2nd Degrees Research Articles

THE COHORT STUDY OF ADIPOCYTES’ SECRETORY ACTIVITY, VITAMIN D, PARATHYROID HORMONE, LEPTIN RESISTANCE AND OBESITY IN HYPERTENSIVE PATIENTS

Objective: Obesity is a major risk factor of essential arterial hypertension (EAH). Therefore, we studied the dependence of 25-OH vitamin D (VitD), parathyroid hormone (PTH), Adiponectine, Leptin and ionized calcium blood values on Obesity degrees in EAH patients. Design and method: Study involves 100 EAH patients with hypertensive-mediated organ damage (moderate-very-high cardiovascular risks, aged 45-65). Obesity was determined by body mass index (BMI) >30 kg/m2: 1st obesity degree – 30-34.9 kg/m2, 2nd – 35-39.9 kg/m2, 3rd – >40 kg/m2. Serum levels of VitD and PTH studied by immunochemiluminescent method, Ca2+– by potentiometric method, Adiponectine and Leptin blood values – by ELISA. Leptin resistance (LR) index calculated by Leptin to Triglycerides Ratio (LTR). Adipocytes Secretory Activity (ASA) calculated by Leptin to BMI Ratio. Results: Adiponectin in EAH with obesity was lower, and leptin, on the contrary, was higher than in EAH without obesity – by 7.54-12.81% (p<0.001) and 1.75-2.63 times (p<0.001) respectively. LR and ASA indexes increased in presence of obesity 1.5-2.2 times (p<0.001) and 1.47-1.85 times (p<0.001), respectively. Adipocytokines concentration depended on the obesity: in 2nd and 3rd degrees EAH patients lower by 5.98% (p<0.001), and leptin, on the contrary, was higher by 50.18% (p<0.001), than in the case of 1st degree obesity, leading to LR and adipocytes’ secretory activity growth by 46.88% (p=0.018) and 26% (p=0.004). In EAH patients with 2nd and 3rd obesity degrees, concentration of 25(OH)VitD was lower by 18.48% (p=0.012), and PTH, was higher by 31.62% (p=0.017), than in obesity-free. Ionized calcium level did not depend on the obesity. Obesity risk in EAH elevated with blood adiponectin decrease (<75ng/ml) by 77 times [OR: 16.25-364.8; p<0.001], leptin augmentation (in women >21 ng/ml, in men >14 ng/ml) – 31 times [OR: 3.93-245.48; p<0.001], LR index increase (>15.0 U) – 5.27 times [OR: 2.04-13.60; p<0.001] and adipocytes’ secretory activity (>0.70 U) – 34.1 times [OR: 4.32-268.7; p<0.001]. Conclusions: Low Adiponectine, Leptin elevation, LR and ASA augmentation increase the obesity risk in EAH 5-77 times (p<0.001). The 2nd and 3rd obesity degrees associate with lower 25(OH)VitD, higher PTH (p<0.05), independetly on ionized calcium.

The role of matrix metalloproteinase-9 and the tissue inhibitor of metalloproteinase — 1 in endogenous uveitis in children

Purpose: to determine the content of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinases — 1 (TIMP-1) in the tear and blood serum (BS) and to analyze how these parameters correlate with the clinical course of endogenous uveitis in children.Materials and methods. 131 eyes with uveitis of 74 patients aged 3 to 17 (mean age 10.57 ± 3.29 years) were examined. The content of MMP-9 was found in 281 samples of the tear and 48 samples of BS. The dynamics of MMP-9 in the tear was studied in 55 patients (100 eyes), in BS — in 9 children. The content of TIMP-1 was studied in 173 tear samples and 25 BS samples. The dynamics of TIMP-1 was studied in the tear of 31 patients (56 eyes). The concentration of MMP-9 and TIMP-1 was determined by enzyme immunoassay (ELISA) using the kits ELISA for MMP-9/ELISA for tissue metalloproteinase inhibitor 1 (Cloud clone corporation, USA).Results. The content of MMP-9 in the tear dropped compared to the control group (p = 0.09). The highest content of MMP-9 in panuveitis was found in the tear as compared to the anterior and intermediate uveitis (p = 0.01). The highest MMP-9 concentration was found in cases of 3rd degree of proliferation, in contrast to the 1st and 2nd degrees (p = 0.16). An increased content of TIMP-1 was found in the tear in subactive/intermediate uveitis in contrast to inactive uveitis (p=0.08). An imbalance of MMP-9 was revealed in relation to TIMP-1 in the tears. In the early postoperative period, an increase in the content of MMP-9 and a decrease in TIMP-1 in the tear returning to the initial level was noted, which corresponds to normal wound healing.Conclusion. An increase in the content of TIMP-1 in the tear is associated with subactive/intermediate uveitis. The content of MMP-9 in the tear correlates with the proliferative process stage. A higher MMP-9 content in the tear in panuveitis, in contrast to the anterior and intermediate uveitis is associated with the involvement of all sections of the choroid of the eye into the inflammatory process. The decrease in the content of MMP-9 in the tears is probably explained by the inhibitory effect of glucocorticosteroid (GCS) therapy.

Compression Hemostasis in Refractory Esophageal Bleeding

RELEVANCE. Efficiency and safety of compression hemostasis with esophageal self-expanding nitinol stents Danis compared to the Sengstaken–Blakemore tube in the treatment program of refractory esophageal bleeding still remains a controversial issue. AIM OF THE STUDY. To conduct a comparative analysis of the effectiveness of Danis self-expanding compression hemostasis nitinol stent and the Sengstaken-Blakemore tube for variceal esophageal bleeding refractory to drug and endoscopic treatment. MATERIAL AND METHODS. The first comparison group included 44 patients, in whose complex treatment program tamponade with a Sengstaken-Blakemore tube was used to save lives. The second main group of the study consisted of 15 patients in whom compression hemostasis was performed using Danis self-expanding nitinol stent. Statistical processing was carried out using the Kolmogorov-Smirnov, Student, χ2 and Fisher exact tests. Differences were considered statistically significant at p ≤ 0.05. RESULTS. In the comparison group, complications occurred in 44 (100 %), in the main group complications were observed in 8 patients (53.3 %). Accordingly, reliable mechanical hemostasis was achieved in 33 (75.0 %) and 13 clinical observations (86.7 %); trophic changes in the esophageal mucosa were detected in 12 (27.2 %) and 8 patients (53.3 %). When assessing the function of external respiration, 5th and 2nd degrees of decrease in the ventilation capacity of the lungs, as well as 3rd and 1st degrees of decrease in the vital capacity of the lungs were established. The overall mortality was 56.8 % in the comparison group and 26.7 % in the main group. CONCLUSION. Self-expanding compression hemostasis nitinol stent Danis as a bridge to the choice of definitive therapy compared to tamponade with the Sengstaken–Blakemore tube is a promising alternative first-line treatment for patients with refractory esophageal bleeding. At the same time, it is necessary to conduct randomized controlled studies to confirm the safety and effectiveness of self-expanding nitinol stents.

Endoscopic and morphological features of chronic gastritis in patients with lumbar spine osteochondrosis.

Aim: of the study is to determine the endoscopic and morphological features of chronic gastritis (CG) in patients with lumbar spinal OC. Materials and Methods: 102 patients with lumbar spine OC and CG were examined. The patients were diagnosed with Helicobacter pylori (HP) infection, according to which the patients were divided into two groups: the first group included 92 HP-positive patients, the second group consisted of 10 HP-negative patients. Results: Among HP infected patients with lumbar spine OC, erosive gastropathy was most often diagnosed (in 40 (43.5%) of the examined), as well as erosive-papular and erosive-hemorrhagic gastropathy (in 14 (15.2%) and in 16 (17, 4 %) of patients, respectively), while erythematous gastropathy was more often diagnosed among HP-negative patients (in 7 (70.0 %) cases, respectively). Conclusions: 1. 90.2% of patients with lumbar spine OC and CG have been diagnosed with HP infection. 2. Endoscopically, the lesion of the stomach MM in patients with lumbar spine OC corresponds mainly to erosive and erosive-hemorrhagic forms of gastropathy. 3. During histological examination of stomach MM, mainly 2nd and 3rd degrees of inflammation were established, especially in patients with erosive, erosive-papular and erosive-hemorrhagic forms of gastropathy.

THE TYPICAL STATE MEDALS AND REWARDS AS AN OPTION OF ENCOURAGEMENT OF ODESA CITY MAYORS IN THE CITY SELF- GOVERNMENT STRUCTURE WITHIN THE PERIOD FROM THE SECOND HALF OF THE 19TH CENTURY TO THE BEGINNING OF THE 20TH CENTURY

The article considers one of the possible characteristics for encouraging the activity of historical figures in the professional field as awards and honors. Preference was given primarily to the state award system, which extended to various sectors of the population, including professional groups – elected positions of city mayors. In the second half of the 19th – at the beginning of the 20th century the municipal self-government of Odesa was headed by nine people – Semen Vorontsov, Mykola Novoselskyi, Grigory Marazli (Grigorios Maraslis), Valerian Ligin, Petro Kryzhanovskyi, Pavlo Zelenyi, Vasyl Protopopov, Mykola Moiseyev and Borys Pelikan. On the basis of the collected sources and the works of researchers, a list of the most typical state orders among the figures of city heads with a chronological reference and brief generalizations regarding the conditions of awarding was revealed. With the beginning of the creation of the post of city mayor, the duties performed did not provide for a normalized and regular financial reward, which is one of the motivating elements in the work process of a person. Awards were one of the options for encoura- gement – thanks from the government, provincial administration, national awards, distinctions, etc. According to the City Regulation of 1870, to represent the power and status of the mayor, was introduced a badge with the image of the city coat of arms on a large silver chain, with the right to the 5th category uniform of the Ministry of Internal Affairs to the heads of provincial cities and cities that were equated to them. Over the years of their life and various activities, Odessa mayors could receive many awards and distinctions that affected their status and position. Among the typical national awards, the following three orders were identified: St. Volodymyr (2nd and 3rd degrees), St. Anna (1st, 2nd and 3rd degrees) and St. Stanislav (1st degree). During the years of activity in the post of mayor, only five people received orders – M. Novoselskyi, G. Marazli, V. Ligin, M. Moiseyev and B. Pelikan. P. Zelenyi worked for a long time in self-governing institutions at the zemstvo level. P. Kryzhanovskyi and V. Protopopov are known for their professional judicial career, which contributed to receiving orders. The first mayor of the post-reform period, S. Vorontsov, was a military man, and he won his main awards on the battlefield.

Возможности хирургической коррекции спонтанной дислокации комплекса «интраокулярная линза – капсульный мешок», развившейся в различные сроки после факоэмульсификации возрастной катаракты

Purpose. Substantiation of surgical correction method of spontaneous dislocation of the complex «intraocular lens – capsular bag» (CICB), that developed after phacoemulsification (PE), in relation to its severity. Material and methods. The clinical material consisted of 28 patients (28 eyes) aged 61 to 89 years. The terms of spontaneous dislocation of CICB after PE performed widely varied from 3 months to 11 years, averaging 5 ± 2 years. According to our proposed classification degrees of severity spontaneous dislocation of CICB, its 1st degree took place in 8 eyes; 2nd – in 9 eyes; 3rd – in 16 eyes; 4th – in 3 eyes. Surgical correction was performed in all cases dislocation of CICB 2nd or more degrees, the volume of which was commensurate with the initial severity of the eye condition. Results. All operations were carried out as planned, without complications. The postoperative response of the eyes was assessed on the 1st and next days of the postoperative period. In all cases, it corresponded to the volume of performed surgical intervention. So, in 19 eyes, it corresponded to the 1st degree; in 6 eyes – 2nd degree; 3 eyes developed 3rd degree postoperative response of the eyes (postoperative uveitis). Indexes of uncorrected visual acuity on days 3–5 in 14 eyes (50 %) ranged from 0.05 to 0.4; in 8 eyes (29 %) we achieved indexes like they were immediately after PE. Conclusion. Thus, in our experience, the surgical correction of spontaneous dislocations of CICB of the 2–4th degrees has shown itself to be effective in all of these cases. Keywords: phacoemulsification, spontaneous dislocation of the «intraocular lens – capsule bag» complex, surgical treatment

Assessment of the Maximum Amount of Orthodontic Force for PDL in Intact and Reduced Periodontium (Part I).

This study examines 0.6 N and 1.2 N as the maximum orthodontic force for periodontal ligament (PDL) at multiple levels of periodontal breakdown, and the relationships with the ischemic, necrotic, and resorptive risks. Additionally, this study evaluates if Tresca failure criteria is more adequate for the PDL study. Eighty-one 3D models (from nine patients; nine models/patients) with the 2nd lower premolar and different degrees of bone loss (0-8 mm) where subjected to intrusion, extrusion, rotation, translation, and tipping movements. Tresca shear stress was assessed individually for each movement and bone loss level. Rotation and translation produced the highest PDL stresses, while intrusion and extrusion determined the lowest. Apical and middle third PDL stresses were lower than the cervical stress. In intact periodontium, the amount of shear stress produced by the two investigated forces was lower than the 16 KPa of the maximum physiological hydrostatic pressure (MHP). In reduced periodontium (1-8 mm tissue loss), the apical amount of PDL shear stress was lower than MHP for both applied forces, while cervically for rotation, translation and tipping movements exceeded 16 KPa. Additionally, 1.2 N could be used in intact periodontium (i.e., without risks) and for the reduced periodontium only in the apical and middle third of PDL up to 8 mm of bone loss. However, for avoiding any resorptive risks, in the cervical third of PDL, the rotation, translation, and tipping movements require less than 0.2-0.4 N of force after 4 mm of loss. Tresca seems to be more adequate for the study of PDL than other criteria.

PREVENTION OF REPRODUCTIVE LOSSES ASSOCIATED WITH INTRAPLANTAR ACCUMULATION OF RADIONUCLIDES.

to determine the effectiveness of radioprotective therapy in preventing reproductive losses and perinatal consequences associated with the incorporation of radionuclides in the placenta. According to the research design, the first group consisted of 153 women with reproductive losses in anamnesis and signs of termination of the current pregnancy. The control consisted of 30 women with a physiological pregnancy and an uncomplicated history. Based on the fact that one of the causes of premature termination of pregnancy is the vulnerable effect of 137Cs incorporated in the placenta, «Apple Pectin Antioxidant» (the «APA») with a high sorption potential was included in preventive measures regarding reproductive losses and perinatal consequences. The effectiveness of therapy with the inclusion of «Apple Pectin Antioxidant» was evaluated based on indicators of the fetoplacental complex and pregnancy scenarios. The results were compared with the effectiveness of standard treatment for habitual miscarriage of pregnancy. It was established that the destructive effect of incorporated 137Cs leads to placental dysfunction and fetal distress. Therapy with the inclusion of «APA» more significantly than standard treatment increases the progesterone-synthesizing function of the placenta, microcirculation, adaptation potential, and antioxidant protection of cells with the efficiency of 7.5 %, 10.7 %, 17.7 %, and 43.4 %, respectively. «APA» has a positive effect on the scenarios of pregnancy. «APA» in the composition of therapy to preserve pregnancy contributed to a decrease in the frequency of premature births by 11.4 % and an extension of their term to 34 weeks of gestation. Extending the gestational age of preterm birth reduced the frequency of severe asphyxia by 18.7 %, hypoxic-ischemic central nervous system injury by 13.5 %, respiratory distress by 17.3 %, and intraventricular hemorrhage 2nd and 3rd degrees by 12.7 %.All children were born alive due to the preservation of the compensatory ability of the placenta. Termination of pregnancy is a universal reaction of the mother and the fetus to negative exogenous and endogenous influences. Placental dysfunction is the most frequent cause of reproductive losses. Incorporated 137Cs is one of the factors that disturb the architecture of the placenta. Extreme effects depend on the number of incorporated 137Cs and the compensatory capacity of the placenta. Today, the possibility of internal exposure to 137Cs is associated due to consumption of agricultural products. Unfortunately, the level of food contamination with radionuclides remains higher than permissible. Living in an area with a standard radiation background does not guarantee a person the radiation safety of agricultural products. The confirmation is the accumulation of 137Cs in the placentas of women from different regions of Ukraine. The high efficiency of therapy with «APA» is associated with the removal of radionuclides and the minimization of the effect of internal irradiation, which made it possible to reduce the frequency of termination of pregnancy by 28.0 % due to the reduction of cases of premature births (-11.4 %), spontaneous abortions (-11.0 %), termination of pregnancy (-5.5 %). The «APA» is advisable to prescribe from pregravid and during pregnancy to all women, regardless of the region of residence.

Algebraic equations and polynomials over the ring of p-complex numbers

In this paper, we study the algebraic equations over the ring of p-complex numbers. Remainder division theorems and an analogue of Bezout’s theorem for p-complex polynomials are represented. For equations of the 2nd and 3rd degrees, conditions for the existence of roots are obtained, in some cases solutions are given in an explicit form. For polynomials of an arbitrary degree with an invertible leading coefficient, theorems on factorisation with a unit leading coefficient are proven in the cases where there are simple roots, multiple roots, and no roots. It is shown that in the absence of multiple roots, this decomposition will be unique, and in the case of the presence of multiple roots, the polynomial admits an infinite number of expansions.

Modern possibilities of correction of postcovid disorders in the fetoplacental complex

The objective: to determine the peculiarities of hormonal support, liver enzymatic function and the state of the fetal-placental complex (FPC) in unvaccinated women with fetal growth retardation (FGR) and placental dysfunction (PD) who was ill with the coronavirus disease during the current pregnancy, on the background of the proposed correction scheme of the disorders and evaluation of its effectiveness.Materials and methods. The study included 22 pregnant women with FGR and PD who were being treated and delivered in the Department of Pregnancy and Childbirth Pathology of the State Institution «Institute of Pediatrics, Obstetrics and Gynecology named after Academician O.M. Lukyanova National Academy of Sciences of Ukraine» in 2021–2022 and suffered a coronavirus disease during the current pregnancy. All pregnant women had a general clinical examination and the following parameters were additionally determined: the level of placental lactogen (PL) in blood serum, indicators of liver enzyme activity (alanine aminotransferase – ALT, aspartate aminotransferase – AST, gamma-glutamyl transpeptidase – GHTP), the level of estriol in urine (after the 22d week of pregnancy). The examination was carried out before the start of treatment and preventive measures and 12–14 days after a 10-day course of therapy with simultaneous ultrasound (US) monitoring of the condition of the FPC. In the case of diagnosis of FGR and PD, a course of therapy was carried out, which included daily consecutive intravenous infusions of a balanced crystalloid infusion preparation with lactate and sorbitol in the amount of 200 ml and a solution of levocarnitine and arginine hydrochloride in the amount of 100 ml for 10 days, followed by ultrasound control of the condition of the fetus and FPC. The evaluation of the effectiveness of the treatment was carried out based on a combination of clinical, laboratory and instrumental indicators after 10 days of therapy. Results. All pregnant women had a moderate or mild course of the coronavirus disease at different terms of the current pregnancy. There were 9 (40.9 %) women who were infected with SARS-CoV-2 in the early terms of pregnancy (up to 12 weeks), and they were diagnosed the 2nd and 2nd-3rd degrees of FGR.The majority of pregnant women had gestational complications. Before treatment, 10 (45.5 %) women had oligohydramnios. FGR was diagnosed in 14 (63.6 %) pregnant women, among them: in 3 (13.6 %) persons – fetal growth retardation of the 2nd-3rd degree, in 6 (27.3 %) – of the 2nd degree, in 5 (22.7 %) – 1st degree. The analysis of laboratory indicators demonstrated the increase in the levels of ALT, AST and GHTP, and a decrease in the levels of estriol in urine. After the proposed course of treatment, oligohydramnios was found only in 2 (9.1 %) women. The average amniotic index before treatment was 10.1, after treatment – 15.3. 4 (18.2 %) women were diagnosed FGR after the treatment. As a result of the treatment, the improvement of all determined laboratory parameters and perinatal consequences were determined. Conclusions. The proposed scheme for correcting the identified disorders with the inclusion of balanced crystalloid infusion preparation with lactate and sorbitol and balanced crystalloid infusion preparation with lactate and sorbitol drugs made possible to improve microcirculation, metabolic processes, and to normalize the consequences of postcovid endotheliitis in the vascular system of pregnant women in general and in the FPC, in particular. This was manifested in the improvement of clinical, laboratory and instrumental indicators of conducted studies and had a positive effect on perinatal results.

Delivering a Birth Safely – Case Reports of Perineal Infection Prevention among Pregnant Women Living Around Ex-landfills

Background: Pregnant women living around ex-landfills have a higher risk of infection due to slum milieu, poor nutritional status, and fetal head pressure on the perineum during labor which can cause it to tear. Objective: This research aimed to emphasize the importance of limiting prophylaxis antibiotics for the 1st and 2nd degrees of perineal tears due to their negligible risk of infection. Case presentations: This is a report of two primigravid women aged 19 years old (cases 1 and 2) and multiparous women aged 29 and 30 yo (cases 3 and 4) who managed to give birth safely in Puskesmas (Indonesian primary healthcare facilities), despite having low blood pressure and non-adherence to antenatal care. All of them suffered from 2nd degree of perineal tears and received analgesics, iron, vitamin B complex, and vitamin A tablets. The subjects attended puerperium care on days, 14, and 42 postpartum at Puskesmas. Discussion: In March 2020, Puskesmas' healthcare team performed a new 1st and 2nd-degree perineal tears prevention without antibiotics following normal vaginal birth. Standard care consists of personal hygiene, perineal wound care, and education on the importance of nutritious food and adherence to maternal supplementation. All subjects presented with complete perineal wound healing without infection at day-42 postpartum. Conclusion: It can be concluded that 2nd-degree perineal tears infection following normal vaginal birth could be prevented without antibiotics. It is strongly suggested to control the maternal nutritional states, potentially interfering with the maternal ability to heal the perineal wound.

Fyodor Ivanovich INOZEMTSEV - Professor, founder of the Moscow Society of Russian Doctors. To the 220th of birthday

Fyodor Inozemtsev was born on February 24, 1802 in the family of a manor manager in the village of Belkino, Kaluga province. In 1814, after the death of his father, F.I. Inozemtsev moved to his older brother, a student of the medical faculty of Kharkiv University, Egor. At the age of 12, Fyodor studied first at a college, then at a gymnasium, and after completing preparatory courses, he entered the verbal faculty of Kharkiv University to study at the state expense, although he initially aspired to the medical faculty. Protesting against studying at the Faculty of Words, he skips classes, becomes the "first hooligan" and for re-education is sent as a history teacher to the Kursk province, where he also teaches arithmetic, geometry and German. In 1826, F.I. Inozemtsev was already studying medicine at the 2nd year of Kharkov, and after that - Dorpat University. A good knowledge of the German language in which the teaching is conducted distinguishes him from other students. The famous surgeon Nikolai Yellinsky, considering that F.I. Inozemtsev has an unconditional "operator talent" already in the 3rd year allows him to perform his first operation - amputation of the lower leg. In 1833, Fyodor Ivanovich defended his doctoral dissertation and went on an internship abroad. Since 1835, F.I. Inozemtsev has been an extraordinary, and in 1937 an ordinary professor of surgery at Moscow University. In 1839-1840 F.I. Inozemtsev studied medicine in Germany, France, Italy, after which he created his own free clinic. He was one of the reformers of the educational system (1840-1860): he prepared a new modern training program for practical surgery (1850), was one of the first in the country to lecture on topographic anatomy; developed a course of eye diseases; created the first faculty surgical clinic in Russia at Moscow University (1846). Fedor Inozemtsev was a very popular doctor, who treated over 6 thousand patients a year. F.I. Inozemtsev performed the operation under general ether anesthesia for the first time in the country; Russian Russian doctor proposed to use a setting for treatment, the recipe of which has been used for more than 100 years; was the organizer of the Congress of Russian doctors, the founder of the Society of Russian Doctors in Moscow (1861); created the Moscow Medical Newspaper (1858-1878). Fyodor Ivanovich advocated that the surgeon should be a therapist at the same time. F.I. Inozemtsev author of 3-x monographs and 33 scientific articles, the founder of the medical school, whose prominent representatives were I.M. Sechenov, S.P. Botkin, G. A. Zakharin, N.V. Sklifosovsky and others. Inozemtsev was awarded the rank of state councilor with seniority, the Orders of St. Anna of the 2nd and 3rd degrees, St. Stanislav of the 2nd degree. In 1859, F.I. Inozemtsev retired due to deteriorating health, but in 1864 he was elected an honorary member of Moscow University. F.I. Inozemtsev died on August 6, 1869 and was buried in the famous cemetery of the Donskoy Monastery. The historian Pyotr Ivanovich Bartenev wrote about Fyodor Ivanovich: "A useful professor, a skilled doctor, a well-meaning citizen, a kind man, an ever-memorable friend of mankind."

LIPID DISORDERS AND ESSENTIAL ARTERIAL HYPERTENSION RISK DEPENDING ON AGTR1 (RS5186) AND VDR (RS2228570) GENES POLYMORPHISM

Objective: Hypertension and dyslipidemia represent two of the most relevant modifiable cardiovascular risk factors and they often coexist. The aim of the research was to study lipid disorders and essential arterial hypertension (EAH) risk depending on AGTR1 (rs5186) and VDR (rs2228570) genes polymorphism. Design and method: 100 subjects with EAH and target-organ damaging (2nd stage), moderate, high or very high cardiovascular risk were involved in the case-control study. Among them, 70,83% females and 29,17% males, mean age 57,86 ± 7,81y.o. Control group consisted of 60 practically healthy individuals of relevant age. The lipid panel parameters, such as: TC (Total cholesterol), TG (Triglycerides), LDL-C (Low-density lipoprotein cholesterol), HDL-C (High-density lipoprotein cholesterol) were investigated in blood plasma, using diagnostic kits “Accent 200” (Poland). The atherogenic index (IA) was calculated by the formula: (TC – HDL-C)/ HDL-C. Gene polymorphism of AGTR1 (rs5186) and VDR (rs2228570), was detected by polymerase chain reaction (PCR). Results: Decreased HDL-C is associated with 2nd and 3d degrees of EAH (p = 0,048). The risk of EAH increases in C-allele carriers of AGTR1 (rs5186) gene with hypercholesterolemia (TC> 5,0mmol/l) 1,5 times (OR–2,50;p = 0,048), with an increase in LDL-C and IA – 1,58 and 2,12 times (OR–10,80;p = 0,019), respectively. Homozygous carriers of the minor A-allele had extremely higher concentrations of TC, atherogenic LDL-C and IA, than GG-carriers – by 9,29%, 11,11% and 12,80% (pAA<0,05), respectively. Risk of EAH increases with hypertriglycerolemia 1,89 times (OR–2,93;p = 0,03) and with the increase in LDL-C – 1,26 times (OR–3,60;p = 0,038) in AA-genotype carriers of VDR (rs2228570) gene. Risk of EAH synergistically escalates almost twice in A-allele carriers of VDR (rs2228570) gene with a decrease of HDL-C (OR–2,88;p = 0,046) and the increase of IA (OR–2,70;p = 0,039), significantly only in AG-carriers though. ANOVA analysis confirmed the association of VDR (rs2228570) gene with the increase in IA (F = 3,80;p = 0,05). Conclusions: The EAH risk escalates with hypercholesterolemia, elevated both LDL-C and IA in C-allele carriers of AGTR1 (rs5186) gene, as well as with decreased HDL-C and increased IA in A-allele carriers VDR (rs2228570) in the observed.

Ejaculate parameters and the results of <i>in vitro </i> fertilization treatment in infertile couples with overweight and obese men

BACKGROUND: Infertility and obesity are actual and at the same time occurring problems of many couples. Conflicting data have been obtained on ejaculate parameters and the results of infertility treatment using in vitro fertilization treatment (IVF) in overweight and obese men.
 AIM: To evaluate the results of examination and treatment using ART, depending on the body mass index (BMI) of men in infertile couples.
 MATERIALS AND METHODS: A retrospective analysis of the results of treatment at the International Center for Reproductive Medicine in 368 infertile couples was carried out. The mean age of men and women was 36.4 6.2 and 33.9 5 years, respectively. Previous treatment for varicocele, sexually transmitted infections, prostatitis and cryptorchidism was performed in 58 (15.7%), 43 (11.7%), 42 (11.4%) and 11 (2.9%) men, respectively. Height and weight were measured for all patients, and BMI was calculated. The ejaculate was processed using a gradient medium (SupraSperm, Origio), IVF or ICSI were used in 110 (29.9%) and 258 (70.1%) couples, respectively, signs of good embryo quality were determined according to recommendations of professional societies for reproductive medicine. The onset of pregnancy was confirmed by the results of ultrasound sonography of the uterus. The results were subjected to statistical analysis.
 RESULTS: The BMI mean was 27.4 4.4 kg/m2, overweight and obesity of the 1st and 2nd degrees were observed in 161 (43%), 58 (15.8%) and 23 (7%) men respectively. Higher BMI values of men corresponded to higher BMI values of women (p 0.001), BMI values did not depend on ejaculate volume, concentration, total number and number of motile spermatozoa, proportion of high-quality embryos, and pregnancy rate. The highest pregnancy rate was noted after treatment of couples with younger women and higher values of the total number, concentration and number of progressively motile spermatozoa and ejaculate volume (p = 0.037, p = 0.028, p 0.001, p = 0.003, p 0.0001, respectively).
 CONCLUSIONS: Overweight and obese men prevail in infertile couples seeking IVF treatment. IVF treatment can overcome infertility in couples with overweight and obese men.

A Spherical Harmonics Decomposition Method (SHDM) for Irregular Matrix Coils Design.

With advantages of reduced coupling and compact structure, Matrix Coils (MCs) design extension to approximate multiple target inhomogeneities is necessary to improve its performance in shimming applications. A Spherical Harmonics Decomposition Method (SHDM) is proposed for the multi-target MCs optimization problem. The magnetic field generated by the MCs is represented in form of SHs' orthogonal basis, based on which the MCs pattern is optimized to adapt to multiple SH targets. With multi-target SHs of the 1st, 3rd, and mixed 1st&2nd degrees in Halbach magnet shimming, MCs structure optimizations were successfully performed. Comparisons with regular interleaved MCs show the optimized coil structure provides better performance, including reduction of power dissipation, maximum current amplitude, and total current requirement. This work proposed a simple and intuitive way of irregular MCs optimization, which is of high benefits in compact MR systems based on permanent magnets. This methodology may also be translated into local gradient & shimming matrix coils designs for conventional magnetic resonance device.

INTERPOLATION OF TABULAR FUNCTIONS FROM ONE INDEPENDENT VARIABLE USING THE TAYLOR POLYNOMIAL

A method of local interpolation of tabular functions from one independent variable using the Taylor polynomial of the nth degree in arbitrarily located interpolation nodes has been developed. This makes it possible to calculate intermediate values of tabular functions between interpolation nodes. The conducted analysis of the latest research and publications in the field of interpolation of tabular functions showed that the main part of the research is a strict theory of interpolation, i.e. clarification of its fundamental mathematical provisions. Some features of the interpolation of tabular functions from one independent variable using the Taylor polynomial of the nth degree are considered, namely: the solution algorithm and mathematical formulation of the interpolation problem are given; its formalized notation is given, as well as the matrix notation of interpolation procedures for certain values of the argument. A scalar algorithm for solving the problem of interpolation of tabular functions from one independent variable using the Taylor polynomial of the 2nd, 3rd, and 4th degrees has been developed. The simplicity and clarity of this algorithm is one of its advantages, but the algorithm is inconvenient for software implementation. The mathematical formulation of the problem of interpolation of tabular functions in terms of matrix algebra is given. The interpolation task is reduced to performing the following actions: based on the values of nodal points known from the table, it is necessary to calculate the Taylor matrix of the nth degree; based on the function values specified in the table a column vector of interpolation nodes should be formed; solve a linear system of algebraic equations, the root of which is the numerical coefficients of the Taylor polynomial of the nth degree. A method of calculating the coefficients of the interpolant, given by the Taylor polynomial of the nth degree for one independent variable has been developed. The essence of the method reduces to the product of the matrix, inverse of the Taylor matrix, which is determined by the nodal points of the tabular function, by a column vector containing the values of the interpolation nodes. Specific examples demonstrate the peculiarities of calculating the interpolant coefficients of the 2nd, 3rd and 4th degrees for one independent variable, and for each of them the interpolated value of the function at a given point is calculated. Calculations were performed in the Excel environment, which by analogy can be successfully implemented in any other computing environment.

Further Improvement on Stability Results for Delayed Load Frequency Control System via Novel LKFs and Proportional‐Integral Control Strategy

In this work, novel stability results for load frequency control (LFC) system considering time‐varying delays, nonlinearly perturbed load, and time‐varying disturbance of system parameters are proposed by using proportional‐integral control strategy. Considering the nonlinearly exogenous load disturbance and system parameters disturbance, an improved stability criterion in the form of linear matrix inequalities (LMIs) is derived by novel simple Lyapunov–Krasovskii functionals (LKFs). The delay‐dependent matrix in quadratic term, cross terms of variables, and quadratic terms multiplied by 1st, 2nd, and 3rd degrees of scalar functions are included in the new simple LKF. Taking the single‐area and two‐area LFC system installed with proportional‐integral (PI) controller as example, our results surpass the previous maximum allowable size of time delay. Meanwhile, the relationship between time delay varying rate, load disturbance degree, gains of PI controller, and delay margin of the LFC system is researched separately. The results can provide guidance to tune the PI controller for achieving maximum delay margin, in which the LFC system can withstand without losing stability. At last, the simulation results verify the effectiveness and superiority of the proposed stability criterion.

MORPHOLOGICAL RESEARCH OF ADHESIONS IN PATIENTS WITH TUBOPERITONEAL INFERTILITY.

The aim: To study history, clinical manifestations and histological structure of adhesions in patients with tuboperitoneal infertility. Materials and methods: 66 women with tuboperitoneal infertility and 30 healthy women were studied. The criterion for inclusion in the study was the presence of adhesions of the 2nd and 3rd degrees by J. Hulka et al. classification. During laparoscopy adhesions were sampled. Serial histological sections after preparation were stained with hematoxylin and eosin, picrofuxin according to van Gizon and fuxelin according to Hart. Results: The study showed that patients with tuboperitoneal infertility, unlike the control group, had surgery on the abdominal cavity and pelvic organs much more often, as well as inflammatory diseases of the reproductive organs. The majority of women in the control group had childbirth in history, whereas among the patients with infertility ectopic pregnancies and abortions prevailed. All examined women had adhesions that were confirmed during laparoscopy. The study showed that ultrasound is not an informative method to confirm this pathology. A histological study of adhesions revealed the presence of differences in their structure depending on the etiological factor (surgery or inflammation). Conclusions: Necessary to take into account the presence or absence of a chronic inflammatory process while developing approaches for the secondary prevention of the formation of adhesions in women with tuboperitoneal infertility at the stage of postoperative rehabilitation and infertility treatment.

Determination of left ventricular diastolic dysfunction using machine learning methods

Abstract Introduction Nowadays, more than 50% of new cases of heart failure (HF) are due to heart failure with preserved ejection fraction (HFpEF). Diastolic dysfunction of left ventricular underlies the development of HFpEF. Determination of diastolic function can be determinated using echocardiographic examination but not as a method of screening. Purpose Create a Machine Learning model to determinate severe (2nd or 3rd degrees) left ventricular diastolic dysfunction (LV DD) using single channel ECG. Methods The study prospectively included 375 patients aged between 18 and 88 years. Each of them underwent an assessment of left ventricular diastolic function using echocardiography based on ASE/EACVI guidelines and standard 2016. ECG was registered in I standard lead for 3 minutes. Then a spectral analysis of the ECG was performed using a wavelet transform based on the Fourier transform. Prediction of LV DD was implemented based on different machine learning methods. Results Based on the time intervals between the waves, the energy of the ECG signal in the target zones of the complexes, the amplitude at different points of the ECG complexes and the asymmetry indicators, different mathematical models were created to determine the severe (2nd or 3rd degree) LV DD. Lasso regression predicted the presence of severe LV DD with sensitivity 90% and specificity 80,6% (AUC- 0.856). The most significant for this method were the following variables: TA, SDNN, RonsF, ASEPMAX, B1, TpTe, ADP, SEPMAX, Sbeta, SEPF, RR, SRP-B0, Pan.1, QT/TQ, PpeakN, SA, SRP-B1. Random Forest also showed high sensitivity 80% and specificity 89, 3% (AUC- 0.860). For Random Forest model the most dignificant were: TpTe, VAT, QTc, QT/TQ, J80A, TA, Tenergy, Tpenergy, Beta, QRS11energy, Pan, Pan.1, RA, Pfi, QRSst, QRSfi, PpeakP, PpeakN, Rpeak, Speak, RonsF, B0-B1, SEP, SEP-B1, SEP-B0, SRP, SRP-B1, SRP-B0, ASEP. LV DD 1 degree did not have markers in our study. Conclusion Several machine learning methods have shown high sensitivity and specificity in identifying severe LV DD. Potentially ECG can be used as a screening method for determination of the LV DD. Funding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): This work was financed by the Ministry of Science and Higher Education of the Russian Federation within the framework of state support for the creation and development of World-Class Research Centers “Digital biodesign and personalized healthcare” No. 075-15-2020-926

Cyber-addictions of the Ukrainian youth

The work is devoted to the study of the problem of dependence on cyberspace of young people. Experts increasingly believe that cyber-addiction is a pathological urge or disease that belongs to the category of non-chemical dependencies and has its own nosology, etiology, pathogenesis and requires prevention, treatment and psycho-correction. Thanks to the analysis of scientific achievements, their actual types were determined, a comprehensive model of classification was built taking into account socially accepted, pathological and cyber-addiction; the stages of cyber-addiction formation are separated. Thanks to the developed and tested method «Test-questionnaire for detecting cyber-addiction», it was found that the most typical addictions for young people are: computer addiction, Internet addiction, game addiction and gadget addiction; girls are more typical: cyber communicative addiction and selfitis. When considering age characteristics, it was found that the highest rates of 3rd degree of addiction are among people aged 19 to 21, a more even distribution of 2nd and 3rd degrees of addiction among people aged 14 to 15 years. Due to the factor analysis of the obtained results, it was established that an addict can have not one dependence, but several, although each of them may have a different degree of manifestation.