Diastolic Pressure Values Research Articles

Kombinasi Senam Lansia dan Obat Hipertensi Berpengaruh terhadap Tekanan Darah Lansia Penderita Hipertensi

Hypertension management can be done pharmacologically or by administering drugs and non-pharmacologically, one of which is elderly gymnastics. Hypertension if not given proper management can lead to heart disease, stroke and kidney failure. The purpose of this study was to determine the effect of a combination of elderly gymnastics and antihypertensive drugs on blood pressure in elderly people with hypertension. This research method uses a quasi-experimental design with a pre-post test nonequivalent control group design approach. The sample of this study was 39 respondents with a total sampling technique, the intervention group consisted of 20 respondents and the control group consisted of 19 respondents. The hypothesis test of this study used the T-test because the data was normally distributed with a p-value> 0.05. The results of this study obtained a significance value of systolic and diastolic pressure in the intervention group p-value = 0.000, while in the control group the significance value of systolic blood pressure p-value = 0.000 and diastolic pressure p-value = 0.048. So it can be stated that the decrease in blood pressure in the intervention group was more optimal than in the control group. Conclusion: There is an effect of giving a combination of elderly exercise and antihypertensive drugs on the blood pressure of elderly people with hypertension

Understanding perioperative risk determinants in carotid endarterectomy: the impact of compromised circle of Willis morphology on inter-hemispheric blood flow indices based on intraoperative internal carotid artery stump pulse pressure and backflow patterns.

Carotid artery stenosis (CAS) often requires surgical intervention through carotid endarterectomy (CEA) to prevent stroke. Accurate cerebrovascular risk assessments are crucial in CEA, as poor collateral circulation can lead to insufficient interhemispheric blood flow compensation, resulting in ischemic complications. Therefore, understanding perioperative risk determinants is vital. This study aims to determine the impact of compromised circle of Willis (CoW) morphology on inter-hemispheric blood flow, focusing on indices based on intraoperative internal carotid artery stump pulse pressure and backflow patterns. In 80 CAS patients who underwent CEA, preoperative CT angiography for CoW was conducted. Patients were categorized into five subgroups based on their CoW anatomy and three additional groups based on intraoperative internal carotid artery (ICA) stump backflow patterns evaluated by the surgeon. Continuous blood pressure signals, including systolic, diastolic, mean, and pulse pressure values, were recorded during the procedure. The relationship between CoW anatomical variants and the systolic and diastolic segments of the averaged pressure waveforms, particularly diastolic pressure decay, was analyzed. The correlation between CoW anatomy and stump backflow intensity was also examined. Significant variability in ICA stump backflow and pressure values was evident across CoW variants. Patients with compromised CoW morphology exhibited weaker backflow patterns and lower ICA stump pulse pressure values, consistent with impaired interhemispheric blood flow. Notably, ICA stump diastolic pressure decay was consistent across most CoW variant groups, indicating developed collateral circulation in cases with CoW anomalies. Thus, impaired CoW integrity is associated with compromised interhemispheric blood flow indices based on intraoperative ICA stump pulse pressure and backflow patterns during CEA. Integrating intraoperative pulse waveform analysis with preoperative CT angiography provides a more detailed assessment of cerebrovascular risk, guiding the selective use of shunts. This combined approach may improve surgical outcomes and patient safety by identifying patients at increased risk of perioperative neurological events due to CoW anomalies.

Traditional Chinese Medicine (TCM)-Inspired Fully Printed Soft Pressure Sensor Array with Self-Adaptive Pressurization for Highly Reliable Individualized Long-Term Pulse Diagnostics.

Reliable, non-invasive, continuous monitoring of pulse and blood pressure is essential for the prevention and diagnosis of cardiovascular diseases. However, the pulse wave varies drastically among individuals or even over time in the same individual, presenting significant challenges for the existing pulse sensing systems. Inspired by pulse diagnosis methods in traditional Chinese medicine (TCM), this work reports a self-adaptive pressure sensing platform (PSP) that combines the fully printed flexible pressure sensor array with an adaptive wristband-style pressure system can identify the optimal pulse signal. Besides the detected pulse rate/width/length, "Cun, Guan, Chi" position, and "floating, moderate, sinking" pulse features, the PSP combined with a machine learning-based linear regression model can also accurately predict blood pressure such as systolic, diastolic, and mean arterial pressure values. The developed diagnostic platform is demonstrated for highly reliable long-term monitoring and analysis of pulse and blood pressure across multiple human subjects over time. The design concept and proof-of-the-concept demonstrations also pave the way for the future developments of flexible sensing devices/systems for adaptive individualized monitoring in the complex practical environments for personalized medicine, along with the support for the development of digital TCM.

Invasive arterial blood pressure delineator for cardiopulmonary resuscitation patients during pauses of chest compressions

Invasive arterial blood pressure (IBP) monitoring is important to assess patient’s cardiovascular competence and guide clinical treatment. Besides, international resuscitation guidelines in force suggest its use during Cardiopulmonary Resuscitation (CPR), but current automated algorithms for IBP variables computation were not designed for cardiac arrest patients. A lack of knowledge is detected in the automated processing of IBP signal during CPR.The aim of this study was to design algorithms for heartbeat detection and for IBP physiological variable computation during CPR, and compare to state-of-the-art (SoA) proposals. The dataset used consists of 81 out-of-hospital-cardiac-arrest (OHCA) patients and two additional public datasets with hemodynamically stable patients. A set of 377 IBP segments, total duration of 1127 min, were extracted from the OHCA dataset during the pauses of chest compressions. The method includes artifact removing from the in IBP using Stationary Wavelet Decomposition and heartbeat detection in the first difference signal. A multicomponent evaluation and two adaptive thresholds were applied to compute IBP physiological variables.Pulsatile segments with heartbeats were discriminated from pulseless segments with mean (standard deviation) sensitivity(Se)/specificity and positive (PPV)/negative predictive values of 98.8(6.9)/91.6(20.2)% and 97.4(9.7)/98.7(6.1)%, respectively. The heartbeat detection showed 96.1(8.3)% of Se, 96.1(7.6)% of PPV and 95.7(6.4)% of F1-score , with absolute errors of 0.55(2.91)/0.39(4.87)/0.78(6.08)mmHg in systolic, diastolic and pulse pressure values, respectively. The proposed algorithms outperformed SoA solutions with both OHCA and stable patients.

Reiki intervention for supporting healthcare professional care behaviors in pediatric palliative care: A pilot study.

Pediatric healthcare professionals (HCPs) working in a palliative setting may experience challenges during their clinical practice in addressing the complex end-of-life phase of children and their families. Nurses, especially, have a frontline role in providing assistance, thereby becoming at risk of physical and psychological burden. Pediatric psychologists have an ethical responsibility to help colleagues by proposing self-care interventions that will improve their well-being and, indirectly, the work climate. This study investigated the impact of a complementary therapy, delivered by a pediatric psychologist and a nurse, on physical and psychological variables among nurses at the Paediatric Hospice of the Regina Margherita Children's Hospital in Italy. Thirty-five nurses participated in 5 weeks of Reiki sessions for an overall total of 175 sessions. The effect of the sessions was analyzed through a paired t-test analysis comparing the values of heart rate, oxygen saturation, and systolic and diastolic pressure collected before and after each session. The same test was conducted comparing the values of the 3 burnout subscales for each of the 35 nurses collected before the beginning of the first session with those collected at the end of the last session 2 months later. Results underlined a positive short-term effect with a significant decrease in heart rate before and after each session (t = 11.5, p < .001) and in systolic pressure (t = 2, p < .05). In addition, a decrease in emotional exhaustion symptoms was found (t = 2.3, p < .05) at the end of the intervention. Reiki could be a valid strategy to complement traditional pediatric psychology clinical practice designed to protect HCPs from emotional and physical demands and to create a more supportive workplace for staff and patients alike.

Foot Massage terhadap Tekanan Darah Penderita Hipertensi

This study aims to identify differences in the mean value of systolic and diastolic blood pressure reduction in hypertension sufferers in the intervention and control groups. The method used is Quasi Experiment pre-test and post-test with a control group design. This study showed a significant difference in the mean values of systolic and diastolic pressure before and after foot massage for 30 minutes, carried out three times within six days in the intervention group. Hypothesis testing was carried out using the Independent Samples Test statistical test, obtaining a p-value of 0.000. In conclusion, there is a significant difference in systolic and diastolic blood pressure between the intervention group and the control group&#x0D; Keywords: Diastolic, Foot massage, Hypertension, Systolic

Analysis of Relaxation Phase in the Rat Heart

The rate and depth of myocardial relaxation determine left ventricular (LV) filling in early diastole. To analyze the relaxation phase, the method of logarithm of LV pressure fall in rats was used. A gradual acceleration of relaxation was found during the transition from the isovolumic phase to the auxovolumic phase, immediately before the opening of the atrioventricular valves. The relaxation rate constant in this phase has been inversely correlated with the values of the minimum LV diastolic pressure and LV endsystolic volume. The results suggest that the gradual acceleration of relaxation is due to the straightening of the spring-like structure of connectin (titin), which is compressed during contraction.

Haemodynamic and Haemato-Biochemical Changes with Ketamine, Propofol and Ketofol as Constant Rate Infusion Anesthesia for Elective Ovariectomy in Dogs

Background: Combination of glycopyrrolate, butorphanol, xylazine as premedication and induction with propofol and maintenance with ketamine, propofol and propofol mixtures (Ketofol 1:1) as constant rate infusion (CRI) would have the ability to maintain better hemodynamic and reduce the dose of general anesthesia for maintenance. This technique once gets standardized; it may transfer to field veterinarians for elective ovariectomy under a routine animal birth control programme (ABC) for safe handling of canines. Therefore, the present study was designed to evaluate haemodynamic and haemato-biochemical changes with Ketamine, Propofol and Ketofol as CRI anesthesia in dogs. Methods: The study was conducted on 18 female dogs during 2019-2021 and these animals were randomly divided into three experimental groups, each group (I, II and III) containing six animals. All animals were pre-medicated with glycopyrrolate @ 0.01 mg/kg b.wt I/M followed by inj. butorphanol 0.2 mg/kg b.wt and xylazine 1mg/kg b.wt I/M after 5 minutes by using different syringes. After 10 minutes of xylazine, animals were induced (till effect) with propofol and immediately just after induction animals were maintained with constant rate infusion of ketamine, propofol and ketofol 1:1 along with normal saline @ 10 ml/kg/hr. Result: Cardiovascular parameters showed that the value of systolic arterial pressure increased significantly (P less than 0.05) after pre-medication in all three groups in comparisons to respective base values. Value of diastolic arterial pressure increased significantly (P less than 0.05) after pre-medication in groups I and II, whereas non-significantly (p greater than 0.05) in group III in comparisons to respective base values. Hemoglobin and PCV values decreased non-significantly after pre-medication and remained non-significantly lower at various intervals in comparison to respective base values during observation periods except at recovery in group II. Changes in TLC did not show a definite pattern and values of TEC in all groups changed non-significantly (p greater than 0.05) at various time intervals in comparison to respective base values during the observation period.

Adherence to the Mediterranean Diet Is Associated with Health-Related Quality of Life and Anthropometric Measurements in University Professors.

The main objective of this study was to assess the relationship between Mediterranean diet (MD) adherence and health-related quality of life (HRQOL) according to the anthropometric measurements of teaching and research staff (TRS) at the University of Granada (UGR), Spain. This diagnostic, non-experimental, cross-sectional, and observational study was performed on university lecturers (65 women and 62 men) using a correlational descriptive methodology. The lecturers' anthropometric measurements were taken, while MD adherence was determined using the PREvention with MEDiterranean diet (PREDIMED) questionnaire. The Short Form Health Survey (SF-36) was used for measuring HRQOL. Better results for body composition were associated with improvements in the physical and mental dimensions and MD adherence. Statistically significant differences were found between sexes, with men showing higher values for weight, height, waist circumference, BMI, waist/hip ratio (WHR), muscle mass, and systolic and diastolic pressure than women. Similarly, MD adherence was positively correlated with vitality (r = 0.233; p = 0.009), social functioning (r = 0.229; p = 0.008), and the mental component summary (r = 0.205; p = 0.021). The regression model determined that the mental component summary (β = 0.239, p = 0.041), diastolic pressure (PD) (β = -0.473, p < 0.000), fat percentage (FP) (β = -0.241, p = 0.004), and age (β = -0.231, p = 0.022) significantly predicted MD adherence. The results obtained in this study suggest that healthy dietary patterns such as the MD and an optimum body composition contribute to an improved HRQOL.

ОЦЕНКА АДАПТАЦИИ К ЭКСТРЕМАЛЬНОМУ КЛИМАТУ ПРЕДСТАВИТЕЛЕЙ АЗИАТСКИХ ПОПУЛЯЦИЙ

The article analyzes the results of studies of the compensatory-adaptive and reserve capabilities of the body in representatives of the Asian populations of Yakuts and Central Asia in the extreme conditions of Yakutia. It is commonly known that Yakutia is characterized by a sharply continental climate, which causes adaptive changes in the basic systems of the body. Anthropometric indicators were studied, such as body length, weight, waist circumference, hips circumference, the state of the cardiovascular system in terms of average blood pressure, heart rate and body mass index. To assess the compensatory-adaptive capabilities of the body, the Kerdo index was calculated to assess the state of autonomic regulation based on the values of pulse and diastolic pressure according to the formula, the index of functional changes according to the method of R. M. Baevsky et al. (1979) in points, which shows the degree of adaptability of the body, the state of functional reserves and can serve as a kind of prognosis of health. Statistical processing of the material was carried out using the IBM SPSS STATISTICS 21.0 software package. To assess the relationship between the studied parameters, a non-parametric correlation analysis according to Spearman and Pearson was carried out. The study revealed that a greater number of overweight and obese individuals were found among the indigenous population compared with natives of the southern regions. The average waist circumference was also statistically significantly higher among the indigenous group. The study of the main parameters of the cardiovascular system showed that they allow us to identify the spectrum of adaptive and adaptive reactions of the body and have ethnic characteristics. Shifts in body mass index can be considered as one of the options for the violation of compensatory-adaptive mechanisms.

CARDIORENAL DYSFUNCTION IN MICE SUBMITTED TO AORTIC STENOSIS AND TREATED WITH SODIUM OXALATE

Objective: The transverse aortic constriction (TAC) model mimics cardiac hypertrophy (CH) caused by hypertension. The model of kidney injury by consumption of soluble sodium oxalate (SO) in the feed also mimics lesions similar to hypertension. Our objective is to test the hypothesis that mice submitted to TAC and gavage with SO will represent an effective model of cardiorenal dysfunction. Design and method: Forty male C57BL mice were randomized into 4 groups: sham-operated animals that received gavage for 15 days with water or sodium oxalate (SO) and animals that received TAC and gavage also for 15 days with water or SO. In the fourth and eighth weeks, an echocardiogram was evaluated. Metabolic cage, direct hemodynamic recording, and histological analysis were performed in the eighth week. Data were analyzed using 1-2 way ANOVA followed by Bonferroni's posthoc, considering significant differences for p&lt;0.05. Results: The TAC+SO group showed increased serum urea (SHAM:37.85±3 vs. TAC+SO:49.9±2.6mg/dL, p = 0.02) and, compared to the SHAM+SO group, a decrease in water consumption and water balance. The TAC+SO group had the highest systolic (SHAM:122.4±5.2 vs. TAC+SO:160±5.2mmHg, p&lt;0.01), diastolic (SHAM:78.9±5.4 vs. TAC+SO:105±5mmHg, p&lt;0.01) and mean pressure (SHAM:100.6±5 vs. TAC+SO:132±4.8mmHg, p&lt;0.01) values. Compared to the SHAM+SO and the SHAM, TAC+SO showed increased double product (DP) (SHAM:64.6 ± 4.7 vs. SHAM+SO:62.7±3.3 vs. TAC+SO:96.6±5.2, p&lt;0.01). The TAC group had the highest weight of corrected ventricles (SHAM:6.73 ± 0.1 vs.TAC:10±0.6mg/mm, p&lt;0.01), and the TAC+SO group had the highest pulmonary congestion index. The SHAM+SO group showed increased autonomic modulation and HR variability, while the TAC+SO group showed an important reduction. TAC animals had the highest mean BP variability. The reflex tachycardia of the TAC, SHAM+SO and TAC+SO groups was very reduced, and only the TAC+SO group had a reduction in the alpha index. Conclusions: TAC surgery caused CH, reduction in reflex tachycardia, and changes in autonomic modulation. Gavage with SO for 15 days promoted primary renal injury, and separately it was able to increase autonomic modulation. TAC surgery associated with SO gavage caused greater cardiac and renal dysfunction.

Investigation of the effects of 8-week Nordic and traditional walking training on blood pressure in prehypertensive postmenopausal women

Objective: This study aimed to investigate the effects of Nordic walking (NW) and traditional walking (TW) training on blood pressure and resting heart rate in prehypertensive postmenopausal women. Materials and Methods: Twenty women aged 57.9 ± 7.2 years participated in the study. Participants were divided into two groups of 10: NW and TW. Exercises were performed three days a week for eight weeks and 50 min/day at 40-60% of the maximum heart rate. Body composition, blood pressure, and resting heart rate values of the participants were measured before and after the 8-week exercise program. Results: Upon comparing the values before and after exercise; body weight, body mass index, hip circumference, systolic and diastolic pressure values decreased significantly (p&lt;0.05), while there was no significant change in the resting heart rate (p&gt;0.05) in the NW group. In the TW group; body weight, body mass index, waist circumference, hip circumference, systolic and diastolic pressure decreased significantly (p&lt;0.05). No significant changes were found in other parameters (p&gt;0.05). The effect size of NW training was found to be higher in body weight, BMI, and systolic and diastolic pressure values. Conclusion: NW training is more effective than TW training in the regulation of blood pressure in prehypertensive postmenopausal women.

PHYSICAL THERAPY OF PREGNANT WOMEN WITH PRIMARY MANIFESTATIONS OF VARICOSE DISEASE OF THE LOWER EXTREMITIES

As a result of the generalization of clinical experience, it has been proved that varicose disease of the lower extremities of pregnant women is defined as a polyetiological disease of the venous system.&#x0D; The high pathological incidence of varicose veins among pregnant women is caused by a number of factors. The consequence of such changes may be stagnation in the venous bed of the lower extremities. Therefore, women who have a history of primary manifestations of varicose veins of the lower extremities often have got problems during pregnancy and the postpartum period in the form of complications of symptoms leading to thrombophlebitis (inflammation of superficial veins).&#x0D; Timely started and implemented physical therapy allows relieving or completely eliminating the above symptoms of the disease of pregnant women, significantly improves the properties of blood circulation and the condition of the inner walls of vessels.&#x0D; The aim of the study is to assess the functional state of the body of women in the second and third trimester of pregnancy with primary manifestations of varicose veins of the lower extremities and the effectiveness of the physical therapy program.&#x0D; Methods and materials. 19 pregnant women with varicose veins, aged 22 to 29 years, from the second to third trimester of pregnancy participated in the study. Two groups were formed: the main number of 10 women (implemented measures of the developed physical therapy program, which included kinesiotherapy, therapeutic and electrophoresis) and a comparison group – 9 women (implemented standard physical therapy technique).&#x0D; The following methods were used during the research: 1) anthropometric examination; 2) physiological monitoring of functional indicators of the state of the cardiovascular system of women (pulsometry and tonometry with systematic registration of the indicators of systolic and diastolic blood pressure, heart rate; 3) functional diagnostics (active orthostatic test, spirometry); 4) clinical somatoscopy with participation; 5) assessment of the quality of life.&#x0D; Conclusions. In the process of different periods of pregnancy, the examined patients were diagnosed with primary varicose veins of the lower extremities. Pregnant women with varicose veins had an intensive increase of body weight in the last trimester of pregnancy.&#x0D; The inconsistency of the actual blood pressure indicators towards hypertension compared to the physiological norms was revealed. After the implementation of the developed physical therapy program, the following dynamics of changes were exposed: the average value of systolic and diastolic pressure and heart rate indicators of the main group decreased in contrast to the comparison group (p&gt;0.05). Among the women of the main group, the vital capacity of the lungs increased by 7.56%. The normalization of the regulation and type of reaction of the orthostatic test with a change of body position from horizontal to vertical was observed among pregnant women of the main group (-20.56%) in contrast to the examined comparison group (p&gt;0.05).&#x0D; The assessment based on the data of the CIVIQ questionnaire showed a probable improvement of all components of the quality of life of the respondents of the main group (indicator of the category of pain and complaints regarding the physical condition) of pregnant women. Thus, the obtained results make it possible to ascertain the effectiveness of the developed physical therapy program.

Management of Incidental Uncontrolled Elevation of Intraoperative Blood Pressure: A Comparative Study on Nitroglycerine Versus Dexmedetomidine Infusion.

Uncontrolled elevation of intraoperative blood pressure can result in deleterious effects with increased risk of morbidity and mortality. We aimed to compare nitroglycerine infusion with dexmedetomidine infusion in controlling accidental intraoperative uncontrolled hypertension. This comparative study was conducted on 73 hypertensive patients undergoing cancer surgeries who experienced uncontrolled intraoperative hypertension. The data of 38 patients were retrieved from the medical records for the nitroglycerine group and 35 patients were prospectively enrolled for the dexmedetomidine group. Group N received nitroglycerine infusion (0.3 - 1 µg/kg/min), while group D received dexmedetomidine infusion (0.2 - 0.7 µg/kg/h). Both groups were comparable regarding their demographic data and clinical characteristics. Systolic, diastolic, and mean arterial pressure (MAP) values were significantly lower in group N compared to group D during the period between 60 and 120 minutes intraoperatively (P < 0.001). Heart rate values were significantly lower in group D than in group N (P < 0.001). Postoperative sedation scores were better for group D with lower analgesic requirements (P < 0.001). Dexmedetomidine infusion can be used to manage the uncontrolled intraoperative elevation of blood pressure in selected patient population.

ROLE OF MELATONIN IN ATTENUATION OF HAEMODYNAMIC RESPONSES TO LARYNGOSCOPY AND INTUBATION IN GENERAL ANAESTHESIA

Objective: The aim of the study was to study the effects of melatonin in attenuation of hemodynamic responses such as heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean blood pressure (MBP) to laryngoscopy and intubation (L&amp;I) in general anesthesia. Methods: This was a prospective and observational study conducted in a tertiary care teaching hospital on 120 patients aged 20–45 years belonging to American Society of Anaesthesiologists Grade I, undergoing elective surgery under general anesthesia. Selected patients were allotted into Group A (control group) and Group B (patients who took tablet melatonin 6 mg, 120 min before induction) of 60 patients each. Hemodynamic parameters such as HR, systolic, diastolic, and MBPs were recorded before the administration of drug (baseline), 120 min after administration of study drug (just before induction), immediately after induction, at L&amp;I, just after L&amp;I and at 1, 3, 5, and 10 min thereafter. Results: The gender distribution and mean age of both groups were comparable. Both the groups were also comparable with respect to baseline values of HR, systolic, diastolic, and mean arterial pressure. The control group showed significant increases in HR, SBP, DBP, and mean arterial blood pressure after L&amp;I and this increase persisted for the next 10 min. In the melatonin group, there was no significant increase in HR, systolic, diastolic, or MBP at any point of measurement after L&amp;I. Conclusion: Pre-treatment with 6 mg oral melatonin 120 min before induction of anesthesia is effective for attenuating hemodynamic responses to L&amp;I without significant side effects.

Sex-Specific Computed Tomography Abdominal Fat and Skeletal Muscle Characteristics in Type 2 Diabetic Retinopathy Patients With/Without Comorbid Diabetic Kidney Disease

To investigate differences in sex-specific computed tomography abdominal fat and skeletal muscle (SM) characteristics between type 2 diabetic retinopathy (DR) patients with and without diabetic kidney disease (DKD). This retrospective study included type 2 diabetes mellitus DR patients with/without DKD between January 2019 and July 2021. Visceral adipose tissue (VAT), subcutaneous adipose tissue, perirenal adipose tissue (PAT), intramuscular adipose tissue, and SM areas were measured. Univariate and multivariate logistic regression analyses were used to analyze risk factors for DKD. Correlation and multiple linear regression analyses were used to clarify the association between computed tomography abdominal fat, SM characteristics, and cystatin C. Two hundred and forty-one patients were enrolled and divided into DR with DKD group (n=142) and DR without DKD group (n=99). In men, hypertension (OR: 5.21; 95%CI: 1.93-14.05; p=0.001), diastolic pressure (OR: 1.07; 95%CI: 1.01-1.12; p=0.011), hemoglobin (OR: 0.94; 95%CI: 0.92-0.97; p < 0.001) and PAT attenuation value (OR: 1.09; 95%CI: 1.01-1.17; p=0.026) were independent risk factors for DKD progression in DR patients, while the VAT index (VATI) (OR: 1.03; 95%CI: 1.01-1.05; p=0.014) was an independent risk factor for female patients. Multiple linear regression analysis revealed significant correlations between hypertension (β=0.22, p=0.002) and hemoglobin (β=-0.53, p < 0.001) with cystatin C in men, and a significant correlation between VATI and cystatin C (β=0.35, p=0.037) in women after adjustment for confounders. Female DR patients with elevated VAT level may suffer from a higher risk of DKD than that in male patients.

Metabolic Dysfunction-Associated Fatty Liver Disease in Newly Diagnosed, Treatment-Naive Hypertensive Patients and Its Association with Cardiorenal Risk Markers.

Patients with arterial hypertension frequently present with comorbidities that are associated with increased cardiorenal risk, such as metabolic dysfunction-associated fatty liver disease (MAFLD). Our study aimed to assess the prevalence and the association of MAFLD with cardiorenal risk markers in newly diagnosed, treatment-naïve hypertensive patients. We recruited 281 individuals with new-onset hypertension who were not prescribed any medication. Medical history, clinical examination findings, and laboratory test results were recorded. Liver steatosis was assessed through fatty liver index (FLI) calculation. Patients with FLI ≥60 together with one main metabolic abnormality (type 2 diabetes mellitus or overweight/obesity) or at least two metabolic risk abnormalities (increased waist circumference, blood pressure, plasma triglycerides, presence of prediabetes or insulin resistance, decreased plasma high-density lipoprotein) fulfilled the diagnostic criteria for MAFLD. The prevalence of MAFLD in our study population was 28.7%. Individuals with MAFLD were more frequently male and had increased body mass index. Systolic, diastolic, and pulse pressure values were significantly higher in this group of patients. Moreover, lipid, renal, glucose, and inflammatory markers were considerably deranged in patients with MAFLD. After multivariate regression analysis, uric acid, ferritin, and apoE emerged as independent predictors of MAFLD. Area under receiver operating characteristics curve revealed that uric acid had the greatest diagnostic accuracy, with the ideal cutoff being ≥5.2 mg/dl (sensitivity: 77.6%, specificity: 76.3%). MAFLD represents a common comorbidity in hypertensive patients and is associated with markers of cardiorenal risk. Uric acid may be indicative of MAFLD in particular.

Conditions of adaptation in teaching environmental disciplines at the university

Students are a special social group united by approximately the same age and specific working and living conditions. The intensive and rather long-lasting learning process imposes strict requirements to the adaptive mechanisms of their organism. The article presents the results of a study of the pedagogical conditions for student adaptation to studying at the university. We examined 90 first-year students majoring in Pedagogy at the Faculty of Foreign Languages of Mari State University. Several groups were composed of the students who came to study from the former USSR countries. We determined a number of core indicators such as cardiac rate, the systolic and diastolic pressure value, the cardiovascular response to breath hold and psychoemotional stress. Also we studied the adaptation potential (AP) value, conducted the 'individual minute' test. We calculated some hemodynamic parameters according to the Baevsky formula. It has been established that differentiated and personality-centered education is an important factor of the effectiveness of student adaptation to the learning process. The study found that the implementation of specified conditions contributed to the effectiveness of student adaptation to the learning process at the university. A comparative analysis of the results showed that the indicators in the experimental group exceeded the similar indicators in the control group by the specified criteria.

PECULIARITIES OF THE POST-INFARCTION PERIOD CLINICAL COURSE IN PATIENTS WITH DIABETES MELLITUS TYPE II AFTER PERCUTANEOUS CORONARY INTERVENTION

Aim – to define the parameters’ dynamics of carbohydrate, lipid, energy and adipokinemetabolism and the structural and functional state of the left ventricle (LV) myocardiumin patients with post-infarction cardiosclerosis and type 2 diabetes mellitus (DM).Materials and methods. 74 type 2 DM patients, who underwent myocardial infarction,were examined. The first subgroup comprised 20 patients, who received medicinaltherapy, and the second subgroup was composed of 50 patients who underwentpercutaneous coronary intervention (PCI). Serum levels of insulin, adropin, irisin, fattyacid binding protein 4 (FABP4) and C1q/tumor necrosis factor- related protein (CTRP3)were determined by enzyme- linked immunosorbent assay. Doppler echocardiographicexamination was performed using a Radmir ULTIMA Pro30 ultrasound scanner. Theresults were statistically analyzed using IBM SPPS software (version 27.0). A level ofp&lt;0.05 was set for determining statistical significance.Results. Following parameters: end-diastolic volume (17,19% and 7,42% respectively),end-systolic volume (30,71% and 10,24% respectively), stroke volume (32,58% and10,61% respectively), iricin (37,57% and 79,89% respectively) increased and such indicesas insulin (46,70% and 58,03% respectively), glucose (35,24 and 39,81% respectively)decreased in patients with post-infarction cardiosclerosis and type 2 DM under conditionsof medicinal therapy in comparison with values of these indices in patients before thetreatment respectively (p&lt;0,05). Following the treatment only with medicinal therapy,in patients with post-infarction cardiosclerosis and type 2 DM higher values of suchindicators as EDS 4.90%, LV PWT 16.67%, LA 18.42%, LVMM 7.77%, LVMMI 19.24%,have been determined, reliably lower value of diastolic arterial pressure – 16,19%,lipoproteins of low density – 5,90%, triglycerides – 13,30%, atherogenic coefficient –16,09%, adropin – 41.43%, FABP4-27.71%, CTRP3-32.91% were established underconditions of only PCI treatment in comparison with the values of those biochemicalparameters before the treatment, respectively, (p&lt;0.05).Conclusions. 1. An increase of echocardiographic indicators, imbalance in energetic andadipokine metabolism have been found in patients with post-infarction cardiosclerosisand type 2 DM. 2. In patients under conditions of PCI structural- functional changes of LVmyocardium delay in comparison with those receiving only medicinal therapy.

General Anesthesia-Related Drop in Diastolic Blood Pressure May Impact the Long-Term Outcome in Stroke Patients Undergoing Thrombectomy.

Background: Several factors affect the efficacy of endovascular thrombectomy (EVT); however, the anesthesia-related factors have not been fully explored. We aimed to identify independent predictors of outcome by analyzing procedural factors based on a multicentric stroke registry. Methods: Data of consecutive patients with acute ischemic stroke (AIS) were extracted from the prospective STAY ALIVE stroke registry. Demographic, clinical, and periprocedural factors including hemodynamic values were analyzed in patients undergoing thrombectomy with either general anesthesia (GA) or conscious sedation (CS). Independent predictors of outcome both at 30 and 90 days based on the modified Rankin Scale (mRS: 0–2 as favorable outcome) were also explored. Results: A total of 199 patients (GA: 76 (38%) vs. CS: 117 (59%); in addition, six patients were converted from CS to GA) were included. The minimum value of systolic, diastolic, and mean arterial pressure was significantly lower in the GA compared to the CS group, and GA was associated with a longer onset to EVT time and a higher drop in all hemodynamic variables (all, p < 0.001). A higher drop in diastolic blood pressure (DBP) was even independently associated with a poor 90-day outcome (p = 0.024). Conclusion: A GA-related drop in DBP may independently predict a poor long-term outcome in stroke patients undergoing thrombectomy.