±0.24 and 3.9±0.26, respectively. In animals treated with esomeprazole 2 times more moderate (2 [0.5; ","PeriodicalId":52737,"journal":{"name":"Medichna nauka Ukrayini","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47734139","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 : 2022-06-30DOI: 10.32345/2664-4738.2.2022.10
M. Khaitovych, N. Kysil, V. A. Zhovnir
Relevance. It is known that in children the frequency of perioperative critical events due to the introduction of drugs is more than 5%. For example fentanyl, which is used as an adjunct to surgical anesthesia, is a major factor in increasing the number of deaths from opioid overdoses. Among the areas of reducing the frequency of severe adverse reactions to perioperative drugs - taking into account the pharmacogenetic variations of the patient. Objective is to consider current data on pharmacogenetic aspects of pharmacokinetics and pharmacodynamics of perioperative drugs. Methods. Analysis of the data presented in PubMed by keywords "pharmacogenetics", "general anesthetics", "analgesics", "muscle relaxants", "children". Search depth – 7 years (2014-2020), with a retrospective deepening of some positions until 2002. Results. The pharmacogenetic aspects of the pharmacokinetics of perioperative drugs are related to the genes of the enzymes that metabolize them and their transporters. Current data on the prevalence of polymorphic alleles of CYP2C9 genes (provides metabolism of nonsteroidal anti-inflammatory and anticonvulsant drugs) and CYP2D6 (metabolizes opioids, antidepressants, antiemetics) in Europe and, in particular, in Ukraine were presented. Thus, the inactive allele CYP2C19 * 2 was found in 13%, while the allele of increased activity CYP2C19 * 17 - in 25% of the population of Ukraine; allele with lost CYP2D6 function (CYP2D6 * 4) - in 18.6% of Ukrainians. Homozygotes with CYP2C9 * 3 polymorphism metabolize nonsteroidal anti-inflammatory drugs much more slowly than wild-type carriers, which may lead to their accumulation and side effects. The analgesic effect of codeine occurs only after it is metabolized in the liver by CYP2D6 to morphine. Respiratory depression, apnea and death may occur in patients with excessive metabolic rate even after a single dose of codeine; however, was noted the ineffectiveness of ondansetron due to a decrease in its concentration in the blood in thesepatients. Concomitant use of midazolam and fentanyl may prolong the effect of fentanyl by competing metabolism of midazolam by the hepatic enzyme CYP3A4, especially in patients with low metabolism. Plasma butyrylcholinesterase deficiency reduces succinylcholine inactivation in 1 in 1,500 people. Changing the genotype of uridine diphosphate glycosyltransferase causes increased glucuronidation of morphine, which may lead to a decrease in its effectiveness. As an example of pharmacogenetic changes in pharmacodynamics can be considered malignant hyperthermia, which occurs due to exposure to volatile anesthetics and depolarizing muscle relaxants in mutations in the RYR1 gene. Carriers of the minor allele (G) of the 5HT2A rs6313 gene require less propofol and 40% less time to start induction of anesthesia. Conclusions. The efficacy and safety of perioperative drugs are largely related to the pharmacogenetic aspects of their pharmacokinetics, especially mutations in ge
{"title":"PHARMACOGENETIC ASPECTS OF THE USE OF PERIOPERATIVE DRUGS IN PEDIATRICS. Review","authors":"M. Khaitovych, N. Kysil, V. A. Zhovnir","doi":"10.32345/2664-4738.2.2022.10","DOIUrl":"https://doi.org/10.32345/2664-4738.2.2022.10","url":null,"abstract":"Relevance. It is known that in children the frequency of perioperative critical events due to the introduction of drugs is more than 5%. For example fentanyl, which is used as an adjunct to surgical anesthesia, is a major factor in increasing the number of deaths from opioid overdoses. Among the areas of reducing the frequency of severe adverse reactions to perioperative drugs - taking into account the pharmacogenetic variations of the patient. \u0000Objective is to consider current data on pharmacogenetic aspects of pharmacokinetics and pharmacodynamics of perioperative drugs. \u0000Methods. Analysis of the data presented in PubMed by keywords \"pharmacogenetics\", \"general anesthetics\", \"analgesics\", \"muscle relaxants\", \"children\". Search depth – 7 years (2014-2020), with a retrospective deepening of some positions until 2002. \u0000Results. The pharmacogenetic aspects of the pharmacokinetics of perioperative drugs are related to the genes of the enzymes that metabolize them and their transporters. Current data on the prevalence of polymorphic alleles of CYP2C9 genes (provides metabolism of nonsteroidal anti-inflammatory and anticonvulsant drugs) and CYP2D6 (metabolizes opioids, antidepressants, antiemetics) in Europe and, in particular, in Ukraine were presented. Thus, the inactive allele CYP2C19 * 2 was found in 13%, while the allele of increased activity CYP2C19 * 17 - in 25% of the population of Ukraine; allele with lost CYP2D6 function (CYP2D6 * 4) - in 18.6% of Ukrainians. Homozygotes with CYP2C9 * 3 polymorphism metabolize nonsteroidal anti-inflammatory drugs much more slowly than wild-type carriers, which may lead to their accumulation and side effects. The analgesic effect of codeine occurs only after it is metabolized in the liver by CYP2D6 to morphine. Respiratory depression, apnea and death may occur in patients with excessive metabolic rate even after a single dose of codeine; however, was noted the ineffectiveness of ondansetron due to a decrease in its concentration in the blood in thesepatients. Concomitant use of midazolam and fentanyl may prolong the effect of fentanyl by competing metabolism of midazolam by the hepatic enzyme CYP3A4, especially in patients with low metabolism. Plasma butyrylcholinesterase deficiency reduces succinylcholine inactivation in 1 in 1,500 people. Changing the genotype of uridine diphosphate glycosyltransferase causes increased glucuronidation of morphine, which may lead to a decrease in its effectiveness. As an example of pharmacogenetic changes in pharmacodynamics can be considered malignant hyperthermia, which occurs due to exposure to volatile anesthetics and depolarizing muscle relaxants in mutations in the RYR1 gene. Carriers of the minor allele (G) of the 5HT2A rs6313 gene require less propofol and 40% less time to start induction of anesthesia. \u0000Conclusions. The efficacy and safety of perioperative drugs are largely related to the pharmacogenetic aspects of their pharmacokinetics, especially mutations in ge","PeriodicalId":52737,"journal":{"name":"Medichna nauka Ukrayini","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69516649","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 : 2022-06-30DOI: 10.32345/2664-4738.2.2022.03
V. Pasko
Relevance. The phenomenon of non-dipper (insufficient nocturnal decrease in blood pressure) has prognostic significance for increasing the risk of complications of arterial hypertension - myocardial infarction, stroke. To date, there are only isolated reports of platelet hemostasis in this category of individuals. Therefore, it is important to find out the peculiarities of state of platelet aggregation depending on circadian rhythm of blood pressure (BP). Objective is to identify the baseline level of platelet and plasma hemostasis at different 24 hours day's blood pressure profiles in middle-aged and elderly hypertensive patients. Materials and methods. Subjects (n=90) are divided into 3 groups. Group 1 (n=30) included middle-aged hypertensive patients (45-59 years), group 2 (n=30) − elderly hypertensive (60-74 years) patients. Patients are divided into two subgroups in each of these groups, 15 people in each: subgroup dipper (D) − with adequate nocturnal blood pressure reduction (10-20 %) and subgroup non-dipper (ND) − with insufficient nocturnal blood pressure reduction (<10 %). The control group (n = 30) consisted of 15 patients without arterial hypertension for each of the examined groups. The state of spontaneous and induced platelet aggregation was determined. Adenosine diphosphate (1´10-5 mM/L) and adrenaline (1 µg/mL) were used as aggregation inducers on SOLAR AP-2110 optical aggregometer. The following parameters of aggregatograms were calculated: amplitude of spontaneous and induced aggregation (AA, %); time of maximal aggregation (TMA, min.); slope of aggregation (SA, %/min.). The state of plasma hemostasis was determined on hemocoagulometer Amelung KC 1A. The following parameters were determined to assess state of plasma hemostasis: fibrinogen (FG, g/L), antithrombin III (AT-III, %), fibrinolysis (min.). Results. The increase in induced platelet aggregation activity was found in middle-aged hypertensive patients. In subgroup D AA was 1,9 times and in subgroup ND – 2,3 times higher than the norm; the rate of SA increased by 105,5 % and 112 %, respectively. In subgroup ND compared with subgroup D AA was higher by 21 % and SA − by 3,2 %. In elderly hypertensive patients, the rate of spontaneous aggregation AA is 1,7 times higher in subgroup ND compared with subgroup D (4,2±1,6 % vs. 2,5±0,2 %). In the ND subgroup AA rate is 68 % higher than in the control. Indicators of induced platelet aggregation were also higher in subgroup ND compared with subgroup D: AA with induction of ADP – 74,7±25,1 % vs. 51,4±22,2 %; TMA with adrenaline induction – 8,2±2,6 minutes against 5,7±2,5 minutes, respectively. There was the significant reduction in TMA with adrenaline-induced aggregation by 30,5 % in subgroup D compared with the control also. Fibrinolysis activity in middle-aged hypertensive patients in subgroup D was slowed down by 36,1% compared with the control group: fibrinolysis was 215,0±49,7 minutes while 158,0±5,7 minutes in the con
{"title":"FEATURES OF HAEMOSTASIS IN DIFFERENT TYPES OF 24 HOURS DAY'S PROFILE OF BLOOD PRESSURE IN HYPERTENSIVE PATIENTS OF DIFFERENT AGE GROUPS","authors":"V. Pasko","doi":"10.32345/2664-4738.2.2022.03","DOIUrl":"https://doi.org/10.32345/2664-4738.2.2022.03","url":null,"abstract":"Relevance. The phenomenon of non-dipper (insufficient nocturnal decrease in blood pressure) has prognostic significance for increasing the risk of complications of arterial hypertension - myocardial infarction, stroke. To date, there are only isolated reports of platelet hemostasis in this category of individuals. Therefore, it is important to find out the peculiarities of state of platelet aggregation depending on circadian rhythm of blood pressure (BP). \u0000Objective is to identify the baseline level of platelet and plasma hemostasis at different 24 hours day's blood pressure profiles in middle-aged and elderly hypertensive patients. \u0000Materials and methods. Subjects (n=90) are divided into 3 groups. Group 1 (n=30) included middle-aged hypertensive patients (45-59 years), group 2 (n=30) − elderly hypertensive (60-74 years) patients. Patients are divided into two subgroups in each of these groups, 15 people in each: subgroup dipper (D) − with adequate nocturnal blood pressure reduction (10-20 %) and subgroup non-dipper (ND) − with insufficient nocturnal blood pressure reduction (<10 %). The control group (n = 30) consisted of 15 patients without arterial hypertension for each of the examined groups. \u0000The state of spontaneous and induced platelet aggregation was determined. Adenosine diphosphate (1´10-5 mM/L) and adrenaline (1 µg/mL) were used as aggregation inducers on SOLAR AP-2110 optical aggregometer. The following parameters of aggregatograms were calculated: amplitude of spontaneous and induced aggregation (AA, %); time of maximal aggregation (TMA, min.); slope of aggregation (SA, %/min.). The state of plasma hemostasis was determined on hemocoagulometer Amelung KC 1A. The following parameters were determined to assess state of plasma hemostasis: fibrinogen (FG, g/L), antithrombin III (AT-III, %), fibrinolysis (min.). \u0000Results. The increase in induced platelet aggregation activity was found in middle-aged hypertensive patients. In subgroup D AA was 1,9 times and in subgroup ND – 2,3 times higher than the norm; the rate of SA increased by 105,5 % and 112 %, respectively. In subgroup ND compared with subgroup D AA was higher by 21 % and SA − by 3,2 %. \u0000In elderly hypertensive patients, the rate of spontaneous aggregation AA is 1,7 times higher in subgroup ND compared with subgroup D (4,2±1,6 % vs. 2,5±0,2 %). In the ND subgroup AA rate is 68 % higher than in the control. Indicators of induced platelet aggregation were also higher in subgroup ND compared with subgroup D: AA with induction of ADP – 74,7±25,1 % vs. 51,4±22,2 %; TMA with adrenaline induction – 8,2±2,6 minutes against 5,7±2,5 minutes, respectively. There was the significant reduction in TMA with adrenaline-induced aggregation by 30,5 % in subgroup D compared with the control also. \u0000Fibrinolysis activity in middle-aged hypertensive patients in subgroup D was slowed down by 36,1% compared with the control group: fibrinolysis was 215,0±49,7 minutes while 158,0±5,7 minutes in the con","PeriodicalId":52737,"journal":{"name":"Medichna nauka Ukrayini","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47006190","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 : 2022-06-30DOI: 10.32345/2664-4738.2.2022.05
T. Andreeva, O. Stoyanov, G. Chebotaryova, O. А. Hruzevskyi, A. Stoianov, L.D. Chikur, O. Kozishkurt
Relevance. Spinal stenosis is a common manifestation of degenerative-dystrophic lesions of the cervical spine (CS). In most cases it occurs with the development of neurological complications in the form of secondary spondylogenic myelopathy, radicular dysfunction, pain. Isolated studies indicate that this type of damage occurs in some animals. Objective: a comparative analysis of clinical, radiological and morphometric data on degenerative-dystrophic lesions in human and domestic animals on the background of degenerative changes in bone structures that provoke stenosis of the spinal canal with the development of spondylogenic myelopathy. Material and methods. The retrospective analysis included 65 patients (25 men, 40 women) with neurological symptoms who underwent computed tomography during 2018-2021. Prospectively, a study was performed with the participation of 75 domestic animals with similar symptoms (19 dogs of large breeds weighing more 20 kg, 42 dogs of small and medium breeds weighing less 20 kg, and 14 cats. Results. There was a close correlation of symptoms in humans and large dogs in the presence and degree of narrowing of the canal: in cases of stenosis of the ventricles in humans (75.3%), large breeds of dogs (78.9%), patients had similar neurological symptoms. The maximum decrease in the sagittal diameter of the spinal canal was found more at the level of the C6 vertebral body in both humans and animals, weighing more than 20 kg. The mass share of stenotic changes was mainly registered in men (84.0% vs. 70.0% in women). In addition, according to the Pavlov-Torg morphometric index, the width of the spinal canal in men was smaller than in women. Stenosis of the spinal canal was mainly registered in large breeds of dogs (78.9%), which almost completely coincided with the morphometry in humans (75.4%). Conclusions. The data of our research indicate the possibility of using large breeds of dogs in predicting the course of degenerative-dystrophic changes in humans, because physiological and pathophysiological processes in dogs are on average 7 times faster than in humans. The severity of the process, the clinic and morphometric data of CS animals depend on the species, breed, weight, age, and common factors in the development of degenerative-dystrophic changes in humans and some groups of animals may be aging in general and the spine in particular.
的相关性。椎管狭窄是颈椎退行性营养不良病变(CS)的常见表现。在大多数情况下，它与继发性脊椎病、神经根功能障碍、疼痛等神经系统并发症一起发生。个别研究表明，这种类型的损害发生在一些动物身上。目的:比较分析人类和家畜的退行性营养不良病变的临床、放射学和形态学资料，其背景是骨结构的退行性改变导致椎管狭窄，并伴有脊髓型颈椎病的发展。材料和方法。回顾性分析包括65名患有神经系统症状的患者(25名男性，40名女性)，他们在2018-2021年期间接受了计算机断层扫描。前瞻性研究纳入了75只具有类似症状的家畜(19只体重在20公斤以上的大型犬，42只体重在20公斤以下的中小型犬和14只猫)。结果。人类和大型犬的症状与椎管狭窄的存在和程度密切相关:在人类(75.3%)和大型犬(78.9%)的脑室狭窄病例中，患者有相似的神经系统症状。椎管矢状直径的最大减少在C6椎体水平处发现，在人类和动物中，体重超过20 kg。狭窄性病变主要发生在男性(84.0% vs. 70.0%)。此外，根据巴甫洛夫-托格形态测量指数，男性的椎管宽度比女性小。椎管狭窄主要发生在大型犬(78.9%)，这与人类(75.4%)的形态学几乎完全一致。结论。我们的研究数据表明，由于狗的生理和病理生理过程平均比人类快7倍，使用大型犬种来预测人类退行性营养不良变化的过程是可能的。CS动物的严重程度、临床和形态测量数据取决于物种、品种、体重、年龄和人类发生退行性营养不良变化的共同因素，一些动物群体可能普遍衰老，尤其是脊柱。
{"title":"CLINICAL-MORPHOMETRIC RATIO OF DEGENERATIVE-DYSTROPHIC PROCESSES OF THE CERVICAL SPINE IN HUMANS AND ANIMALS IN SPINAL CHANNEL STENOSIS","authors":"T. Andreeva, O. Stoyanov, G. Chebotaryova, O. А. Hruzevskyi, A. Stoianov, L.D. Chikur, O. Kozishkurt","doi":"10.32345/2664-4738.2.2022.05","DOIUrl":"https://doi.org/10.32345/2664-4738.2.2022.05","url":null,"abstract":"Relevance. Spinal stenosis is a common manifestation of degenerative-dystrophic lesions of the cervical spine (CS). In most cases it occurs with the development of neurological complications in the form of secondary spondylogenic myelopathy, radicular dysfunction, pain. Isolated studies indicate that this type of damage occurs in some animals. \u0000Objective: a comparative analysis of clinical, radiological and morphometric data on degenerative-dystrophic lesions in human and domestic animals on the background of degenerative changes in bone structures that provoke stenosis of the spinal canal with the development of spondylogenic myelopathy. \u0000Material and methods. The retrospective analysis included 65 patients (25 men, 40 women) with neurological symptoms who underwent computed tomography during 2018-2021. Prospectively, a study was performed with the participation of 75 domestic animals with similar symptoms (19 dogs of large breeds weighing more 20 kg, 42 dogs of small and medium breeds weighing less 20 kg, and 14 cats. \u0000Results. There was a close correlation of symptoms in humans and large dogs in the presence and degree of narrowing of the canal: in cases of stenosis of the ventricles in humans (75.3%), large breeds of dogs (78.9%), patients had similar neurological symptoms. The maximum decrease in the sagittal diameter of the spinal canal was found more at the level of the C6 vertebral body in both humans and animals, weighing more than 20 kg. The mass share of stenotic changes was mainly registered in men (84.0% vs. 70.0% in women). In addition, according to the Pavlov-Torg morphometric index, the width of the spinal canal in men was smaller than in women. Stenosis of the spinal canal was mainly registered in large breeds of dogs (78.9%), which almost completely coincided with the morphometry in humans (75.4%). \u0000Conclusions. The data of our research indicate the possibility of using large breeds of dogs in predicting the course of degenerative-dystrophic changes in humans, because physiological and pathophysiological processes in dogs are on average 7 times faster than in humans. The severity of the process, the clinic and morphometric data of CS animals depend on the species, breed, weight, age, and common factors in the development of degenerative-dystrophic changes in humans and some groups of animals may be aging in general and the spine in particular.","PeriodicalId":52737,"journal":{"name":"Medichna nauka Ukrayini","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44504184","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 : 2022-06-30DOI: 10.32345/2664-4738.2.2022.08
H.V. Mostbauer, M. Dzhus
Relevance. Nonspecific aortoarteritis (NAA) or Takayasu's disease can exacerbate life-threatening arteritis of the pulmonary artery (LA), which is usually diagnosed with delay and lead to a poor prognosis. Objective: to review the literature data on LA lesions in NAA to improve the diagnosis and timely appointment of appropriate treatment for better the prognosis of the overall outcome. Methods. Review of scientific literature in international electronic databases PubMed, Google Scholar by keywords for the period 2007-2022. The search was conducted by two independent authors. 90 sources were selected for analysis, of which 43 were used, which were written in English and met the search criteria. Results. In NAA, LA lesions are not a rare pathology, which is observed in 5.7-66% of cases. LA arteritis can manifest itself in the form of stenosis, occlusion, dilatation, aneurysm, thrombosis in situ, and thickening of the arteries. When LA is involved in the pathological process, the risk of developing pulmonary hypertension (LH), heart failure, and lung parenchymal lesions increases, which worsens the prognosis of such patients. The pathology of LA is often diagnosed with a delay due to nonspecific symptoms. It should be noted that in NAA LH can develop not only due to LA arteritis but also due to the presence of pathology in the left heart. Conclusions. LA lesions are common in patients with NAA, however, are often diagnosed with a delay. Involvement of LA in the pathological process can lead to the development of LH, HF, and lung parenchymal lesions and worsen the prognosis, so early diagnosis and timely appropriate treatment are important to reduce morbidity and mortality due to LA lesions in NAA. In addition, pulmonary blood flow and intracardiac hemodynamics should be monitored regularly.
{"title":"PULMONARY ARTERY INFLAMMATION IN NON-SPECIFIC AORTOARTERITIS. Review","authors":"H.V. Mostbauer, M. Dzhus","doi":"10.32345/2664-4738.2.2022.08","DOIUrl":"https://doi.org/10.32345/2664-4738.2.2022.08","url":null,"abstract":"Relevance. Nonspecific aortoarteritis (NAA) or Takayasu's disease can exacerbate life-threatening arteritis of the pulmonary artery (LA), which is usually diagnosed with delay and lead to a poor prognosis. \u0000Objective: to review the literature data on LA lesions in NAA to improve the diagnosis and timely appointment of appropriate treatment for better the prognosis of the overall outcome. \u0000Methods. Review of scientific literature in international electronic databases PubMed, Google Scholar by keywords for the period 2007-2022. The search was conducted by two independent authors. 90 sources were selected for analysis, of which 43 were used, which were written in English and met the search criteria. \u0000Results. In NAA, LA lesions are not a rare pathology, which is observed in 5.7-66% of cases. LA arteritis can manifest itself in the form of stenosis, occlusion, dilatation, aneurysm, thrombosis in situ, and thickening of the arteries. When LA is involved in the pathological process, the risk of developing pulmonary hypertension (LH), heart failure, and lung parenchymal lesions increases, which worsens the prognosis of such patients. The pathology of LA is often diagnosed with a delay due to nonspecific symptoms. It should be noted that in NAA LH can develop not only due to LA arteritis but also due to the presence of pathology in the left heart. \u0000Conclusions. LA lesions are common in patients with NAA, however, are often diagnosed with a delay. Involvement of LA in the pathological process can lead to the development of LH, HF, and lung parenchymal lesions and worsen the prognosis, so early diagnosis and timely appropriate treatment are important to reduce morbidity and mortality due to LA lesions in NAA. In addition, pulmonary blood flow and intracardiac hemodynamics should be monitored regularly.","PeriodicalId":52737,"journal":{"name":"Medichna nauka Ukrayini","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46386309","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 : 2022-06-30DOI: 10.32345/2664-4738.2.2022.07
V. Moskalyuk, Y. Randiuk, B. V. Syrota, I. Balanyuk
Relevance. The outbreak of new coronavirus disease (COVID-19) caused by SARS-CoV-2 is the biggest medical problem of the 21st century. Every year, humanity is faced with new diseases of viral etiology, the unpredictable occurrence and severe manifestations of which often lead to the stupor of scientists and physicians around the world. Although the virus primarily affects the lungs, and the clinical manifestations of the disease are dominated by respiratory symptoms, but it significantly affects the risk of development and clinical course of cardiovascular disease. It should be noted that heart disease with COVID-19 can be observed in patients with chronic diseases of the cardiovascular system, as well as in patients who had no signs of heart disease before this infection. Objective: to consider current data on cardiovascular disease in patients with COVID-19. Methods. Analysis of latest data presented in PubMed by keywords "COVID-19", "SARS-CoV-2", "pandemic", "cardiovascular disease", "myocardial infarction". Search depth – 2 years (2020-2022), with retrospective deepening of some positions until 2003. Results. Coronavirus interacts with the cardiovascular system on many levels, increasing the incidence of patients with concomitant cardiovascular disease and provoking myocardial damage and dysfunction. In addition, cardiovascular disease in patients with coronavirus disease may pose an increased risk of mortality. Therefore, an understanding of the damage to SARS-CoV-2 to the cardiovascular system and its underlying mechanisms is of the utmost importance to ensure that the treatment of these patients is timely and effective and that mortality is reduced. Conclusions. COVID-19, caused by SARS-CoV-2, is a global pandemic that is evolving in real time. Concomitant cardiovascular disease is common in patients on COVID-19, and these patients have a higher risk of morbidity and mortality. Therefore, in addition to routine examinations for coronavirus disease, patients with cardiovascular disease should receive ancillary studies of the heart and blood vessels, such as cardiac biomarkers, cardiac imaging, electrocardiography, echocardiography and angiography.
{"title":"CARDIOVASCULAR SYSTEM INJURIES IN PATIENTS WITH COVID-19. Review","authors":"V. Moskalyuk, Y. Randiuk, B. V. Syrota, I. Balanyuk","doi":"10.32345/2664-4738.2.2022.07","DOIUrl":"https://doi.org/10.32345/2664-4738.2.2022.07","url":null,"abstract":"Relevance. The outbreak of new coronavirus disease (COVID-19) caused by SARS-CoV-2 is the biggest medical problem of the 21st century. \u0000Every year, humanity is faced with new diseases of viral etiology, the unpredictable occurrence and severe manifestations of which often lead to the stupor of scientists and physicians around the world. Although the virus primarily affects the lungs, and the clinical manifestations of the disease are dominated by respiratory symptoms, but it significantly affects the risk of development and clinical course of cardiovascular disease. It should be noted that heart disease with COVID-19 can be observed in patients with chronic diseases of the cardiovascular system, as well as in patients who had no signs of heart disease before this infection. \u0000Objective: to consider current data on cardiovascular disease in patients with COVID-19. \u0000Methods. Analysis of latest data presented in PubMed by keywords \"COVID-19\", \"SARS-CoV-2\", \"pandemic\", \"cardiovascular disease\", \"myocardial infarction\". Search depth – 2 years (2020-2022), with retrospective deepening of some positions until 2003. \u0000Results. Coronavirus interacts with the cardiovascular system on many levels, increasing the incidence of patients with concomitant cardiovascular disease and provoking myocardial damage and dysfunction. In addition, cardiovascular disease in patients with coronavirus disease may pose an increased risk of mortality. Therefore, an understanding of the damage to SARS-CoV-2 to the cardiovascular system and its underlying mechanisms is of the utmost importance to ensure that the treatment of these patients is timely and effective and that mortality is reduced. \u0000Conclusions. COVID-19, caused by SARS-CoV-2, is a global pandemic that is evolving in real time. Concomitant cardiovascular disease is common in patients on COVID-19, and these patients have a higher risk of morbidity and mortality. Therefore, in addition to routine examinations for coronavirus disease, patients with cardiovascular disease should receive ancillary studies of the heart and blood vessels, such as cardiac biomarkers, cardiac imaging, electrocardiography, echocardiography and angiography.","PeriodicalId":52737,"journal":{"name":"Medichna nauka Ukrayini","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42331284","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 : 2022-06-30DOI: 10.32345/2664-4738.2.2022.09
O. Pankova
Relevance. Cardiovascular diseases occupy leading positions in the structure of morbidity and mortality both in Ukraine and in other countries. Metabolic disorders are one of the leading risk factors for the development and progression of cardiovascular diseases. In accordance with the above-mentioned special attention should be paid to catestatin, which regulates carbohydrate and lipid metabolism, that determines its diagnostic potential in the management of diseases, which are accompanied by metabolic dysregulation. Objective: Determination of the diagnostic potential of catestatin in the management of diseases associated with metabolic disorders such as type 2 diabetes mellitus, obesity and metabolic syndrome, in accordance with its role in the regulation of metabolic homeostasis based on the analysis of data literature sources. Methods. Analysis of the research results by reviewing electronic scientometric databases PubMed and Google Scholar by keywords. Results. The influence of catestatin on the pathogenetic mechanisms of cardiometabolic diseases is analyzed. The general characteristic of catestatin and its physiological properties is given. The effect of catestatin on carbohydrate metabolism due to its insulin-like action is studied, which in combination with antioxidant, immunomodulatory and anti-inflammatory action of catestatin determines its role in the regulation of glucose metabolism. The property of catestatin to regulate cardiometabolic homeostasis by modulating the bioenergetic activity of the myocardium is noted. Mechanisms of regulation of fat metabolism by catestatin are established, in particular, realization of its lipolytic effect due to suppression of α2-adrenoreceptors and regulation of adrenergic and leptin signaling. Correlations between catestatin levels and lipid profile and anthropometric data are considered. Typical changes in catestatin levels at the development of cardiometabolic diseases are defined. Conclusions. Catestatin has metabolic effects, in particular, participates in the regulation of carbohydrate and lipid metabolism, which determines its prognostic role in the development and progression of cardiometabolic diseases.
{"title":"THE ROLE OF CATESTATIN IN THE REGULATION OF METABOLIC DISORDERS. Review","authors":"O. Pankova","doi":"10.32345/2664-4738.2.2022.09","DOIUrl":"https://doi.org/10.32345/2664-4738.2.2022.09","url":null,"abstract":"Relevance. Cardiovascular diseases occupy leading positions in the structure of morbidity and mortality both in Ukraine and in other countries. Metabolic disorders are one of the leading risk factors for the development and progression of cardiovascular diseases. In accordance with the above-mentioned special attention should be paid to catestatin, which regulates carbohydrate and lipid metabolism, that determines its diagnostic potential in the management of diseases, which are accompanied by metabolic dysregulation. \u0000Objective: Determination of the diagnostic potential of catestatin in the management of diseases associated with metabolic disorders such as type 2 diabetes mellitus, obesity and metabolic syndrome, in accordance with its role in the regulation of metabolic homeostasis based on the analysis of data literature sources. \u0000Methods. Analysis of the research results by reviewing electronic scientometric databases PubMed and Google Scholar by keywords. \u0000Results. The influence of catestatin on the pathogenetic mechanisms of cardiometabolic diseases is analyzed. The general characteristic of catestatin and its physiological properties is given. The effect of catestatin on carbohydrate metabolism due to its insulin-like action is studied, which in combination with antioxidant, immunomodulatory and anti-inflammatory action of catestatin determines its role in the regulation of glucose metabolism. The property of catestatin to regulate cardiometabolic homeostasis by modulating the bioenergetic activity of the myocardium is noted. Mechanisms of regulation of fat metabolism by catestatin are established, in particular, realization of its lipolytic effect due to suppression of α2-adrenoreceptors and regulation of adrenergic and leptin signaling. Correlations between catestatin levels and lipid profile and anthropometric data are considered. Typical changes in catestatin levels at the development of cardiometabolic diseases are defined. \u0000Conclusions. Catestatin has metabolic effects, in particular, participates in the regulation of carbohydrate and lipid metabolism, which determines its prognostic role in the development and progression of cardiometabolic diseases.","PeriodicalId":52737,"journal":{"name":"Medichna nauka Ukrayini","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46522248","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 : 2022-06-30DOI: 10.32345/2664-4738.2.2022.02
Удк, Оцінка Ефективності, Назогастрального Харчування, У Хворих, З Тяжким Перебігом, Гострого Панкреатиту
Relevance. Early onset of enteral nutrition (up to 48 hours after hospitalization) in patients with severe acute pancreatitis is associated with a 24% reduction in infectious complications and a 32% reduction in mortality. Data on the possibility of nasogastric tube feeding remain contradictory. Objective: comparison of the effectiveness and safety of nasogastric administration of food mixtures in patients with severe acute pancreatitis. Methods. The study included 103 patients with severe acute pancreatitis, which were divided depending on the characteristics of the chosen treatment tactics into three groups: based group (nasogastric nutrition was performed) - 34 patients, comparison group #1 (standard enteral nutrition) - 33 patients and comparison group #2 (parenteral nutrition) - 36 patients. To analyze the effectiveness of nutritional support in the study groups after 7 and 14 days from the beginning of treatment, the level of laboratory parameters was assessed, the incidence of local complications, mortality, duration of multiorgan failure and hospital stay were analyzed. Results. After 7 and 14 days of nutritional support, a significant difference was found between total protein, albumin, creatinine, urea, cholesterol, glucose and serum Na + (p<0.05) between patients in the main group and comparison group #2, with the level of cholesterol, K + and Na + corresponded to the norm in both groups. There was also a significant difference in the incidence of infected local complications of severe acute pancreatitis in the main group and comparison group #2 - 35.3% and 61.1%, respectively (χ2=4.59, 95% CI 2.43-45.53, p=0.03), duration of multiorgan failure - 12.2±1.7 [8-16] days and 15.3±1.1 [13-18] days, respectively (p<0.001), duration of hospital stay - 55.5±30.5 [27-124] days and 71.5±35.9 [35-148] days, respectively (p=0.04) and fatalities - 14.7% and 36.1%, respectively (χ2=4.13, 95 % CI 0.81-39.68, p=0.04). When comparing these indicators between the main group and the comparison group #1 no significant difference was obtained (p>0.05). Conclusions. Nasogastric nutrition is an effective and safe method of administration of mixtures in patients with severe acute pancreatitis and can be considered as an alternative to enteral nutrition.
{"title":"EVALUATION OF THE EFFICIENCY OF NASOGASTRAL NUTRITION IN PATIENTS WITH SEVERE ACUTE PANCREATITIS","authors":"Удк, Оцінка Ефективності, Назогастрального Харчування, У Хворих, З Тяжким Перебігом, Гострого Панкреатиту","doi":"10.32345/2664-4738.2.2022.02","DOIUrl":"https://doi.org/10.32345/2664-4738.2.2022.02","url":null,"abstract":"Relevance. Early onset of enteral nutrition (up to 48 hours after hospitalization) in patients with severe acute pancreatitis is associated with a 24% reduction in infectious complications and a 32% reduction in mortality. Data on the possibility of nasogastric tube feeding remain contradictory. \u0000Objective: comparison of the effectiveness and safety of nasogastric administration of food mixtures in patients with severe acute pancreatitis. \u0000Methods. The study included 103 patients with severe acute pancreatitis, which were divided depending on the characteristics of the chosen treatment tactics into three groups: based group (nasogastric nutrition was performed) - 34 patients, comparison group #1 (standard enteral nutrition) - 33 patients and comparison group #2 (parenteral nutrition) - 36 patients. To analyze the effectiveness of nutritional support in the study groups after 7 and 14 days from the beginning of treatment, the level of laboratory parameters was assessed, the incidence of local complications, mortality, duration of multiorgan failure and hospital stay were analyzed. \u0000Results. After 7 and 14 days of nutritional support, a significant difference was found between total protein, albumin, creatinine, urea, cholesterol, glucose and serum Na + (p<0.05) between patients in the main group and comparison group #2, with the level of cholesterol, K + and Na + corresponded to the norm in both groups. There was also a significant difference in the incidence of infected local complications of severe acute pancreatitis in the main group and comparison group #2 - 35.3% and 61.1%, respectively (χ2=4.59, 95% CI 2.43-45.53, p=0.03), duration of multiorgan failure - 12.2±1.7 [8-16] days and 15.3±1.1 [13-18] days, respectively (p<0.001), duration of hospital stay - 55.5±30.5 [27-124] days and 71.5±35.9 [35-148] days, respectively (p=0.04) and fatalities - 14.7% and 36.1%, respectively (χ2=4.13, 95 % CI 0.81-39.68, p=0.04). When comparing these indicators between the main group and the comparison group #1 no significant difference was obtained (p>0.05). \u0000Conclusions. Nasogastric nutrition is an effective and safe method of administration of mixtures in patients with severe acute pancreatitis and can be considered as an alternative to enteral nutrition.","PeriodicalId":52737,"journal":{"name":"Medichna nauka Ukrayini","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43416093","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 : 2022-06-30DOI: 10.32345/2664-4738.2.2022.11
K. Maidenko
Relevance. Primary open-angle glaucoma (POAG) is a progressive optic neuropathy with loss of retinal ganglion cells (RGCs) and narrowing of the visual fields in the eyes with a gonioscopic open angle. The main mechanisms of this are increased intraocular pressure (IOP), circulatory disorders, trabecular meshwork (TM), ischemic metabolic disorders and chronic inflammation. However, questions about the role of POAG genetic predisposition remain open. Objective: analysis of current data on the mechanisms of pathogenesis of progressive neuropathy in POAG and the role of genetic predisposition. Methods. The analysis of scientific publications in open international electronic scientometric databases: Scopus, PubMed, Web of Science, Google Scholar, SID, MagIran, IranMedex, IranDoc, ScienceDirect, Embase by keywords (a total of 67 sources). Search depth – 10 years (2012-2022). Results. There are more than 60 million glaucoma patients in the world, 20% of whom have an incurable stage. By 2040, the number of patients is projected to increase to 112 million, with POAG accounting for 75% of cases. Among the main mechanisms of glaucoma, an important role belongs to chronic inflammation and immune damage, which occur in response to ischemic injury. Prolonged inflammatory process leads to hypersecretion of inflammatory mediators and infiltration of inflammatory cells into ischemic tissue, which aggravates the effects of increased IOP and ischemia. It is known that mutations in the gene of Toll-like receptor 4 (TLR4) are associated with both infectious and non-infectious diseases, including POAG: activation of TLR4 initiates TM fibrosis, causes increased IOP, activates RGCs apoptosis in the model of acute glaucoma. TLR4 ligands, such as heat shock proteins and lipopolysaccharides are candidate antigens for glaucoma. TLR4 overexpression at retinal microglia and astrocytes induce an innate immune response through NF-κB activation, which enhances the expression of proinflammatory cytokines. Conclusions. A promising direction is to study the contribution of TLR4 mutations to the POAG mechanisms, which will identify the mechanisms of immune disorders and establish the genetic risk of individual mutations in different ethnic groups.
的相关性。原发性开角型青光眼(POAG)是一种进行性视神经病变，伴有视网膜神经节细胞(RGCs)的丧失和视野狭窄。其主要机制为眼压升高、循环系统紊乱、小梁网紊乱、缺血性代谢紊乱和慢性炎症。然而，关于POAG遗传易感性的作用仍然存在疑问。目的:分析目前有关POAG进行性神经病变发病机制及遗传易感性的研究资料。方法。对开放的国际电子科学计量数据库Scopus、PubMed、Web of Science、b谷歌Scholar、SID、MagIran、IranMedex、IranDoc、ScienceDirect、Embase中的科学出版物进行关键词分析(共67个来源)。搜索深度- 10年(2012-2022)。结果。世界上有6000多万青光眼患者，其中20%处于无法治愈的阶段。到2040年，预计患者数量将增加到1.12亿，其中POAG占75%。在青光眼发生的主要机制中，慢性炎症和免疫损伤是对缺血性损伤的反应，具有重要作用。炎症过程延长导致炎症介质大量分泌，炎症细胞向缺血组织浸润，加重IOP升高和缺血的影响。已知toll样受体4 (TLR4)基因突变与感染性和非感染性疾病均相关，包括POAG:在急性青光眼模型中，TLR4的激活引发TM纤维化，导致IOP升高，激活RGCs凋亡。TLR4配体如热休克蛋白和脂多糖是青光眼的候选抗原。TLR4在视网膜小胶质细胞和星形胶质细胞中的过表达通过激活NF-κB诱导先天免疫反应，从而增强促炎细胞因子的表达。结论。研究TLR4突变对POAG机制的贡献是一个有希望的方向，这将有助于确定免疫疾病的机制，并确定不同种族个体突变的遗传风险。
{"title":"PRIMARY OPEN ANGLE GLAUCOMA: MECHANISMS OF PATHOGENESIS AND GENETIC PREDISPOSITION. Review","authors":"K. Maidenko","doi":"10.32345/2664-4738.2.2022.11","DOIUrl":"https://doi.org/10.32345/2664-4738.2.2022.11","url":null,"abstract":"Relevance. Primary open-angle glaucoma (POAG) is a progressive optic neuropathy with loss of retinal ganglion cells (RGCs) and narrowing of the visual fields in the eyes with a gonioscopic open angle. The main mechanisms of this are increased intraocular pressure (IOP), circulatory disorders, trabecular meshwork (TM), ischemic metabolic disorders and chronic inflammation. However, questions about the role of POAG genetic predisposition remain open. \u0000Objective: analysis of current data on the mechanisms of pathogenesis of progressive neuropathy in POAG and the role of genetic predisposition. \u0000Methods. The analysis of scientific publications in open international electronic scientometric databases: Scopus, PubMed, Web of Science, Google Scholar, SID, MagIran, IranMedex, IranDoc, ScienceDirect, Embase by keywords (a total of 67 sources). Search depth – 10 years (2012-2022). \u0000Results. There are more than 60 million glaucoma patients in the world, 20% of whom have an incurable stage. By 2040, the number of patients is projected to increase to 112 million, with POAG accounting for 75% of cases. Among the main mechanisms of glaucoma, an important role belongs to chronic inflammation and immune damage, which occur in response to ischemic injury. Prolonged inflammatory process leads to hypersecretion of inflammatory mediators and infiltration of inflammatory cells into ischemic tissue, which aggravates the effects of increased IOP and ischemia. It is known that mutations in the gene of Toll-like receptor 4 (TLR4) are associated with both infectious and non-infectious diseases, including POAG: activation of TLR4 initiates TM fibrosis, causes increased IOP, activates RGCs apoptosis in the model of acute glaucoma. TLR4 ligands, such as heat shock proteins and lipopolysaccharides are candidate antigens for glaucoma. TLR4 overexpression at retinal microglia and astrocytes induce an innate immune response through NF-κB activation, which enhances the expression of proinflammatory cytokines. \u0000Conclusions. A promising direction is to study the contribution of TLR4 mutations to the POAG mechanisms, which will identify the mechanisms of immune disorders and establish the genetic risk of individual mutations in different ethnic groups.","PeriodicalId":52737,"journal":{"name":"Medichna nauka Ukrayini","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46777919","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：