Correlation Of Medium Strength Research Articles

МОЖЛИВОСТІ ГАЛОАЕРОЗОЛЬТЕРАПІЇ ЯК РЕСПІРАТОРНОЇ РЕАБІЛІТАЦІЇ В КОРЕКЦІЇ ІНСУЛІНОРЕЗИСТЕНТНОСТІ У ХВОРИХ НА ХРОНІЧНЕ ОБСТРУКТИВНЕ ЗАХВОРЮВАННЯ ЛЕГЕНЬ

Comorbidity in chronic obstructive pulmonary disease (COPD) considerably determines both the prognosis and social-economic outcomes and requires thorough evaluation. The aim of the study was to investigate the possibilities of insulin resistance (IR) correction, as the basis for comorbidity, in COPD patients under the influence of renewal non-pharmacological treatment using haloaerosoltherapy (HAT). Materials and methods. Complex clinical, functional and laboratory examinations were carried out in 32 patients with COPD (GOLD II-III) beyond the acute period. The average age of patients was 60.3±1.71 years, and duration of the disease — (14.2 ± 0.89) years. The control group of apparently healthy subjects included 24 persons. Data of the COPD Assessment Test, results of the six-minute walk test, and lung function data were analysed. The severity of oxidant stress (OS), activity of systemic inflammatory process were evaluated. Carbohydrate metabolism was studied according to the data of glucose, insulin, C-peptide levels in the blood and the HOMA-IR index was calculated. The basis for renewal treatment was HAT with certain parameters of concentration and dispersion. Results. It was found that, regardless of the remission, certain clinical and functional changes were persistent, which indicated a tendency to the progression of disease, which is confirmed by the OS severity, endogenous intoxication presence and the inflammatory process activity. These changes were the pathogenetic basis for IR and the corresponding metabolic and clinical consequences. In particular, strong direct correlations were found between the content of Schiff bases and the level of insulin (r = 0.71), HOMA-IR index value (r = 0.76), the content of C-peptide (r = 0.67) and a correlation of medium strength between the level of tumor necrosis factor-α and insulin (r = 0.52). After renewal treatment with the use of HAT, positive change of the studied indices were observed, which was accompanied by a decrease in the manifestations of IR, but not reaching the level of the control group. Conclusions. 1. Chronic bronchial obstruction and insulin resistance are mutually aggravating pathological processes, connected by a common pathogenetic link — the presence of OS, endogenous intoxication and systemic chronic inflammation of low intensity. This determines the necessity to develop complex long-term management programs for patients with COPD, taking into account both respiratory disorders, as well as probability of IR, type 2 diabetes development and its complications. 2. Under the influence of HAT as a non-pharmacological method of respiratory rehabilitation, in accordance with the improvement of clinical manifestations of COPD, ventilation function, reduction in OS intensity and systemic inflammation activity, there is a decrease in the IR manifestations, but a certain level of it remains even after the renewal treatment course, which indicates a significant pathogenetic role of these metabolic disorders and determines the necessity for appropriate corrections in the complex programs of patients long-term management. Key words: COPD, insulin resistance, metabolic disorders, haloaerosoltherapy

Evaluation of CXCL2 and autophagy genes expression in rheumatoid arthritis patients and its relation to cardiovascular diseases

Background Cardiovascular disease (CVD) is among the most common comorbidity and the leading cause of mortality in rheumatoid arthritis (RA) patients. The aim of this study was to assess at the levels of CXCL2 and autophagy genes such LC3 and Beclin 1 in RA patients and how they relate to the clinical manifestations and carotid intimal medial thickness. Methods This cross-sectional study included RA patients. Sociodemographic characteristics, clinical and therapeutic data were recorded. Thorough medical and clinical examination was conducted to evaluate the disease status including the number of swollen and tender joints, visual analogue scale and disease activity score 28 (DAS28).About 5ml of whole blood was collected from each subject and CXCL2, LC3 and Beclin-1 expression levels were evaluated. The carotid intima-media thickness (CIMT) was assessed by a duplex ultrasound system. As a control group, 79 healthy individuals of matching age and gender were included. Results Seventy-nine patients with RA were included in the study with mean age 45.24 years with (SD=10.07 years). Most of them were females (87.3%) and the median duration of RA was 7 years. Approximately 85% had positive RF, while 70.9% had positive Anti CCP antibody. CXCL2 and LC3 had a statistically significant positive correlation of medium strength (P = 0.026). CXCL2 showed significant positive correlation with presence of subcutaneous rheumatoid nodules while there was a positive correlation of low strength between CXCL2 and systolic BP, diastolic BP and HAQ score. For LC3 gene expression, it was significantly correlated positively with presence of joint deformities, negatively with hypercholesteremia. There was a statistically significant positive correlation of medium strength between LC3 and CIMT in those with disease duration ≥7 years after controlling (adjusting) for patient’s age. Conclusions CXCL2 and autophagy gene expression levels (LC3 and beclin1) are positively correlated with the clinical manifestations and CIMT in RA patients. These genes may serve as predictors for CVD in RA patients.

Effects of tablet-based drawing and paper-based methods on medical students' learning of gross anatomy.

The way medical students learn anatomy is constantly evolving. Nowadays, technologies such as tablets support established learning methods like drawing. In this study, the effect of drawing on a tablet on medical students' anatomy learning was investigated compared to drawing or summarizing on paper. The quality of drawings or summaries was assessed as a measure of the quality of strategy implementation. Learning outcome was measured with an anatomy test, both immediately afterward and after 4-6 weeks to assess its sustainability. There were no significant group differences in learning outcome at both measurement points. For all groups, there was a significant medium strength correlation between the quality of the drawings or summaries and the learning outcome (p < 0.05). Further analysis revealed that the quality of strategy implementation moderated outcomes in the delayed test: When poorly implemented, drawing on a tablet (M=48.81) was associated with lower learning outcome than drawing on paper (M=58.95); The latter (M=58.89) was related to higher learning outcome than writing summaries (M=45.59). In case of high-quality strategy implementation, drawing on a tablet (M=60.98) outperformed drawing on paper (M=52.67), which in turn was outperformed by writing summaries (M=62.62). To conclude, drawing on a tablet serves as a viable alternative to paper-based methods for learning anatomy if students can make adequate use of this strategy. Future research needs to identify how to support student drawing, for instance, by offering scaffolds with adaptive feedback to enhance learning.

The concept of the comorbidity model in predicting laparoscopic cholecystectomy results in patients with acute cholecystitis.

In recent years, there has been an unceasing increase in the number of patients with acute cholecystitis, including those with a complicated course of the disease against the background of concomitant pathology. The aim of the study was to establish the level of comorbidity and its influence on the level of postoperative complications in patients with acute cholecystitis who underwent laparoscopic cholecystectomy. We included 457 patients with acute cholecystitis with accompanying pathology, averaging 64.5±9.74 years. Operative intervention was carried out laparoscopically. Patients who scored 4-3 points were considered favorable, and those who scored 0-2 were considered unfavorable. The assessment of comorbidity was carried out using a special index - the Charlson comorbidity index. The majority of patients had a comorbidity index at 2 points (28.0% of all examined patients), indicating the presence of concomitant pathology in the vast majority of patients. We found that the Charleston comorbidity index increased with age, which indicates a higher frequency of concomitant diseases in older patients. A reliable correlation of medium strength was established (R=0.68; p<0.05) between the age and comorbidity indexes. When predicting the mortality of an experimental cohort of patients with acute cholecystitis who underwent laparoscopic cholecystectomy, it can be predicted that the level of the Charlson comorbidity index correlates with the age of patients while the level of postoperative complications increases.

Charactirestics of vitamin D level in patients with atopic dermatitis

The peculiarity of the skin is that it acts not only as a place of synthesis of vitamin D, but also as an organ targeted for its biologically active form. The aim of our study was to analyze the level of vitamin D in patients with atopic dermatitis. There were examined 48 people aged between 18 to 55 years; they are residents of Vinnytsia and Vinnytsia region. Serum levels of vitamin D, total IgE and eosinophilic cationic protein (ECP) were determined in the subjects. The average level of vitamin D in the serum of patients with atopic dermatitis was 19.2 [11.3-25.4] ng/ml, which corresponded to a deficiency. Among those surveyed, vitamin D deficiency was found in 68.4±4.7% (n=26) while vitamin D insufficiency in 31.6±4.5% (n=12). The severe course of the disease prevailed among patients aged 18-40 years (63.33±8.79) % more than in the age group of 41 years and older, (36.67±8.8%, p&lt;0.05; OR=2.98, S=0.53, 95% SI:1.04-8.52). The proportion of people with vitamin D deficiency and moderate severity of atopic dermatitis was 62.5% (n=10) with a median level of 14 [8.3–19] ng/ml, and patients with severe atopic dermatitis made up 90.9% (n=20) (χ²=4.6; p=0.023), in which the median level of vitamin D was 14 [8.3-19] ng/ml. Serum vitamin D levels were in the zone of deficiency in patients with moderate and severe atopic dermatitis. Vitamin D deficiency was significantly more common in the group of patients with elevated levels of allergic inflammation markers. A positive correlation of medium strength between the level of vitamin D and ECP in the serum of patients with atopic dermatitis (rs=0.53, p&lt;0.001), was revealed.

Course and structure of corneal nerve fibers in patients with primary open-angle glaucoma

PURPOSE. T o analyze the course and structure of corneal nerve fibers (CNF) in patients with different stages of primary open-angle glaucoma (POAG), and to determine possible correlations with the available diagnostic indicators of glaucoma progression. METHODS. The study included 48 patients (48 eyes) diagnosed with stages I–IV POAG at the age of 33 to 75 years. In addition to standard examination methods, all patients underwent static perimetry with Humphrey Field Analyzer II, optical coherence tomography (OCT) of the optic disc, measurement of biomechanical properties of the fibrous membrane of the eye, as well as laser confocal microscopy of the cornea on HRT III device with corneal adapter Cornea Rostock. RESULTS. There were positive correlations of medium strength between the indices of basic nerve fiber length (r = 0.64 and r = 0.63; p &lt; 0.05) and density (r = 0.6 and r = 0.65; p &lt; 0.05) with perimetry data (MD and PSD) and retinal nerve fiber thickness measured with OCT of the optic disc (r = 0.65 and r = 0.61; p &lt; 0.05). Nerve fiber anisometry and symmetry coefficients depended on glaucoma stage (r = 0.62 and r = 0.65; p &lt; 0.05). An increase in the number and density of Langerhans cells and an increase in the length of their processes were detected. A reliable correlation (r = 0.63) was found between glaucoma stage and corneal inflammatory response. The immune etiology of the glaucoma process considered by several authors may be a reason of an increase in the number and density of macrophages during the progression of POAG. CONCLUSION. Laser confocal microscopy can be used as an additional diagnostic method for patients with different stages of POAG.

Correlations between vessel stiffness and biomarkers of senescent cell in elderly patients

Aim To study the association between vascular wall stiffness and known markers for accumulation of senescent cells in blood, cells, and tissues of old patients.Material and methods This study included male and female patients aged 65 years and older who were referred to an elective surgical intervention, that included a surgical incision in the area of the anterior abdominal wall or large joints and met the inclusion and exclusion criteria. For all patients, traditional cardiovascular (CV) risk factors and arterial wall stiffness (pulse wave velocity, PWV) were evaluated. Also, biomaterials (peripheral blood, skin, subcutaneous adipose tissue) were collected during the surgery and were used for isolation of several cell types and subsequent histological analysis to determine various markers of senescent cells.Results The study included 80 patients aged 65 to 90 years. The correlation analysis identified the most significant indexes that reflected the accumulation of senescent cells at the systemic, tissue, and cellular levels (r&gt;0.3, р&lt;0.05) and showed positive and negative correlations with PWV. The following blood plasma factors were selected as the markers of ageing: insulin-like growth factor 1 (IGF-1), fibroblast growth factor 21 (FGF-21), and vascular endothelium adhesion molecule 1 (VCAM-1). A significant negative correlation between PWV and IGF-1 concentration was found. Among the tissue markers, P16INK, the key marker for tissue accumulation of senescent cells, predictably showed a positive correlation (r=0.394, p&lt;0.05). A medium-strength correlation with parameters of the 96-h increment of mesenchymal stromal cells and fibroblasts and a weak correlation with IL-6 as a SASP (specific senescent-associated secretory phenotype) were noted. Results of the multifactorial linear regression analysis showed that the blood plasma marker, VCAM-1, and the cell marker, 96-h increment of fibroblasts, were associated with PWV regardless of the patient's age.Conclusion Stiffness of great arteries as measured by PWV significantly correlates with a number of plasma, tissue, and cellular markers for accumulation of senescent cells. This fact suggests PWV as a candidate for inclusion in the panel of parameters for evaluation and monitoring of the biological age during the senolytic therapy.

Features of geriatric status in elderly patients with osteoarthritis combined with neuropathic pain: data from the Russian epidemiological study EVKALIPT

The main symptoms of osteoarthritis (OA) are pain and dysfunction of the joints. Neuropathic pain (NP) occurs in more than half of patients with OA, it is refractory in nature and is the cause for seeking medical advice more frequently, poor quality of life and disability.Objective: to evaluate the frequency of NP and its relationship with geriatric syndromes (GS) in patients with OA aged 65 years and older. Patients and methods. The subanalysis of the study EVKALIPT included 2286 patients with OA and chronic pain syndrome. All patients underwent a comprehensive geriatric assessment (CGA) and diagnostics of NP using the DN4 questionnaire.Results and discussion. The prevalence of NP in patients with OA was 22.7%. Patients with OA and NP more often experienced pain of any localization with a large number of tender points, they had a higher frequency and intensity of pain syndrome, they more often took analgesics and noted limitations in daily life. When conducting a correlation analysis, correlations of medium strength were found between the sum of scores according to DN4 questionnaire and the pain intensity assessment on a numerical rating scale at the time of examination (r=0.26; p&lt;0.001) and in the previous 7 days (r=0.29; p&lt;0.001). CGA data in patients with OA and NP demonstrated worse geriatric status and a higher incidence of GS. The most common GSs were basic (81%) and instrumental (64%) dependence in everyday life, senile asthenia (70%), urinary incontinence (69%), depression (69%) and cognitive impairment (67%). Multivariate analysis showed that, in addition to age, the presence of NP was independently associated with sensory deficits, depression, falls, urinary incontinence, and bedsores (odds ratio 1.77–2.49). Patients with NP were more likely to use mobility aids, absorbent underwear, and orthotics.Conclusion. NP was diagnosed in 22.7% of OA patients aged 65 years and older. Such patients have worse functional status, they are more often diagnosed with a number of GSs.

ПСИХОЛОГІЧНІ ОСОБЛИВОСТІ ВЗАЄМОЗВ'ЯЗКУ ЖИТТЄСТІЙКОСТІ Й ОПАНУВАЛЬНОЇ ПОВЕДІНКИ ОСОБИСТОСТІ

The article reveals the concept of coping behavior, its features, and its main functions in the life of a person. It is presented as a special type of social behavior that ensures the preservation of the mental health and well-being of the individual and helps to cope with stressful events and difficult life situations with the help of conscious actions. The main ways of coping behavior are characterized. It is emphasized that an important factor in the formation of coping behavior is the adaptive potential of the individual, namely the level of its hardiness. It is emphasized that it is the hardiness of the individual that is the leading factor in the effective life of the individual, which provides the ability to productively overcome difficulties, using constructive behavioral strategies, to cope with difficult life situations and psychological stress. It helps to minimize the negative consequences, turning them into new opportunities for one's development, and most importantly, to maintain harmonious communication with the environment. The article also presents the results of a study of the features of the relationship between hardiness and the coping behavior of an individual. Among the features of the manifestation of methods of coping behavior in the subjects, a high level was found among such indicators as self-control, flight avoidance, and positive reassessment. The study established a relationship between coping behavior and personality resilience. In particular, the presence of a direct statistically significant correlation of medium strength (r=0.390, sig=0.012) between the "Problem Solving Planning" strategy and hardiness was revealed; the presence of a direct statistically significant relationship of average-strength (r=0.388, sig=0.013) between the "Self-control" strategy and hardiness; the presence of a direct statistically significant relationship of medium strength (r=0.463, sig=0.000) between the "Taking responsibility" strategy and hardiness; the presence of an inverse statistically significant relationship of average-strength (r=-0.429, sig=0.000) between the "Escape-avoidance" strategy and hardiness. Peculiarities of expressiveness of ways of coping behavior in the subjects with high and low hardiness were determined. Thus, a group of people with a high level of hardiness is characterized by the manifestation of constructive skills to resist difficulties, energy, and the ability to defend their interests, minimize their anxiety and positively reassess the current situation. At the same time, individuals with low levels of hardiness are more inclined to be attracted by the support of others than to solve problems on their own, they tend to use an escape-avoidance strategy, often distance themselves, and show low self-control and low ability to solve problems.

Disorders of lipid metabolism and lipid transport system in women with unstable angina in the dependence on smoking: pathogenetic connections and development risks

The aim of the study. To study the effect of smoking on lipid metabolism, lipid transport system and systemic inflammation, to find out their correlations and the risks of unstable angina in women, depending on the habit of smoking.Material and methods. 225 women were examined: 150 women - patients with unstable angina and 75 healthy women. The level of total cholesterol, low and high-density lipoprotein cholesterol, triglycerides, apolipoproteins A1 (ApoA1) and B (ApoB), C-reactive protein, fibrinogen were determined in all subjects. Multifactor correlation-regression analysis was performed using Fisher's test. Statistical processing of the results was performed using the applications "Microsoft Office Excel 2016" and "Statistics ver. 10.Results. The relative risk of developing unstable angina in patients with a smoking habit is most often associated with atherogenic dyslipidemia (total cholesterol &gt; 4 mmol, OR = 12.02, SI = 8.12-16.32; low-density lipoprotein cholesterol &gt; 1.8 mmol / l, OR = 9,32, SI = 6,13-12,56, high-density lipoprotein cholesterol &lt;1,2 mmol / l, OR = 3,91, SI = 2,12-5,45, the ratio of apolipoproteins ApoV / ApoA1&gt; 0.85, OR = 2.69, SI = 1.15-4.21) and the highest activity of systemic inflammation (C-reactive protein &gt;3 mg / l, OR = 3.62, SI = 2.15- 4.56). The risk of developing unstable angina associated with these indicators is 1.5-2 times higher in women with a smoking habit than in women who have never smoked. Significant direct correlations of high and medium strength between the severity of systemic inflammation, disorders of the lipid transport system (increase in the ratio of ApoB / ApoA1 and decrease in the level of ApoA1), in patients with unstable angina in women smokers.Conclusions. Smoking is one of the most aggressive factors of unstable angina in women, which contributes to the emergence and progression of other important risk factors and leads to disorders of lipid metabolism, lipid transport system, systemic inflammation and increased chances of unstable angina.

The level of alkaline phosphatase activity and the content of calcium and phosphorus ions in the blood of pregnant women in different trimesters of pregnancy

Calcium-phosphorus exchange is an important part of the metabolism in the human body, which primarily ensures the mineralization processes of hard tissues, including teeth, which is a prerequisite for their resistance to the carious process. The aim of the study was to establish the dynamics of changes in the indicators of calcium-phosphorus metabolism in the blood of pregnant women in different trimesters of pregnancy. An examination and laboratory tests of the blood of 210 pregnant women aged 18 to 36 years were carried out, in which the level of calcium ions, the content of magnesium, phosphate ions and the activity of alkaline phosphatase were determined in the I, II and III trimesters of pregnancy. The degree of probability of the obtained results was statistically assessed. The results of the study indicate an increasing deficit of Ca ion content with increasing gestational age, namely: by 3.33% in the second trimester and by 5.98% in the third trimester compared to the first trimester. The level of phosphate ions was within normal limits and tended to increase in the second trimester of pregnancy by 11.88% with a subsequent decrease in the third trimester by 7.62%. The content of Mg is low and in some places borders on the lower limit of the norm, which indicates the insufficient supply of it to the body of pregnant women. The level of LF enzyme activity in the blood of pregnant women also decreased with each trimester of pregnancy. A strong positive correlation was established between the level of LF activity and the content of Mg in the blood of women throughout pregnancy, namely: I trimester ‒ r=0.75, p&lt;0.05; II trimester ‒ r=0.78, p&lt;0.05; III trimester ‒ r=0.81, p&lt;0.05. Positive correlations of moderate and medium strength were also observed between the level of LF activity and the content of phosphate ions in the blood of pregnant women in the I trimester of pregnancy (r=0.62, p&lt;0.05) and the III trimester ‒ (r=0, 44, p&lt;0.05), which is quite understandable, since the direct result of the enzyme's work is the formation of available phosphate ions, which are subsequently incorporated into the structure of hydroxyapatites. As a result of the conducted research, it was determined that the II trimester of pregnancy is the most vulnerable, which is characterized by changes in all indicators of calcium-phosphorus metabolism and a break in most of the interdependencies between them, which, in turn, indicates the restructuring of metabolic processes in the body of a pregnant woman. Keywords: pregnancy, calcium-phosphorus exchange, alkaline phosphatase activity, mineralization of hard tooth tissues.

MАR-test and Spermiological Research Indices

Antisperm antibodies are detected in 3% to 25% of cases in men and women diagnosed with infertility. They can also be diagnosed in 1–10% of healthy fertile men. The presence of a high titer of AST is one of the factors of male infertility, which can be «hidden», i. e. not cause symptoms and deterioration of the overall spermogram. The objective: to analyze the results of sperm testing in men with antisperm antibodies, which were detected by MAR-test. Material and methods. A retrospective analysis of the examination results of 555 men was conducted on the basis of the Medical Center for Infertility Treatment in Chernivtsi. Spermograms were examined according to WHO recommendations in 2000, using an inverted microscope Olympus CKX41 in a Broker chamber. Determination of the percentage of sperm coated with antisperm antibodies was performed using the MAR-test (MAR-test, MAR-mixed antiglobulin reaction). Results. If we calculate the percentage of patients in whom we assume the connection between the presence of antisperm antibodies and undertaken surgery, genital infections and allergy history, we get only 48.3% of cases. It has been found that most changes in sperm counts correlate with the percentage of sperm that are coated with IgG. These data indicate that increased IgG levels play an important role in the development of pathospermia. A negative medium-strength correlation was found between the percentage of Category A sperm and the percentage of IgG-coated sperm. Persistence of IgG in semen is accompanied by a probable decrease in the morphological quality of sperm. Conclusion. In 52% of patients it was not possible to establish the etiological factor for the presence of Ig in the ejaculate. It has been found that most changes in sperm counts correlate with the percentage of sperm that are coated with IgG. It has been determined that an increase in the level of IgA and IgG leads to a probable increase in the percentage of pathological sperm forms and decrease in sperm motility. In the presence of 30% of sperm that are coated with IgG, with a probability of 95%, the ejaculate of patients will have 100% of pathologicoalr mf s of sperm.

Морфометрична характеристика стегнових кісток у плодів людини

Defining quantitative growth parameters of individual skeletal bones, namely the right and left femurs, is practically important for determining the age of the fetus. Lack of data on changes in the length of the femur in 4-10 months’ fetuses, as well as the dependence of its morphometric parameters on the length of the lower limb and the age of the fetus, prompted us to conduct this study. The purpose of the study was to determine the morphometric parameters of the length of the right and left femurs during the fetal period of human ontogenesis, which could form the base of normal indicators. Materials and methods. Morphometric study was performed on the lower extremities specimens of 40 human fetuses of an 81.0-375.0 mm parietal-coccygeal length. Results and discussion. As a result of the study, the dynamics of changes in the length of the right and left femurs and lower extremities in 4-10 months’ human fetuses was established. Direct correlations were found in the studied fetal groups, and only in 5-month-old fetuses a direct medium-strength reliable correlation between the lengths of the right and left femurs was found. A weak correlation between the length of the left lower limb and the length of the left femur was found in 7-month-old fetuses. In other cases, direct significant strong correlations were found between the analyzed indicators. The results obtained regarding the change in the length of the right and left femurs, as well as the Pearson correlation coefficient between the morphometric parameters of the length of the right and left femurs and the length of the lower extremities and parietal-coccygeal length of human fetuses 4-10 months are important both theoretically and practically for fetal anatomy. Conclusion. During the fetal period of human ontogenesis, where there is a relatively uniform increase in the length of the right and left femurs, no significant differences in their length were detected. Between the 4th and the 10th month of fetal development, the length of the right femur increases by 5.59 times (from 13.18 ± 2.56 mm to 73.66 ± 2.19 mm), and the length of the left femur increases by 5.44 times: from 13.54 ± 2.35 mm to 73.73 ± 2.12 mm, respectively. In the fetal period the right and left lower extremities also grow equally, no significant differences in their length have been established

Ендотеліальна дисфункція як фактор розвитку порушення функції нирок у хворих на гіпотиреоз

Вступ. Установлено, що ендотеліальна дисфункція виявляється навіть у межах нормальних значень тиреотропного гормону і погіршується в міру зростання рівня тиреотропного гормону. Мета дослідження: вивчення стану ендотелію та його впливу на функцію нирок у хворих на первинний гіпотиреоз.Матеріали та методи. Обстежено 188 пацієнтів із маніфестним гіпотиреозом. Пацієнти були розділені на групи: І групу становили 45 пацієнтів із гіпотиреозом на тлі автоімунного тиреоїдиту без ожиріння; ІІ групу — 46 хворих на автоімунний тиреоїдит із гіпотиреозом та ожирінням; ІІІ групу — 47 хворих на післяопераційний гіпотиреоз без ожиріння; IV групу — 50 хворих на післяопераційний гіпотиреоз з ожирінням.Результати. При дослідженні ендотеліальної функції у всіх групах хворих на гіпотиреоз виявлена вірогідна різниця в її показниках, причому ендотеліальна дисфункція була більш вираженою в пацієнтів ІІ та IV груп. Приріст діаметра плечової артерії після компресії як у ІІ, так і в IV групі був удвічі менший, і, відповідно, ендотелійзалежна вазодилатація (ЕЗВД) теж була меншою, ніж у здорових, на 46,4 та 47,7 %. В об’єднаній групі маніфестного гіпотиреозу було виявлено зворотний середньої сили кореляційний зв’язок між рівнем тиреотропного гормону та ЕЗВД, а також між ЕЗВД та загальним холестерином і ліпопротеїнами низької щільності. Установлено також середньої сили зворотний зв’язок у І і ІІ групах та слабкий, але позитивний зворотний зв’язок у ІІІ та ІV групах між васкулоендотеліальним фактором росту і швидкістю клубочкової фільтрації. Висновки. Отримані кореляційні зв’язки вказують на взаємообтяжуючий вплив гіпофункції щитоподібної залози, ожиріння та гіперхолестеринемії на розвиток ендотеліальної дисфункції у хворих на первинний гіпотиреоз та зниження швидкості клубочкової фільтрації. Поєднане застосування левотироксину, інгібітора ангіотензинперетворюючого ферменту еналаприлу та аторвастатину суттєво покращує ЕЗВД.

Рівні моноцитарного хемоатрактантного протеїну у хворих із первинним гіпотиреозом

Мета дослідження — визначити вміст моноцитарного хемоатрактантного протеїну‑1 (МХП‑1) у сечі хворих на первинний гіпотиреоз.Матеріали і методи. Обстежено 141 хворого з маніфестним гіпотиреозом. З числа обстежених у 71 пацієнта був післяопераційний гіпотиреоз, у 70 — гіпотиреоз на тлі автоімунного тиреоїдиту (АІТ). Пацієнти були розділені на ІА групу, що становили з 35 пацієнтів із гіпотиреозом на ґрунті АІТ без ожиріння; ІБ групу — 35 хворих на АІТ із гіпотиреозом та ожирінням; ІІА групу — 34 хворіх на післяопераційний гіпотиреоз без ожиріння; IІБ групу — 37 хворих на післяопераційний гіпотиреоз з ожирінням.Результати. В обстежених пацієнтів виявлено вірогідне підвищення рівнів МХП‑1 у всіх групах. При проведенні кореляційного аналізу встановлений прямий кореляційний зв’язок між рівнями МХП‑1 і тиреотропним гормоном, а також рівнем креатиніну в крові та зворотний середньої сили кореляційний зв’язок між швидкістю клубочкової фільтрації та концентрацією МХП‑1 із найбільшим ступенем вираженості при некомпенсованому гіпотиреозі на ґрунті АІТ з ожирінням.Висновки. Виявлені зв’язки свідчать, що рівень МХП‑1 певною мірою відображає функціональний стан нирок та може бути використаний як доповнення до традиційних методів обстеження хворих.

Relationship between biochemical parameters and glomerular filtration rate by Cockcroft-Gault, CKD EPI and cystatin C in patients with type 1 diabetes

Annotation. The aim of research is to study correlations of biochemical parameters with glomerular filtration rate according to Cockcroft-Gault, CKD EPI and cystatin C in patients with type 1 diabetes (T1D). 78 men and 62 women aged 22-26 years with T1D were examined. The control group consisted of 8 almost healthy men and 13 almost healthy women of the same age. The level of microalbuminuria and cystatin C was determined in all patients by enzyme-linked immunosorbent assay. Biochemical evaluation of fasting blood glucose, glucose 2 h after exercise, mean value of glucose, creatinine, GFR according to Cockcroft-Gault, CKD EPI and GFR according to cystatin C. Correlation analysis between the series of indicators was calculated using Spearman statistics in the license package “Statistica 5.5”. In patients with T1D, there is no significant correlation in normoalbuminuria between urinary albumin levels and GFR by Cockcroft-Gault (in women), CKD EPI and cystatin C (in all study groups). No significant correlations were found between urinary albumin levels and GFR by Cockcroft-Gault, CKD EPI and cystatin C in the proteinuria group. The correlation analysis revealed in the general group and in women with proteinuria an association between the average value of blood glucose and low GFR levels by Cockcroft-Gault, CKD EPI (negative medium strength correlation r = from -0.31 to -0.46) and elevated creatinine (positive strong correlation r=0.62 and r=0.91), indicating an unfavorable role of hyperglycemia in the development of nephropathy in patients with T1D. Higher correlations of cystatin C with GFR by cystatin C (r= -1.0) than by creatinine with GFR by Cockcroft-Gault (r = from - 0.63 to 0.99) and by CKD EPI (r = from -0.73 to -0.99) were demonstrated. The strength of the correlations increases from GFR by Cockcroft-Gault to GFR by cystatin C. Correlations between creatinine and GFR by Cockcroft-Gault and CKD EPI were characterized by sex differences (greater in women) and an increase in their strength synchronously with an increase in urinary microalbumin. At the same time, there is a consistently high identical value (r= -1.0) of correlations of the level of cystatin C with GFR on cystatin C in all comparison groups. Neither the sex factor nor the degree of albuminuria affected the change in their strength. Only men with microalbuminuria had moderate feedback between creatinine and cystatin C (r= -0.46). In all groups of women, in the general group and in men with normoalbuminuria and proteinuria, the correlations are close to zero, which may indicate the absence of a linear relationship between these indicators. When dividing the sample according to the level of cystatin C between the level of creatinine and the level of cystatin C, the following were found: medium feedback (r= -0.37) in the general group with normoalbuminuria and cystatin C&gt;0.9; moderate feedback (r= -0.37) in the general group and in men with proteinuria and cystatin C&lt;0.9 strong feedback (r= -0.90 and r= -0.88). Thus, in the course of correlation analysis it was found: microalbuminuria is not an independent marker of diabetic nephropathy (DN), starting from preclinical and ending with a clinically manifested stage of this complication; for timely and adequate diagnosis of DN it is necessary to measure the level of albumin, creatinine and cystatin C, which are independent markers of renal dysfunction; cystatin C gives a more accurate approximation to the actual values of GFR than creatinine; cystatin C is more sensitive in the early stages, and creatinine is a marker of later stages of DN development; hyperglycemia is the main initiating metabolic factor in the development and progression of DN.

Number of Gastroesophageal Refluxes Detected With Oesophageal pH-Impedance Study Correlates With Dietary Patterns

Abstract Objectives To evaluate association of number of gastroesophageal refluxes detected with oesophageal pH-impedance study with dietary patterns Methods Subjects referred to oesophageal pH-impedance examination were invited to participate in the study, approved by LEC. In case of agreement, they were asked to provide data of their usual nutrition based on food frequency questionnaire (Nutrilogic, Russia). Diet was assessed in accordance with healthy eating index, for the following main groups of products: grains, fruits, vegetables, dairy products, meats, fats and confectioneries. The results are shown as a quotient of dividing the actual values by the recommended. Spearman rank R was used to analyse correlation between number of gastroesophageal refluxes (GER) detected with oesophageal pH-impedance examination and dietary patterns assessment. Results Data of 40 consecutive patients (12 of them with confirmed gastroesophageal reflux disease, 28 females, age (Mean ± SD): 52.2 ± 12.9 y.o.) served as the source for the study. Mean energy value of the ration was 2302 ± 1391 kcal/day. Dietary patterns for main food groups was as follows: grains 1.4 ± 0.7, vegetables 1.1 ± 0.7, fruits 0.8 ± 0.9, dairy products 0.6 ± 0.6, meats 1.7 ± 1.0, fats 0.6 ± 0.8, confectionaries 0.3 ± 0.5. Mean number of GERs was 43.8 ± 24.4, acid GERs - 26.2 ± 20.5 per day. Direct medium-strength correlation was found between pattern of dairy products consumption and total number of GERs (Spearman R = 0.47, P &amp;lt; 0.05), weak-acid GERs (R = 0.49, P &amp;lt; 0.05), non-acid GERs (R = 0.62, P &amp;lt; 0.05). Pattern of confectionaries consumption was associated with high (that reached proximal oesophagus, ∼17 cm above LES) GERs: R = 0.47, P &amp;lt; 0.05. Conclusions This preliminary results may serve as a basis for further research in larger comparative trials and may be considered when diet modification is planned for patients with GERD. Funding Sources Russian Science Foundation research grant #19–76-30014.

Frequency of examination and perceived contribution of factors relating to work-related musculoskeletal disorders of physiotherapists

Objective. Literature confirms that many physiotherapists suffer from work-related musculoskeletal disorders (WMSDs), but studies mention different, complementary and contradictory findings regarding risk factors. This scoping review aimed at revealing the most frequently examined and contributory WMSD factors mentioned in recent studies about physiotherapists. Methods. Based on specific inclusion/exclusion and appraisal criteria, 11 studies published between 2012 and 2018 were included in the analysis. The factors recorded per publication were grouped into 18 categories, the frequency of their appearance across the sources was counted and the median ranks of their relative reported contribution were calculated. Results. Excessive workload was found to be the most contributory factor, followed by the application of manual orthopaedic techniques. However, demanding and repetitive manual tasks were the most common factors investigated in the publications reviewed. A medium-strength correlation was found between the frequency of examination and reported contribution of factors but with a noticeable range of the confidence interval possibly due to the diversity of the approaches in the studies reviewed. Conclusions. The findings indicate a relative discordance between the level of contribution of each factor to the development of WMSDs and the types of factors most frequently addressed by studies.

Кореляція елементів насіннєвої і вегетативної продуктивності у колекційних зразків люпину білого

The aim of the study was to establish the strength and direction of the correlations between the quantitative traits that form vegetative and seed productivity of white lupine. Field, measuring-weight and mathematical-statistical research methods were used. A significant positive correlation of the average strength between seed productivity and such traits as plant height, number of lateral racemes, number of beans from the central and lateral racemes, etc. was established. A strong positive correlation was found with the vegetative development of plants, weak - with the number of seeds in one bean and the weight of 1000 seeds. A significant positive strong correlation of vegetative productivity with such quantitative features as the mass of beans from the central racemes and the mass of leaves and stems was established. A positive correlation of medium strength was found with the number of beans from the central and lateral racemes, the mass of beans from the side racemes, the mass of roots and so on. It was found that the seed productivity of white lupine plants is mainly due to the development of such traits as the number of beans from the lateral racemes, the weight of leaves and roots, the number of seeds and the weight of seeds from the central and lateral racemes. The formation of vegetative productivity primarily depends on the mass of beans from the central racemes and the mass of leaves and stems. The use of established patterns of productivity will help increase the effectiveness of selection of breeding material for the specified parameters.

ASSOСIATION BETWEEN VITAMIN D STATUS AND METABOLIC DISORDERS IN PREMENOPAUSAL WOMEN WITH AUTOIMMUNE HYPOTHYROID DISEASE

The aim: Is to establish a relationship between serum vitamin D level with carbohydrate and lipid indexes in women with autoimmune hypothyroid disease. Materials and methods: 146 women with autoimmune hypothyroid disease were examined in the period 2017-2019, who signed the informed consent. The mean age of women was 43.8 ± 0.7 years. Anthropometric, general clinical and biochemical examinations were performed including determination of lipid metabolism, hydrocarbon metabolism and establishment of vitamin-D status. Results: Vitamin D deficiency was found in 78.8%, insufficiency in 17.1% of women with autoimmune hypothyroidism. Statistical processing of results was carried out and established strong negative correlation between 25 (OH) D and Thyroid Peroxidase Antibody (r = -0,77) and thyrotropic hormone level (r = -0.72), р&lt;0,05. Strong inverse correlations were found between vitamin D levels and body mass index (r=-0,74) and total cholesterol levels (r=-0,72), negative correlation of medium strength was with highdensity lipoprotein cholesterol (r=-0,58), triglycerides (r=-0,46), atherogenic coefficient (r=-0,65) and the HOMA-IR (r=-0,57), The values of p &lt; 0.05 were considered reliable. Conclusions: The incidence of vitamin D hypovitaminosis in women with autoimmune thyroid disease is significantly higher than in the healthy population. Low vitamin D status is significantly associated with autoimmune thyroid dysfunction and determines the degree of metabolic disorders and cardiovascular risk in premenopausal women with autoimmune hypothyroid disease.