Development Of Many Complications Research Articles

Development, evaluation and validation of machine learning models to predict hospitalizations of patients with coronary artery disease within the next 12 months

BackgroundImproved survival of patients after acute coronary syndromes, population growth, and overall life expectancy rise have led to a significant increase in the proportion of patients with stable coronary artery disease (CAD), creating a significant load on the entire healthcare system. The disease often progresses with the development of many complications while significantly increasing the likelihood of hospitalization. Developing and applying a machine learning model for predicting hospitalizations of patients with CAD to an inpatient medical facility will allow for close monitoring of high-risk patients, early preventive interventions, and optimized medical care. AimsDevelopment and external validation of personalized models for predicting the preventable hospitalizations of patients with stable CAD and its complications using ML algorithms and data of real-world clinical practice. Methods135,873 depersonalized electronic health records of 49,103 patients with stable CAD were included in the study. Anthropometric measurements, physical examination results, laboratory, instrumental, anamnestic, and socio-demographic data, widely used in routine medical practice, were considered as potential predictors, a total of 73 features. Logistic regression, decision tree-based methods including gradient boosting (AdaBoost, LightGBM, XGBoost, CatBoost) and bagging (RandomForest and ExtraTrees), discriminant analysis (LinearDiscriminant, QuadraticDiscriminant), and naive Bayes classifier were compared. External validation was performed on the data of a separate region. ResultsThe best results and stability to external validation data were shown by the CatBoost model with an AUC of 0.875 (95% CI 0.865–0.885) for the internal testing and 0.872 (95% CI 0.856–0.886) for the external validation. The best model showed good performance evaluated through AUROC, Brier score and standardized net benefit (for the target NPV threshold) for the validation dataset that was only slightly similar to the train data. ConclusionThe metrics of the best model were superior to previously published studies. The results of external validation demonstrated the relative stability of the model to new data from another region that confirms the possibility of the model’s application in real clinical practice.

Urinary incontinence in obese women

In recent decades, obesity has assumed the features of a pandemic. Leading to the development of many complications, obesity also contributes to the development of urinary incontinence. The review presents current data on the etiology, pathophysiology and approaches to the treatment of stress urinary incontinence in obese patients. There are a large number of publications by foreign authors on the problem of urinary incontinence in patients with obesity. The results of the studies allow us to say with confidence about the direct relationship between an increase in body mass index and the risk of developing urinary incontinence. Long-term results of surgical treatment of urinary incontinence in obese patients require reflection and further observation. It is noteworthy that this problem is practically not reflected in the works of domestic authors. It is relevant to conduct domestic clinical studies on the problems of urinary incontinence in patients with obesity.

Clinical, Radiological, and Histopathological Characteristics of a Patient with a Pituitary Tumor of the Corticotrophinoma Type — Case Report

Introduction. Cushing disease is a rare but severe endocrine disorder. It is caused by a pituitary tumor producing excessive amounts of adrenocorticotropic hormone (ACTH) which is subsequently responsible for excessive production of cortisol in the adrenal glands. Hypercortisolism manifests with many symptoms and disorders that affect numerous organs.
 Aim. To increase knowledge among nursing staff about the symptoms, causes, and treatment of patients with Cushing disease.
 Case Report. A 40-year-old patient with a history of infertility treatment was admitted to the Clinical Department of Neurosurgery of St. Raphael Hospital in Krakow due to a pituitary tumor. For 7 years the patient had been experiencing symptoms such as weight gain, excessive tiredness, and menstrual disorders. The MRI examination of the pituitary showed a tumor in the sella turcica with dimensions of 4.5×5.5×4.5 mm. The histopathological examination revealed corticotropic pituitary adenoma (positive for ACTH). The patient underwent surgery after which symptoms of hypercortisolism decreased and menstruation returned. The patient became pregnant and gave birth to a child.
 Discussion. A proper diagnosis in this patient’s case could protect her from development of many complications related to other organs, such as diabetes mellitus or hypertension.
 Conclusions. Cushing disease remains in some cases undiagnosed for many years. The patient is being referred to various specialists (ophthalmologist, gynecologist, rheumatologist) due to symptoms that are in fact complications of hypercortisolism. The case illustrates the importance of early recognition of the main symptoms of hypercortisolism. Such clinical skill would undeniably help to refer the patient to the appropriate specialist, i.e., an endocrinologist much earlier, and thus establish the correct diagnosis and implement appropriate treatment. (JNNN 2023;12(3):134–139)

2-4 weeks is the optimal time to operate on colorectal liver metastasis after neoadjuvant chemotherapy.

Neoadjuvant chemotherapy (NAC) is generally accepted for treatment of liver metastasis of colorectal cancer (CRLM), but what is a reasonable interval between the latest NAC and surgery is still unknown. The aim of the current study was to investigate the proper timing of surgery after NAC. Subjects were 141 patients with CRLM who underwent NAC and then surgery were retrospectively identified from 2008 to 2020. They were divided into a short interval group (SIG, ≤ 4 weeks) and long interval group (LIG, > 4 weeks) using the software X-tile. The SIG was subclassified group into 3 time periods (1-2 weeks, 2-3 weeks, and 3-4 weeks) to assess the incidence of complications. Patients in the SIG were more likely to have significantly better recurrence-free survival (RFS) (3-year RFS of 47.4% vs. 20.5%, P = 0.043) and no difference in overall survival (OS) (3-year OS 76.1% vs. 79.9%, P = 0.635). The postoperative complication rate was 23.5% in the SIG and 14.0% in the LIG (P = 0.198). The postoperative complication rate in the 1-2 weeks subgroup was marginally higher than that in the > 4 weeks subgroup (35% vs. 14.3% P = 0.055). Multivariate analysis revealed that chemotherapy-free intervals of 1-2 weeks were an independent predictor of increased postoperative complications (OR = 0.263, 95% CI 0.7-0.985 P = 0.048). Patients who underwent surgery within 4 weeks of NAC had better RFS. In addition, 1-2 weeks was an independent factor influencing the development of more complications. For patients with CRLM, performing surgery within 2-4weeks of NAC was feasible and safe, and it did not increase the incidence of postoperative complications but it did prolong RFS.

Pro-Inflammatory Adipokine and Cytokine Profiles in the Saliva of Obese Patients with Non-Alcoholic Fatty Liver Disease (NAFLD)-A Pilot Study.

Undiagnosed and untreated non-alcoholic fatty liver disease (NAFLD) can lead to the development of many complications, such as cirrhosis, hepatocellular carcinoma, or cardiovascular diseases. Obese people are at increased risk of developing NAFLD. Due to the current lack of routine diagnostics, it is extremely important to look for new diagnostic methods and markers for this disease. The aim of this study was to assess the concentration of selected pro-inflammatory adipokines and cytokines in the unstimulated saliva of obese people with fatty liver disease in various stages (with or without slight fibrosis) and to analyze them for possible use as early markers of NAFLD diagnosis. The study involved 96 people who were divided into 5 groups based on the criterion of body mass index (BMI) and the degree of fatty liver (liver elastography). There were statistically significant differences between the groups in the concentrations of MMP-9 (matrix metalloproteinase 9), resistin, and IL-1β (interleukin 1β) in saliva. Statistically significant, positive correlations between hepatic steatosis and the concentration of MMP-2 (matrix metalloproteinase 2), resistin, and IL-1β in saliva were also found. Statistically significant positive correlations were also found between the concentration of resistin in saliva and the concentration of ALT (alanine aminotransferase) and GGTP (gamma-glutamyl transpeptidase) in serum. MMP-2, IL-1β, and resistin may be potential markers of NAFLD development, assessed in saliva. However, further research is needed because this is the first study to evaluate the concentrations of the selected pro-inflammatory parameters in the saliva of patients with NAFLD.

ЕКСПРЕСІЯ ГЕНІВ PTGS2 ТА NOS2 У СИНОВІАЛЬНІЙ РІДИНІ ХВОРИХ НА ОСТЕОАРТРИТ ПІСЛЯ SARS-CoV2-ІНФЕКЦІЇ

Background. The emergence of a new severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) has created a serious global threat to the health of people in various countries. The 2019 coronavirus disease (Coronavirus disease 2019, COVID-19) has caused the development of many complications in the population of most countries of the world. Currently, many people have felt the unpleasant consequences of the coronavirus infection. Among them, a special group consists of patients with chronic diseases, particularly osteoarthritis. The development of inflammation and intensification of free radical processes is a leading link in the pathogenesis of osteoarthritis. Inflammatory and degenerative processes that develop in osteoarthritis cause modification of the molecular and cellular composition of the synovial fluid. Methods. The aim of the work was to determine the expression of (Prostaglandin-endoperoxide synthase 2) and NOS2 (Nitric Oxide Synthase 2) genes in synovial fluid cells of patients with osteoarthritis after SARS-CoV2 infection. All study participants were divided into two groups. The first group (n = 22) is patients with osteoarthritis of the knee joints II-III degree. The second group (n = 14) is patients with osteoarthritis of the knee joints II–III degree, who suffered a mild and moderate form of COVID-19 6–9 months ago. Expression of PTGS2 and NOS2 genes was determined in nuclear cells of synovial fluid. RNA was obtained by the Chomczynski method. Synthesis of cDNA and quantitative polymerase chain reaction in real time (Real-time PCR, qPCR) using the commercial kit "Thermo Scientific Verso SYBR Green 1-Step qRT-PCR ROX Mix" ("Thermo Scientific, Lithuania). Processing of research results was carried out using generally accepted methods of variational statistics. Results. In patients with osteoarthritis of the knee joints after SARS-CoV2 infection, the expression of PTGS2 and NOS2 genes increases in nuclear cells of the synovial fluid compared to patients diagnosed with osteoarthritis. Conclusions. Our results indicate that patients with osteoarthritis may develop a more severe course of synovial inflammation after infection with COVID-19.

Попередження інтраопераційної ненавмисної гіпотермії у пацієнтів із політравмою

Актуальність. Ненавмисна гіпотермія розвивається спонтанно як наслідок травми, хірургічного втручання та наркозу в результаті порушення відповідності теплопродукції тепловтрат і пригнічення компенсаторної терморегуляційної відповіді. Мета: вивчити ефективність способу корекції інтраопераційної ненавмисної гіпотермії з використанням системи конвекційного обігріву в пацієнтів із політравмою. Матеріали та методи. Обстежено 20 пацієнтів із політравмою, яким проводились ургентні оперативні втручання. Пацієнти були розділені на 2 групи: I — основна група (n = 10), в якій інтраопераційно проводилося активне зігрівання системою конвекційного обігріву WarmAir 135 (CSZ) з використанням ковдр для зігрівання в умовах операційної; II — контрольна група (n = 10) без використання конвекційного зігрівання. Вивчалася температура ядра тіла (Тсо): початково, через 30, 60 хвилин і наприкінці операції. Розраховувалися наступні показники: мінімальна (Тмін.) і максимальна (Тмакс.) температура, середня температура (Тср.), температурний діапазон (Тдіап. = Tмакс. – Тмін.). Результати. У всіх пацієнтів із політравмою та проведенням ургентних хірургічних втручань відзначається розвиток клінічно значущої ненавмисної гіпотермії. На етапі 60 хвилин інтраопераційного періоду Тсо була вірогідно вище в I групі (35,38 ± 0,28 °С) порівняно з пацієнтами II групи (34,70 ± 0,39 °С) (p < 0,05). Виявлено вірогідно вищий рівень середньої Тсо в I групі (35,53 ± 0,66 °С) порівняно з II групою (34,67 ± 1,74 °С) пацієнтів (p < 0,05). Діапазон температур, який являє собою різницю максимальної та мінімальної Тсо, був вірогідно нижче в I групі пацієнтів (1,36 ± 0,74 °С) порівняно з II групою (4,55 ± 1,11 °С) (p < 0,05). Висновки. Використання в комплексі інтенсивної терапії конвекційної системи зігрівання хоча й не дозволяє досягти вихідних значень Тсо, але попереджає прогресування поглиблення гіпотермії, ефективно забезпечуючи підтримку температурного гомеостазу у критичних пацієнтів із політравмою.

Клинический случай липоидного некробиоза на фоне неконтролируемого течения сахарного диабета 2 типа

Diabetes mellitus (DM) is an endocrinopathy that leads to the development of many complications in various organs and systems. Skin, as the largest organ, is also one of the targets of DM. Among the most specific dermatological complications of DM is lipoid necrobiosis (LN), a chronic condition leading to the development of disfiguring skin defects. Despite the fact that this disorder occurs in many metabolic and systemic disorders, the most common LN can be observed in patients with a severe uncontrolled course of diabetes mellitus. This paper presents a clinical case of VD in a patient with a severe course of type II diabetes mellitus, discusses the possible causes of this condition and management options for the patient.

Assessment of nursing and midwifery students’ knowledge of treatment of diabetic foot syndrome using Lucilia servicata larvae

Background. Diabetes mellitus is one of the most common chronic diseases, and in recent years its prevalence has been systematically increasing. Untreated or ineffectively treated diabetes leads to the development of many complications. Among these that can significantly affect the quality of life is diabetic foot syndrome (DFS). Larvotherapy is a therapeutic method of treating wounds arising during the course of DFS. Aim of the study. The main objective of this study was to assess the level of knowledge of nursing and midwifery students on the treatment of DFS using Lucilia sericata larvae. Material and Methods. This study is a cross-sectional, observational study in which 202 nursing and midwifery students of Opole University were surveyed. The study was conducted online between June and November 2020, using a questionnaire developed by the authors. Results. The analysis showed considerable variation in the level of students' knowledge of treatment techniques for DFS. Those with the highest level of knowledge represented 39.15% (n=79), the average level of knowledge was represented by 28.2% (n=57), and the lowest level of knowledge was represented by 32.7% (n=66) of students. Regarding biosurgery in general, the highest level of knowledge about biosurgery was represented by 48.0% (n=97) of students. Nursing students had a higher level of knowledge than midwifery students regarding DFS treatment methods (p=0.001). There was no difference in the level of knowledge about biosurgery between nursing and midwifery students (p=0.503). Conclusions. The research presented in this study indicates that nursing and midwifery students have insufficient knowledge of DFS treatment methods and biosurgery. Nursing students are more likely than midwifery students to derive knowledge of DFS treatment methods from their studies and the literature. Education on treatment methods and techniques for DFS should be increased among students. Students' knowledge can be increased by classes in the course of their education and meetings with professionals.

Techniques, indications and complications of pericardiocentesis

The main aim of pericardiocentesis is to remove excess fluid in the pericardial space and enhance the functions of the heart to intervene against the development of many complications. Accordingly, the procedure is usually performed to manage cardiac tamponade to correct secondary hypotension that attributes to the low stroke volume as a result of the external pressure of the pericardial fluid on the chambers of the heart. In the present literature review, we have discussed the techniques, indications, and complications of pericardiocentesis. Furthermore, the main techniques and approaches include computed tomography-guided pericardiocentesis, echo-guided, and fluoroscopy-guided techniques. These modalities can be successfully used for hemodynamically unstable patients to adequately remove excess fluid to normalize ventricular filling and maintain adequate cardiac output to the peripheral tissues. Considerations for using the modality have been made for small effusions and many authors suggest that it should not be routinely used in these situations. Many major and minor complications can occur secondary to conducting pericardiocentesis. The major complications might include lacerations of the intercostal vessels of the coronary arteries, injury to the cardiac chambers, death, puncture of the peritoneal cavity or abdominal viscera, pneumopericardium, pneumothorax which might require chest intubation, pericardial decompression syndrome, and ventricular arrhythmias. Therefore, carefully approaching these patients and deciding the best management plan, in addition to providing proper interventional approaches for the potential development of these complications is essential to enhance the intended outcomes and enhance the quality of care.

Cardiovascular diseases in youth patients with glucose metabolism impairment

Glucose metabolism disorders in adolescent patients have a diverse background. The most common cause is type 1 diabetes. Persistently elevated blood glucose initiates many processes that lead to blood vessel and nerve damage. Early detection and treatment of these abnormalities can help prevent the development of many complications.

Gestational diabetes mellitus: peculiarities of course and pregnancy outcomes in real clinical practice

Introduction. According to various authors, uncompensated gestational diabetes mellitus (GDM) is accompanied by the development of many complications affecting the mother and fetus. However, published data on the prevalence of GDM and its complications in real clinical practice in our country are insufficient.Aim. To estimate the prevalence of GDM among pregnant women in the South-Eastern Administrative District of Moscow, to analyze the main risk factors, the features of the course and pregnancy outcomes in women with GDM.Materials and Methods. Retrospective analysis of primary records of 510 pregnant women who were diagnosed with GDM during 2019. A comparative analysis of pregnancy complications and outcomes depending on the age of diagnosis of GDM was performed.Results and Discussion. During 2019, 510 pregnant women out of 5,000 women observed were diagnosed with GSD. The mean age of the women was 31.9 ± 4.8 (95% CI 31.5-32.3). Most frequently, 224 pregnant women (43.9%) were diagnosed in the 1st trimester of pregnancy, 31.8% (162) in the 2nd trimester, and 18.6% (95) in the 3rd trimester. Mean venous plasma glucose values were 5.43 [5.25; 5.7] mmol/L, and glycated hemoglobin was 5.19 ± 0.4% (95% CI 5.15-5.24). Diet therapy was predominantly sufficient to achieve GSD compensation - 84.3%. Complications of pregnancy were observed in 123 women (24.1%). Unfavorable pregnancy outcomes were recorded in 153 women with GSD out of 213 women analyzed (71.8%). There was no statistically significant difference in pregnancy outcomes depending on the age of diagnosis of GDM.Conclusions. The prevalence of GDM in the South-Eastern Administrative District of Moscow was 10.2%, which is consistent with the data of various epidemiological studies in other regions. The development of adverse pregnancy outcomes remains at a high level. Therefore, it is advisable to conduct further research aimed at assessing the main factors influencing the course and outcomes of pregnancy.

Diabetic autonomic neuropathy of the gastrointestinal tract.

Diabetes is a metabolic disease leading to the development of numerous health complications. In developed countries, it is the main cause of blindness, end-stage renal disease, and non-traumatic amputation of the lower limbs. Neuropathy is the most common chronic complication of diabetes. A long-term course of a metabolically unbalanced disease causing damage to the autonomic nervous system of the digestive tract results in the development of many complications, such as intensification of gastro-oesophageal reflux disease, gastroparesis, chronic diarrhoea or faecal incontinence.

Protection of upper respiratory tract of patient in conditions of respiratory support: current state of issue

Acute respiratory failure has been and remains one of the main problems of modern medicine. Among the large number of high-tech methods of treating acute respiratory failure, adequate moisture and warming of the upper respiratory tract of the patient at all stages of the respiratory therapy are important. It should be noted that ensuring optimal moistening and warming of the inhaled gas mixture allows to avoid the development of many pulmonary complications. On the other hand, even with the use of the most modern treatment methods, inadequate microclimate in the upper respiratory tract can significantly reduce the effectiveness of their use. Thus, maintaining an adequate microclimate in the upper airways is normal, with various bronchopulmonary diseases and in conditions of respiratory support will improve the functional state of the lungs, prevent the development of many complications, reduce material costs and duration of treatment, reduce the mortality of this patient population. Despite the existence of the large database, the question of choosing the most effective technology to ensure homeostasis and protection of the upper respiratory tract in different clinical situations with different methods of respiratory support is still relevant. This dictates the necessity of continuing the research in this direction. This review is devoted to the current state of the problem of moistening, warming and filtering the breathing mix under conditions of prosthetic respiratory function.

Cardiovascular complications in hemodialysis patients: current approaches to prolong and improve quality of patients’ life

Cardiovascular complications are a leading cause of morbidity and mortality in dialysis patients. Cardiovascular mortality is more than 40% of the total mortality in this cohort of patients. Recently, there has been an increase in publications on the role of uremic toxins, including “middle molecules”, in the development and progression of cardiovascular complications in dialysis patients.
 Conventional low-flux (LF) hemodialysis well removes small molecular weight uremic toxins not bound with protein. Evidence for the role of "middle molecules" in the development of many complications, including cardiovascular complications, has contributed to the emergence and development of such dialysis therapy methods as high-flux (HF) hemodialysis, hemofiltration (HF) and hemodiafiltration (HDF).
 Further evolution of membrane technology has led to the development of protein-leaking membranes or super-flux or high cutoff (HCO) membranes. These membranes are capable of removing molecules in excess of the molecular weight of albumin. The use of these membranes is limited because of the risk of hypoalbuminemia.
 Today, the closest approximation to the natural glomerular membrane is the so-called Middle Cut-Off (MCO) membrane. The use of MSO membranes is implemented in a new method of dialysis therapy - expanded hemodialysis (HDx). The method is defined as a treatment where diffusion and convection are conveniently combined inside a hollow-fibre dialyser equipped with an MCO membrane. A standard hemodialysis machine is used for the HDx. Increased removal of large medium molecules in HDx may lead to an improvement of clinical outcomes, including a decrease of the cardiovascular events incidence, an all-cause and cardiovascular mortality reduction in dialysis patients.

Učestalost balanitis xerotica obliterans-a kod dječaka sa fimozom

Introduction: Balanitis xerotica obliterans (BXO) is an inflammatory disease of unknown etiology and pathogenesis, that represents genital form of lichen sclerosus. Disease is located on foreskin, glans of penis and on urethra. It was discovered that BXO is common cause of phimosis. There is evidence of connections between balanitis xerotica obliterans and appearance of squamous cell carcinoma. The diagnosis of the disease can be clinical and pathohistological. Therapy can be conservative and surgical. The Aim: Determining the frequency of BXO among the boys with phimosis in the light of increasing number of evidence about importance of this clinical entity in development of many complications of urogenital system. Material and methods: Our research contained 470 male patients aged from 1 to 18 years. All the patients who were included in the study were surgically treated in period from 1. January 2014. till 1. January 2017. in University Children's Hospital and all of them had diagnosed phimosis. All the patients underwent circumcision. Foreskins that were suspicious of BXO diagnosis, but could not be diagnosed clinically, were sent to pathohistological analysis. Statistical methods used for measuring central tendency and for determining frequency of BXO were methods of descriptive statistics, or frequency analysis in IBM SPSS Statistics 22 program. Results: Patients with phimosis were in average age of 9.12 ± 4.46 (1-18) years. After data analysis, it was established that in the group of 470 patients there are 48 with BXO diagnosis (10.21%). Patients with BXO were in average age of 10.33 ± 3.14 (6-18) years. Conclusion: Our research has shown that the frequency of BXO among boys with phimosis population is coherent with results of other studies. We concluded that pathohistological analysis of the foreskin is necessary to avoid false negative results after clinical examination.

Impact of noninvasive ventilation on the outcome of extubated chronic hypercapnic patients in the respiratory intensive care Unit

Background Patients with respiratory failure frequently require endotracheal intubation and mechanical ventilation to sustain life, but it has been associated with the development of many complications, making the reduction of invasive mechanical support an important goal of critical care medicine. Noninvasive ventilation (NIV) can be used to facilitate weaning (earlier extubation) and to prevent reintubation in patients with respiratory failure after planned extubation. Aim This work aimed to study the impact of NIV on the outcome of the extubated chronic hypercapnic patients and to compare it versus conventional oxygen therapy in the Respiratory Intensive Care Unit at Ain Shams University Specialized Hospital during the period spanning from October 2013 to May 2015. Patients and methods This was a prospective study that was conducted upon 80 patients divided into two groups: group A included 40 patients (29 male patients and 11 female patients with a mean age of 57.25±6.54) who were kept on NIV immediately after removal of the endotracheal tube, and group B included 40 patients (27 male patients and 13 female patients with a mean age of 59.15±5.82) who were kept on conventional oxygen therapy after removal of the endotracheal tube. Results The present study showed that 75% of patients in group A were discharged from the Respiratory Intensive Care Unit versus 42.5% of patients in group B. Moreover, it showed that only 22.5% of patients in group A required reintubation versus 52.5% of patients in group B. As regards the length of ICU stay after extubation, the present study showed that it was shorter in group A patients with a mean duration of 1.6±0.49 than that in group B patients with a mean duration of 6.13±1.79. Conclusion NIV, applied immediately after removal of the endotracheal tube, has improved the final outcome, decreased the rate of reintubation, and decreased the length of ICU stay after extubation in chronic hypercapnic respiratory failure patients.

Assessment of Cardiovascular Disease Risk in Type 2 Diabetic Patients: A Comparison of Risk Indices

Diabetes mellitus is a major public health problem; it is synchronized with the development of many complications of which cardiovascular disease is the most prevalent and detrimental. This study aimed at comparing the strength of various cardiovascular risk indices among diabetes type 2 patients. The risk indices evaluated were: Apoprotein A1, Apoprotein B1, lipoprotein (a), total cholesterol, (TCHOL), Triglyceride (TG), low density lipoprotein (HDL), TC/HDL, pentad and tetrad. Two hundred and four (204) subjects were studied comprising of 152 diabetes subjects and 52 non-diabetics as control. The result shows significantly higher values in the mean blood pressure of diabetic subjects when compared with the control at (p < 0.05. Mean HbA1C and total cholesterol values for diabetes subjects were significantly higher when compared with the control. However, the HDL-cholesterol of the diabetes subjects was significantly lower when compared to the control subjects. There was no significant difference in triglyceride level of both groups. The mean values of Apo A, Apo B and lipoprotein a, were higher in diabetic subjects compared to the control subjects at (p < 0.05). Comparison of the liporprotein induces in terms of sensitivity, specificity and accuracy, Lpa had a sensitivity of 97.3%, specificity of 100% and accuracy of 95.7%, next was pentad with sensitivity of 91.45%, specificity of 100% and accuracy of 95.73%. Tetrad had a sensitivity of 81.05%, specificity of 100% and accuracy of 90.5%, the TC/HDL ratio and the least accuracy of 75.76%. Based on the overall accuracy Lpa tend to display highest accuracy followed by PENTAD and TETARD.

DOES HYPOGONADISM ON RESULTS TRANSURETHRAL RESECTION OF BENIGN PROSTATIC HYPERPLASIA?

Influence of hypogonadism on the results of transurethral resection of the prostate (TURP) in patients with benign prostatic hyperplasia (BPH) remains unexplored. At the survey included 98 patients with benign prostatic hyperplasia who underwent TURP. Revealed that the postoperative period in patients characterized by a significant decrease in the level of performance testosteronemii in all cases, and against the background of hypogonadism accompanied by the development of more complications. Preoperative correction of hypogonadism for 2 weeks prior to surgery allows a 2-3 times lower risk of postoperative complications.

High perinatal risk in two ethnic groups during pregnancy: associations with the state of the system «Lipid Peroxidation-Antioxidant Defense»

The high perinatal risk in Buryat and Russian ethnic groups during pregnancy has been studied. In the pregnant Russian women compared to thosw of the Buryat ethnic group, the following risk factors prevailed: more than 3 abortions in history, cystic changes in the ovaries, essential arterial hypertension in relatives, premature birth. It has been found that activation of lipid peroxidation in the pregnant Buryat women is associated with the increased total antioxidant, α-tocopherol and SOD activities in blood.. In the pregnant Russian women components of antioxidant defense system. The decrease slightly, while lipid peroxdation products increase comparison of the lipid peroxidation components of in the two ethnic groups showed an increase in the lipid peroxidation products and retinol in the pregnant Russian women during all trimesters of pregnancy. It may be concluded that the risk factors create unfavorable conditions for changes in the lipid peroxidation-antioxidant defense system, which determines the development of many complications of pregnancy and child birth.