Chronic Non-infectious Diseases Research Articles

Role of a unified preventive environment with the partici pation of pharmacy organizations in the fight against chronic non-communicable diseases

Relevance. Preserving and strengthening the health of the population is the most important task of the healthcare system, including pharmacy organizations. Therefore, it is important to unite the efforts of medical and pharmaceutical specialists to form a unified preventive environment in the region. This will make it possible to rationally distribute the resources of healthcare organizations in the fight against chronic non-communicable diseases and increase citizens’ satisfaction with accessible preventive care.Methodology. To achieve the goal and solve the assigned problems, content analysis, comparative and logical analysis, and observation and graphic methods were used. The objectives of this study were to obtain regulatory documentation data, the main strategies and recommendations of the World Health Organization in the field of protecting public health, the infrastructure of pharmacy organizations, and consumer opinion.Results. The study highlighted the main aspects of preventive activities, which are the actions of pharmaceutical specialists toward preserving public and individual health. The current state of preventive work of pharmacies in the Yaroslavl region has been studied, and the most common preventive services have been identified. The need for the formation of a unified preventive environment in the region with the participation of pharmacies is substantiated as one of the ways to improve the professional activities of pharmaceutical specialists in the prevention of chronic non-infectious diseases. A model of a unified preventive environment for the regional healthcare system was developed, indicating the general and specialized functions of the organizations. An assessment of the effectiveness of the implementation of preventive services in the activities of pharmacy organizations was conducted.Conclusion. An analysis of the current state of preventive activities of pharmacy chains indicates the potential of a pharmacy organization to implement a wider range of preventive services. Combining the efforts of healthcare professionals through the formation of a unified preventive environment with the participation of pharmacy organizations can provide a significant impetus in the fight against chronic non-communicable diseases.

Contribution of obesity, insulin resistance and diabetes mellitus to cognitive impairment

Obesity is a vivid example of one of the most common chronic non-infectious multifactorial diseases in today’s world. Not only the conventional elements of an “unhealthy lifestyle” such as hypodynamia and overeating, but also external socio-economic and psychosocial factors play an important role in the development of this disease. This review summarizes the main pathogenetic components that combine the development of both metabolic and vascular, including cerebrovascular, complications of obesity. The authors present the current classification of obesity adopted by domestic endocrinologists, which includes an assessment of the risk of obesity-associated complications. The mechanisms of pathological effects of insulin resistance, which morphological substrate is visceral obesity, are considered in detail. Its key role in the initiation and progression of diabetes mellitus, cardiovascular and cerebrovascular diseases has been shown. The mechanisms involved in the development of cognitive impairment in patients with obesity, insulin resistance and diabetes mellitus are described. Due to the urgency of the problem raised, the prospective of choosing a therapeutic and preventive approach to the management of such patients are assessed. With regard to this category of patients, the use of fonturacetam was discussed. Fonturacetam has been shown to have the proven clinical effects that not only improve the cognitive and emotional status in patients with cerebrovascular pathology, but also have a direct effect on the potential root cause of the development and progression of vascular and metabolic disorders, i.e. on the obesity. Fonturacetam that has an anorexigenic effect can also be prescribed as a weight corrector in addition to the diet therapy. Thus, the use of fonturacetam can become a promising trend in the treatment and prevention of today’s most common diseases.

Models of work with patients older than working age suffering from chronic non-infectious diseases: overview of foreign and Russian practices

The analysis of Russian and foreign practices on the application of models for the management of patients suffering from chronic non-communicable diseases (CNID) had been carried out. Examines the features of different models of management of patients older than working age with CNID and reflects the results of their use in primary health care. The models of treatment of chronic diseases and their adaptation were considered from the point of view of examples of proactive approaches to treatment. The features of the developed models of management of patients older than working age with CNID living in rural areas of foreign countries were presented. The features of dynamic follow-up of patients with CNID in medical organizations were considered. The experience of countries in the application of management of patients suffering from CNID at the primary level in low- and middle-income countries were analyzed. The integral role of an integrated patient-oriented approach in providing medical care to patients with established CNID had been demonstrated. The prospects for the development of models for the management of patients with CNID had been determined

The relationship between gastroesophageal pathogenic reflux and metabolic syndrome

Currently, special attention is drawn to the phenomenon of comorbidity of chronic non-infectious diseases. The emergence of comorbidity is facilitated by the high incidence of coexisting diseases. One such combination is GERD and metabolic syndrome (MS). GERD and MS are multifactorial diseases, the pathogenesis of which is intertwined and mutually aggravates each other. Every year throughout the world and the Russian Federation, there is a clear trend towards an increase in the incidence of pathology of the upper gastrointestinal tract, namely gastroesophageal reflux disease (GERD). The prevalence of obesity in Russia over 40 years of observation has increased 4 times among men and 1.5 times among women. Despite the high incidence, to date there is no diagnosis of “metabolic syndrome” (MS) in ICD-10. MS is coded based on its constituent pathologies (obesity, dyslipidemia, insulin resistance, arterial hypertension). Treatment of this comorbid pathology requires a multidisciplinary approach, thereby placing a high burden on the healthcare system. This article displays the features of the pathogenesis and clinical picture of GERD, as well as the combination of this pathology with the components of MS.

Obesity provokes the development of bronchopulmonary pathology and aggravates its course

The increase in the prevalence of obesity in recent decades is an urgent medical and social problem for all countries, increasing the cost of medical care and worsening the quality of life of patients. Obesity is an independent risk factor for the development of a number of chronic non-infectious diseases, including respiratory diseases. The presence of excess body weight not only provokes the development of bronchopulmonary pathology, but also aggravates its course. The article discusses the mechanisms of the impact of obesity on the pathogenesis of diseases such as bronchial asthma, chronic obstructive pulmonary disease and coronavirus infection.

Oxidative modification products of lipids in the intraocular fluid of patients with cataracts associated with chronic non-infectious diseases

Introduction. To clarify the role of oxidative stress in the development of cataracts, it is necessary to determine the content of oxidative modification products directly in the eye tissue, but such studies are scarce, which is due to the difficulty of obtaining a sufficient amount of biomaterial for analysis and the need to use highly sensitive research methods as a result. Therefore, to assess the pathological changes in the lens, intraocular or tear fluid is used.Aim. To elucidate the role of oxidative stress in the development of cataracts by determining the content of lipid oxidation products and their comparative characteristics in intraocular fluid and in blood plasma in patients with cataracts associated with chronic non-infectious diseases.Materials and methods. The study involved 83 patients with cataracts associated with non-infectious diseases, who underwent surgical treatment. Of these, 30 patients had chronic obstructive pulmonary disease (COPD) as a comorbid condition, 45 had cardiovascular diseases (CVD), and 13 had diabetes mellitus (DM). The control group consisted of 30 practically healthy individuals without clinical signs of acute or chronic diseases. Lipid oxidation products were determined by ultraviolet spectroscopy. Absorption spectra of non-oxidized lipids (E204), diene conjugates (E233), conjugated trienes, and ketodiene (E278) were recorded. Additionally, the ratios of absorption spectra of diene conjugates to non-oxidized lipids (E233/E204), as well as conjugated dienes and ketodienes to non-oxidized lipids (E278/E204), were calculated. Tear and intraocular fluids, as well as blood plasma, served as materials for the study.Results. In the group of patients with cataracts associated with non-infectious diseases, the content of diene conjugates, conjugated trienes, and ketodienes was increased relative to similar indicators in the tear fluid of people in the control group. Moreover, more pronounced changes were observed in the group of patients with cataracts associated with COPD relative to those with CVD and DM. A comparative analysis confirmed that in the group of patients with cataracts associated with COPD, the content of oxidized lipids in intraocular fluid and in blood plasma was increased. Correlation-regression analysis showed a positive relationship between the indicators of diene conjugates in intraocular fluid and in blood plasma.Conclusions. The significant direct linear relationship between the indicators of oxidized lipids in intraocular fluid and in blood plasma in patients with cataracts and non-infectious diseases may indicate the possibility of using blood plasma for studying oxidative processes in the lens and its pathological changes for the purpose of selecting therapy and evaluating treatment efficacy. The results obtained confirm the role of oxidative stress in the development of cataracts in patients with chronic non-infectious diseases.

Defective Mitophagy Impairs Response to Inflammatory Activation of Macrophage-Like Cells.

The role of mitophagy in atherosclerosis has been extensively studied during the last few years. It was shown that mitophagy is involved in the regulation of macrophages, which are important players as immune cells in atherosclerosis development. In this study, we investigated the relationship between mitophagy and response to inflammatory stimulation of macrophage-like cells. Six cybrid cell lines with normal mitophagy, that is, increasing in response to stimulation, and 7 lines with defective mitophagy not responding to stimulation were obtained. The objective of the study was to compare the nature of the inflammatory response in normal and defective mitophagy in order to elucidate the role of mitophagy defects in inflammation. We used cytoplasmic hybrids (cybrids) as cellular models, created using mitochondrial DNA from different atherosclerosis patients. Mitophagy was stimulated by carbonyl cyanide m-chlorophenyl hydrazone (CCCP) and assessed as the degree of colocalization of mitochondria with lysosomes using confocal microscopy. Western blotting methods were used for the determination of proteins involved in the exact mechanism of mitophagy. Experiments with stimulation of mitophagy show a high correlation between these two approaches (microscopy and blotting). The pro-inflammatory response of cybrids was stimulated with bacterial lipopolysaccharide (LPS). The extent of the inflammatory response was assessed by the secretion of cytokines CCL2, IL8, IL6, IL1β, and TNF measured by ELISA. Basal level of secretion of cytokines CCL2, IL8 and TNF was 1.5-2 times higher in cultures of cybrids with defective mitophagy compared to cells with normal mitophagy. This suggests a persistently elevated inflammatory response in cells with defective mitophagy, even in the absence of an inflammatory stimulus. Such cells in the tissue will constantly recruit other immune cells, which is characteristic of macrophages derived from monocytes circulating in the blood of patients with atherosclerosis. We observed significant differences in the degree and type of response to inflammatory activation in cybrids with defective mitophagy. These differences were not so much quantitative as they were dramatically qualitative. Compared with cells with normal mitophagy, in cells with defective mitophagy, the relative (to basal) secretion of IL8, IL6 and IL1b increased after the second LPS activation. This indicates a possible lack of tolerance to inflammatory activation in cells with defective mitophagy, since typically, re-activation reveals a smaller pro-inflammatory cytokine response, allowing the inflammatory process to resolve. In cells with normal mitophagy, exactly this normal (tolerant) inflammatory reaction was observed. Data on the involvement of mitophagy, including defective mitophagy, in disturbances of the inflammatory response in sepsis, viral infections, autoimmune diseases and other pathologies have previously been reported. In this work, we studied the role of defective mitophagy in non-infectious chronic inflammatory diseases using the example of atherosclerosis. We showed a dramatic disruption of the inflammatory response associated with defective mitophagy. Compared with cybrids with normal mitophagy, in cybrids with defective mitophagy, the secretion of all studied cytokines changed significantly both quantitatively and qualitatively. In particular, the secretion of 3 of 5 cytokines demonstrated an intolerant inflammatory response manifested by increased secretion after repeated inflammatory stimulation. Such an intolerant reaction likely indicates a significant disruption of the pro-inflammatory response of macrophages, which can contribute to the chronification of inflammation. Elucidating the mechanisms of chronification of inflammation is extremely important for the search for fundamentally new pharmacological targets and the development of drugs for the prevention and treatment of chronic inflammatory diseases, including atherosclerosis and diseases characteristic of inflammation. Such diseases account for up to 80% of morbidity and mortality.

Correction of azotemia in patients with chronic kidney disease

Chronic kidney disease (CKD) has become one of the most common non-infectious chronic diseases in the world. The World Health Organization predicts that CKD will become the 5th most common chronic disease in 2040. The causes of CKD are multifactorial and varied, but early symptoms are often subtle and silent. For most patients with CKD, pharmacological treatment involves a more general approach that does not depend on the nephrosclerosis. It is believed that in addition to the renoprotective effect, the issue of correcting azotemia in patients with CKD remains relevant. Azotemia is a biochemical abnormality defined as an increase or accumulation of nitro­genous products, creatinine in the blood and other secondary waste pro­ducts in the body. An increase in the level of nitrogenous wastes is associated with the inability of the renal system to adequately filter waste products. This is a typical sign of both acute kidney injury and CKD. For the correction of azotemia in patients with CKD, it is advi­sable and pathogenetically justified to use Duo­nefril® (Lespedeza capitata extract in combination with silymarin), which contains a scientifically based combination of substances of plant origin with nephroprotective properties. Duonefril® in combination with traditional approaches helps preserve and improve the filtration function of the kidneys, due to an increase in the estimated glomerular filtration rate and a hypoazotemic effect in CKD against the background of diabetes mellitus, hypertension and other kidney conditions

Практичні аспекти застосування парентеральної озонотерапії у лікуванні різних контингентів хворих

In Ukraine, parenteral ozone therapy has been successfully used for many years in the treatment of injuries, poisonings, infectious and non-infectious diseases. Clinical evaluation of the effectiveness of ozone therapy is carried out by doctors based on various approaches and using a wide range of biomarkers. Aim. Analysis of the results of the practical use of parenteral ozone therapy and determination of parameters of its clinical effectiveness in the treatment of patients in the intensive care unit. Materials and Methods. Summarized results of treatment of 144 patients with poisoning, injuries, infectious and somatic diseases, aged 18–72 years, women ‒ 84 (58.3%), men ‒ 60 (41.7%), who underwent a course of parenteral ozone therapy in 2017-2021 in the CNE Kyiv City Clinical Hospital of Emergency Medical Care and ozone therapy rooms of private clinics. Parenteral ozonation of blood was carried out with the help of devices of the "Bozon-N-plus" series following the methodology approved by the Ministry of Health of Ukraine ("Methods of ozone therapy", 2001). The methods of systematic, comparative and statistical analysis were used. Results. All patients were divided into 5 clinical groups based on the nature of their disease: the first group ‒ patients with acute poisoning by substances of suffocating hemotoxic effect; the second group ‒ patients with acute infectious diseases; the third group ‒ patients with chronic non-infectious diseases; the fourth group ‒ patients with purulent wounds; the fifth group ‒ patients with drug addiction. Criteria for evaluating the effectiveness of ozone therapy were used for each clinical group. A total of 1423 medical procedures using ozone were performed. The average course of treatment consisted of 3 to 10 procedures. Among them, 313 procedures of intravenous infusion of ozonated physiological solution (200 ml, ozone dose ‒ 0.48 mg, procedures were performed daily or every other day) were performed. 1110 procedures of intravenous infusion of ozonated autologous blood (200 or ‒ 400 ml of autologous blood, ozone dose ‒ 1.8 or 3.6 mg) were performed. The beginning of the course of autohemotherapy was preceded by a session of intravenous administration of ozonated physiological solution (the first procedure), after which the course of autohemotherapy began, with a frequency of 2-3 times a week. Conclusions. The clinical effectiveness of ozone therapy has been confirmed through a complex dynamic assessment of the patient's condition, which involves the use of subjective assessments (well-being, mood, duration of sleep, severity of pain syndrome, etc.) and objective parameters of the patient (clinical, functional, laboratory indicators, specific biomarkers). Keywords: chemical poisoning, ozone therapy, blood ozonation.

Непсихотичні психічні розлади у пацієнтів з хронічними соматичними неінфекційними захворюваннями в умовах перманентного стресу: роль метаболічної терапії

bstract. The article discusses the current issues of comorbidity between mental disorders and chronic non-infectious somatic diseases, highlighting the importance of a multidisciplinary patient-centered approach in the treatment of these conditions. Additionally, in light of the negative impact of the Russian military aggression on the mental health of Ukrainians, this paper presents the positive experience of using the dietary supplement Cognitium® in a regimen of 1 ampule twice a day as an additional therapy for non-psychotic mental disorders in adult patients with chronic somatic diseases under conditions of chronic stress. The positive impact of Cognitium® was noted in the reduction of affective, cognitive and somatoform symptoms, specifically: decreasing in the level of anxiety and depression, mood stabilization, improvement of concentration and memorization of new information, increasing energy levels, restoration of sleep and appetite.

Occupational risk of developing chronic non-communicable diseases in bearing production workers

Introduction. Prevention of chronic non-communicable diseases, maintaining health and prolonging the occupational longevity of the working population is the most important strategic direction of the state policy of the Russian Federation in the field of public health
 The purpose. Stratification of the occupational risk of developing chronic non-communicable diseases among workers in the production of bearings for the subsequent development of specialized targeted programs for the prevention of health disorders.
 Material and methods. An assessment of the occupational risk of developing chronic non-communicable diseases among workers in the production of bearings is given on the basis of complex studies of production factors, primary and general chronic morbidity using the methodology for assessing occupational health risk.
 Results. It has been established that the development of chronic non-infectious diseases in bearing production workers is determined by a complex of harmful (classes 3.2–3.4) factors of the working environment of various nature, which form an occupational health risk in categories from medium to very high. In the structure of the general chronic non-infectious morbidity of workers, diseases of the eye and its adnexa (24.4%), diseases of the musculoskeletal system and connective tissue (20.7%), diseases of the circulatory system (19.32%) and diseases of the endocrine system had the highest prevalence in systems of eating disorders and metabolic disorders — 15.1%. A causal relationship of varying severity with the work of the most common nosological forms of chronic was revealed as arterial hypertension (RR = 1.425; EF = 29.837%; C = 1.044–1.945), obesity (RR = 1.731; EF = 42.24%; CI = 1.219–2.459), presbyopia (RR = 2.443; EF = 59.071%; CI = 1.549–3.855), indicating their occupational conditioning.
 Limitations. The limitation of the study was the assessment of the occupational risk of developing chronic non-communicable diseases in one occupational cohort of workers. 
 Conclusion. The development of specialized programs for the prevention of chronic non-communicable diseases among workers should include the study of causal aspects of health disorders and the rationale for measures to minimize the impact of occupational risk factors for occupationally determined pathology.

Implementation of Mobile Applications in The Process of Screening Compliance of Patients in The Treatment of Chronic Non-Communicable Diseases

Currently This article describes the results of a study on the adaptation, implementation and evaluation of the effectiveness of the MyTherapy mobile application in the practice of treating chronic non-infectious diseases in order to monitor treatment and patient compliance. Based on the more pronounced positive dynamics of the therapy itself, the improvement in the quality-of-life indicator and the indicator of adherence to treatment, it is shown that the use of this mobile application can be a highly effective method of monitoring the therapy of chronic non-infectious diseases when used correctly.

Russian eligibility criteria prescribing menopausal hormonal hormones therapy for patients with cardiovascular and metabolic diseases. Consensus document of the Russian Cardiological Society, Russian Society of Obstetricians and Gynecologists, Russian Association of Endocrinologists, Eurasian Association of Therapists, Association of Phlebologists of Russia

Menopausal symptoms can disrupt the life course of women at the peak of their career and family life. Currently, the most effective treatment for these manifestations is menopausal hormone therapy (MHT). The presence of cardiovascular and metabolic diseases in itself does not exclude the possibility of prescribing MHT to relieve menopausal symptoms and improve quality of life. However, often an obstacle to the use of this type of hormonal therapy is the fear of doctors who are afraid of doing more harm to patients than good. Caution is especially important when it comes to women with underlying health conditions. Moreover, it should be recognized that there is a lack of high-quality research regarding the safety of MHT for major chronic non-infectious diseases and common comorbid conditions. The presented consensus document analyzed all currently available data obtained from clinical trials of various designs and created a set of criteria for the acceptability of prescribing MHT to women with concomitant cardiovascular and metabolic diseases. Based on the presented document, doctors of various specialties who advise women in menopause will receive an accessible algorithm that will allow them to avoid potentially dangerous situations and reasonably prescribe MHT in real practice.

Russian Eligibility Criteria for Prescribing Menopausal Hormone Therapy to Patients With Cardiovascular and Metabolic Diseases. Consensus Document of RSC, RSOG, RAE, EUAT, RAP

Menopausal symptoms can impair the life of women at the peak of their career and family life. At the present time, the most effective treatment for these manifestations is menopausal hormone therapy (MHT). The presence of cardiovascular and metabolic diseases in itself does not exclude the possibility of prescribing MHT to relieve menopausal symptoms and improve quality of life. However, often an obstacle to the use of this type of hormone therapy is the fear of physicians to do more harm to patients than good. Caution is especially important when it comes to women with concurrent diseases. Moreover, it should be recognized that there is a shortage of high-quality research on the safety of MHT for underlying chronic non-infectious diseases and common comorbidities. The presented consensus analyzed all currently available data from clinical trials of various designs and created a set of criteria for the appropriateness of prescribing MHT to women with concomitant cardiovascular and metabolic diseases. Based on the presented document, physicians of various specialties who advise menopausal women will receive an accessible algorithm that will allow them to avoid potentially dangerous situations and reasonably prescribe MHT in real-life practice.

Arterial spin labeling perfusion in acute Wernicke encephalopathy: a case series discussion

Wernicke’s encephalopathy (WE) is a life-threatening neurologic disorder resulting from thiamine (vitamin B1) deficiency that can be secondary to chronic alcohol abuse, gastrointestinal surgery, systemic infectious and non-infectious diseases, and chemotherapy. WE is classically characterized on MRI by reduced diffusion and T2 prolongation along the mammillothalamic tracts, periaqueductal gray and tectal plate. We present two patients with acute WE who had baseline arterial spin labeling (ASL) perfusion at the time of presentation, demonstrating increase in cerebral blood flow (CBF) within the classically involved brain regions and concurrent global cerebral cortical hypoperfusion. Both patients were successfully treated with intravenous thiamine infusion. Post-treatment MRI demonstrated improvement of reduced diffusion and normalization of CBF within the involved structures. Prior histopathological studies have documented prominent undulation and luminal dilatation of arteries and arterioles in acute WE lesions, likely explaining the increased perfusion shown by imaging. The root of this pathophysiologic process may trace back to thiamine’s biochemical role in maintaining osmotic gradients and glucose metabolism, that if failed can lead to arterial hyper-perfusion. Our findings show that ASL-CBF can highlight the underlying pathophysiology in patients with acute WE by demonstrating increased CBF in involved central structures. This luxury perfusion may be a compensatory or protective mechanism by which increased metabolic demand is met in the acute setting and which, if treated timely, will show normalization of CBF on ASL imaging.

Features of management of patients with cardiometabolic polymorbidity phenotype: focus on the efficacy and safety of bisoprolol

The presence of coexisting chronic non-infectious diseases is associated with reduced quality of life and increased risk of early disability and mortality. The coexistence of two or more diseases in a patient is defined by the term polymorbidity. Currently, there is an increase in polymorbid pathology not only among elderly patients, but also among young and middle-aged people, which entails significant health care costs and has a negative impact on the economy of the country as a whole. Therefore, the problem of polymorbidity and the management of such patients in real clinical practice is urgent and key in the field of public health. According to major foreign and domestic studies, the most common polymorbidity phenotype is the cardiometabolic phenotype. Taking into account the fact that in our country almost every second patient with arterial hypertension has metabolic disorders and, therefore, polymorbid pathology, approaches to the management of such patients should be personalized already from the beginning of drug therapy. In this regard, this review reviews some key pathophysiological mechanisms of the relationship between arterial hypertension and metabolic disturbances occurring in patients with the cardiometabolic phenotype of polymorbidity, presents features of antihypertensive therapy in such patients, in particular, describes in more detail the class of beta-blockers with pathogenetic validity of use in this case. Also, a review of the available clinical trial data concerning the effects of the highly selective beta-adrenoblocker bisoprolol in patients with arterial hypertension is presented, emphasizing its effect on metabolic status and its importance for comprehensive clinical management.

Comparative assessment of echocardiographic parameters in persons without diagnosed chronic non-communicable diseases depending on body mass index

Aim: To compare the indicators of structural remodeling and intracardiac hemodynamics in people without previously diagnosed chronic non-communicable diseases, depending on body mass index (BMI).Material and Methods. We analyzed the data of 123 people aged 21 to 59 years who did not have chronic non-infectious diseases and did not take any drug therapy that affects the indicators of central and peripheral hemodynamics, as well as lipid, carbohydrate and fat metabolism. All the examined persons were divided depending on the BMI into 2 groups, comparable in sex, but with age differences. The first group consisted of 60 people (75% women) with a BMI < 30 kg/m2, whose median age was 40 years (Q1–Q3: 35–48 years). The second group included 63 subjects (76.1% women) with BMI ≥ 30 kg/m2 at the age of 48.5 years (Q1–Q3: 38–54 years). Structural and functional parameters of the heart were assessed during transthoracic echocardiography, which was performed on the Philips EPIQ CVx 2D ultrasound machine by one specialist.Results. In the group of persons with increased BMI, the average values of the left ventricular relative wall thickness (RWT LV) were higher – 0.37 [0.34; 0.40] versus 0.41 [0.37; 0.47], p = 0.01; left ventricular mass index (LVMI) – 64.0 [53.0; 76.5] g/m2 and 27.0 [23.1; 30.9] g/m2,7 vs. 82.0 [70.0; 92.0] g/m2 and 38.1 [34.5; 46.5] g/m2,7, p = 0.01; epicardial fat (EF) – 5 [4; 6] mm vs. 8 [5; 10] mm, p = 0.01, left ventricular global longitudinal strain (LV GLS) –21.8 [–23.6…–19.7]% vs. –19.2 [–21.2…–18.2] %, p = 0.01. Statistically direct correlations of BMI with LVMI g/m2,7 (ρ = 0.746; p = 0.01), EF (ρ = 0.563; p = 0.01), LV GLS (ρ = 0.418; p = 0 .01), RWT (ρ = 0.438; p = 0.01). With an increase in BMI by 1 kg/m2, one should expect an increase in the thickness of EF by 0.172 mm, longitudinal deformation of the LV by 0.151%, RWT by 0.003, LVMI, g/m2 by 1.200, LVMI g/m2,7 by 1.116.Conclusion. The increase in BMI is associated with changes in structural remodeling and systolic function of the LV. In individuals with increased BMI, to determine structural remodeling and changes in the geometry of the heart chambers, it is necessary to use growth indexing, to determine indicators of GLS LV, to determine the thickness of EF in order to detect intracardiac hemodynamic disorders in the early stages and timely prevention of complications.

Contact methods for registering respiratory rate: opportunities and perspectives

Introduction. Respiratory rate is known to be one of the most important indicators reflecting the vital functions of a person. An increase in respiratory rate can be found in many diseases and pathological conditions, for example, in chronic obstructive pulmonary disease, pneumonia, bronchial asthma, myocardial infarction, heart failure, anaemia, etc. Due to the active introduction of telemedicine monitoring into clinical practice, the measurement of the abovementioned indicator is particularly relevant for the purpose of early detection and prevention of complications of chronic non-infectious diseases, as well as dynamic monitoring of the condition of patients in both inpatient and outpatient settings.Aim. To search and update information about existing and promising developments for the control of respiratory rate based on different physical principles.Materials and methods. For this review we used databases PubMed, Scopus, MedLine and eLIBRARY. The following keywords were used for the search: “respiratory rate”, “contact”, “measurement”, “sensor”.Results. Contact methods for measuring respiratory rate include a wide range of sensors based on various physical principles. All types of sensors have their own application, but also they have some drawbacks. In order to achieve maximum accuracy of respiratory rate monitoring, it is necessary to carefully assess the conditions in which the patient is located, selecting the most appropriate technological solutions for them. Probably, complex systems, including several different sensors, are able to overcome many shortcomings. In addition, the development of information analysis methods, machine learning and artificial intelligence technologies can increase the sensitivity and accuracy of methods of measuring respiratory rate, reducing the frequency of bias associated with various artefacts.Conclusion. Thus, technological development opens up wide opportunities for long-term monitoring of vital functions, prevention and timely response to adverse events.

НЕЙРОПИЛИН – НОВЫЙ МАРКЕР ХРОНИЧЕСКИХ НЕИНФЕКЦИОННЫХ ЗАБОЛЕВАНИЙ

Neuropilin is of wide scientific and practical interest in the development of pathological conditions in both adult and pediatric patients. Modern scientific researches expand the role of this protein in various systems of the child's body both intrauterine and after birth. The results of recent studies related to the role of neuropilin, its effects and relationship with the development of various chronic diseases are considered in this bibliographical review of PubMed, ClinicalKey covering 2018-2023 with the purpose of expanding the understanding of neuropilin as a protein involved in the intranatal development of the fetus and metabolic processes in the extrauterine period. Further studies of neuropilin would clarify its role in the development of chronic noninfectious diseases and therapeutic approaches in pediatric practice.

Behavioral risk factors for the health of machine tool operators as the basis of the company’s social policy

To form a competent social policy of the enterprise, aimed at reducing the risk of chronic non-infectious diseases, early loss of ability to work, information is needed not only about working conditions, but also about the priority behavioral health risk factors for workers. In order to identify the priority behavioral health risk factors for the workers of the machine-building enterprise the characteristics of the lifestyle, information on the awareness and perception of behavioral and occupational health risk factors (by active interviewing method) were obtained. The observation groups consisted of machine-tool workers of the machine-building enterprise with different work experience (Group 1 — ≤5 years; Group 2 — > 5 years). Numerous violations of lifestyle characteristics of machine operators were revealed, priority health risk factors were established: bad habits, low physical activity, violation of quality nutrition, low medical activity. The absence of self-preserving behavior in everyday life and in the workplace was shown. The increase in the prevalence of behavioral risk factors in the dynamics of length of service, and pronounced differences in the understanding of the significance of behavioral and occupational risk factors depending on age have been established. The results justified the need for a differentiated approach to the development of preventive programs to preserve health and longevity of the contingent of workers, taking into account the length of service, age and nature of work.