First Month Of Observation Research Articles

Post-COVID-19 syndrome: a discussion of onset timing

Introduction. Post-COVID syndrome (alternatively: chronic COVID syndrome, post-acute sequelae of COVID-19, long-haul COVID, long COVID, PASC, CCS) is a state of permanent or permanent presence of symptoms of a pathological process after COVID-19. Currently, there is no consensus on the timing of the onset of post-COVID-19 syndrome. The purpose of this study was to analyze the appearance of some post-COVID symptoms 1, 2 and 3 months after infection with the SARS-CoV-2 virus. Materials and methods. The analysis of clinical and laboratory data of 59 medical workers who had a mild or moderate form of COVID-19 was carried out. Three groups were formed: with the assessment of post-COVID-19 changes 1 month after the onset of the disease; with the detection of changes after 2 months; and with the detection of dysfunctions after 3 months. Results and discussion. It was found that 57.7% of respondents complained of fatigue, weakness, sleep disorders in the first month of observation. After 2 months, the frequency of complaints decreased by 42.3%, and by 3 months it increased again by 15.6%. A month after COVID-19, several cases were recorded when employees were unable to perform any, even very light, work. However, by 3 months of follow-up, 96.2% of the surveyed declared full recovery of efficiency. The appearance of muscle, joint, and spinal pain was reported more often in the first month after COVID-19, then the number of complaints decreased by half to 23–25% of the total number of observations. The assessment of the severity of the infection among the respondents of the three groups did not reveal significant differences between the data in 1, 2 and 3 months after COVID-19. Conclusion. An analysis of some post-COVID symptoms showed that in mild and moderate COVID-19, manifestations are observed 1, 2 and 3 months after infection with the SARS-CoV-2 virus. Multidirectional change dynamics were revealed, more often accompanied by a decrease in the manifestation of post-COVID syndrome 2 months after coronavirus infection, which may create a false impression of an absence of signs of post-COVID syndrome during this period.

Adherence to the treatment in patients with hypertension during the war in Ukraine

Background. The aim of the study: to investigate additional factors that affect the adherence to antihypertensive therapy in patients with hypertension in conditions of war in Ukraine. Materials and methods. The study included 1,299 hypertensive patients with an average age of 65.4 ± 14.8 years, who are residents of different regions of Ukraine. The observation period lasted 3 months, from October 1 to December 12, 2023. All patients were divided into four groups: I — a fixed three-component combination of olmesartan medoxomil/amlodipine/hydrochlorothiazide, II — a fixed two-component combination of olmesartan/hydrochlorothiazide, III — a fixed two-component therapy with olmesartan/amlodipine, IV — any other non-fixed two- or three-component antihypertensive therapy. Adherence to therapy was assessed after 1, 2, and 3 months and statistical analysis of the obtained data was performed. Results. During the first month of observation, 50 (3.8 %) patients stopped or did not even start taking antihypertensive therapy, during the second — 71 (5.5 %), during the third — 127 (9.8 %). Adherence to antihypertensive therapy is higher in younger people (up to 55 years) compared to patients aged over 65, in people with higher education, in patients taking fixed combinations, especially olmesartan/amlodipine, or olmesartan/amlodi-pine/hydrochlorothiazide, while gender had no effect on adherence. Additional factors related to adherence to antihypertensive therapy during the war were as follows: the level of danger in the region of residence, the internally displaced status of the patient or doctor. The lowest adherence to antihypertensive therapy after 3 months was registered in the internally displaced persons who suffered morally or physically and is only 34.5 % compared to patients who stayed in the place of permanent residence — 82.6 % (р = 0.0001), or to those who moved preventively — 74.3 % (р = 0.0001). Adherence to therapy also depends on the status of the doctor. Among doctors with the status of an internally displaced person, patients’ adherence to therapy is lower: 68.3 against 82 % (р = 0.0008). Conclusions. Adherence to antihypertensive therapy in Ukraine during the war depends on known factors influencing the completeness of the doctor’s recommendations, including age, educational level, concomitant diseases, the number of tablets, and specific factors caused by the war, such as activity of hostilities in the region, as well as the status of an internally displaced person, both in patients and doctors.

Changes in zonulin levels and possibilities for its correction in patients with liver cirrhosis and hepatic encephalopathy after COVID-19

Background. The liver is frequently affected in coronavirus disease 2019 (COVID-19), which can range from a simple increase in transaminase levels to the development of acute liver failure. The study of the peculiarities of the course of liver cirrhosis (LC) and its complications, especially hepatic encephalopathy (HE), in COVID-19 and the study of possible markers indica­ting the progression of the disease and the development of effective methods for their correction is an urgent task today. Aim of the research: to study the features of changes in serum and faecal zonulin levels and its dynamics in patients with LC and HE after COVID-19 on the background of a comprehensive therapy with a butyric acid preparation. Materials and methods. The study was conducted in two stages. At the first stage, 126 patients with LC were examined to determine the features of HE course, colonic dysbiosis, and zonulin levels in blood serum and faeces at discharge from the hospital after COVID-19, as well as after 1 month of outpatient follow-up. At the second stage of the study, patients with LC and HE after COVID-19 were divided into two groups depending on the treatment: group I (n = 56) received only basic therapy for LC, which included constant use of the β-blocker bisoprolol, lactulose, as well as a combined hepatoprotective agent, melatonin and rifaximin; group II (n = 70) in addition to basic therapy took a combined probiotic preparation containing butyric acid. Results. During the first month after COVID-19, progression of the HE severity was diagnosed in patients with LC. Among participants with LC classes B and C, an increase in the number of patients with grade II HE (up to 57.2 and 72.2 %, respectively) was found a month after COVID-19, and in 16.7 % of patients with decompensated LC, grade III HE was diagnosed. Colonic dysbiosis progression was detected in patients with LC and HE after COVID-19. In one month of the follow-up, a repeated microbiological exami­nation of faeces revealed a significant increase in the number of patients with LC and HE after COVID-19 with grade III colonic dysbiosis, regardless of the stage of the disease, which, accordingly, occurred against the background of a decrease in patients with grade I and II colonic dysbiosis. Among patients with LC and HE after COVID-19, a significant increase in serum and faecal zonulin was found with maximum values in patients with class C according to the Child-Pugh score, which also tended to increase during the first month of observation (up to (171.4 ± 2.2) ng/ml in serum and up to (198.2 ± 3.4 ng/ml) in faeces). The administration of a probiotic complex containing butyric acid contributed to a decrease in both blood and faecal zonulin levels in patients with LC and HE after COVID-19 during a one-month course of treatment. Conclusions. In patients with LC after COVID-19, a progression of HE and colonic dysbiosis severity was diagnosed during the first month of outpatient follow-up. Participants with LC and HE after COVID-19 reported an increase in the level of zonulin in the blood serum and faeces (up to (102.7 ± 1.4) ng/ml, p < 0.01, and up to (131.4 ± 2.6), p < 0.001, respectively), which tends to increase depending on the progression of the disease severity. Comprehensive therapy with the use of a drug containing butyric acid is an effective method to reduce the level of blood and faecal zonulin in patients with LC and HE after COVID-19.

Morphological features of bone regenerate when using bone plastic material based on collagen hydrogel in an experiment

Background: Bone-plastic materials of various origin are used when it is necessary to restore or increase the volume of bone tissue of the jaws. Collagen hydrogel of xenogenic origin is a relatively new form of materials used for bone grafting, and is of interest for studying its osteoplastic properties.
 Aim: Morphological evaluation of osteoplastic properties of a material based on collagen hydrogel in an experiment.
 Material and methods: to evaluate the osteoplastic properties of collagen hydrogel, an experimental study was conducted on laboratory animals. A model of a critical defect in the cranial vault of rats was chosen for the study. In the experimental group, the defect was filled with xenogenic bone matrix and collagen hydrogel. In the comparison group, the defect was filled with xenogenic bone matrix. morphological evaluation of bone regeneration of samples of the experimental group and the comparison group was performed at different study periods.
 Results and their discussion:
 After the first month of observation, the histological picture in the samples of the experimental group and the comparison group had no significant differences. After two months of the study, the formation of an osseomucoid and the appearance of an insignificant number of osteoblasts were observed in the experimental group, while in the comparison group the stromal component was represented only by collagen fibers. After three months of observation, the organization of the stromal component was determined in the comparison group, single osteoblasts were observed, whereas in the experimental group the stromal component was partially replaced by a bone plate, and the cellular composition was represented by osteoblasts, osteocytes and osteoclasts.
 Conclusion: The addition of collagen hydrogel to the bone plastic material provides not only acceleration of the process of osteoreparation, but also the formation of a regenerate having the correct histoarchitectonics. The issue of using collagen hydrogel as a component of bone-plastic materials is promising and requires further study.

Comparative evaluation of the effectiveness of autological bone marrow aspirate concentrate and platelete-rich plasma injected intraosseously in the treatment of the knee osteoarthritis

The aim of the study was a comparative evaluation of bone marrow aspirate concentrate (BMAC) and platelet-rich plasma (PRP), administered intraosseously to patients with stage IIIII knee osteoarthritis (OA) according to the Kellgren Lawrence (K-L) classification. Materials and methods: 40 patients were recruited and divided into 2 groups for the multicenter randomized study. Patients in the main group (n = 19) underwent a single intraosseous BMAC injection, and those in the comparison group (n = 21) had a similar procedure, but with the use of PRP. Treatment results were assessed at follow-up after 1, 3, 6, and 12 months using the verbal patient satisfaction scale (VSS), visual analog scale (VAS), WOMAC index (Western Ontario and MCMaster Universities osteoarthritis index), and Leken. Results: Estimated effectiveness of the application according to VSS from 1 to 6 months of observation, the opinions of patients were intercepted in the direction of BMAC (up to 65% of positive reviews) in the detection of PRP (up to 55 % of positive reviews). However, during the period of 6 to 12 months of observation we did not get significant results. Interpretation of the application of the VAS scale indicated a pronounced decrease of pain in both groups of patients. However, in the PRP group pain scores were higher. Analysis of the treatment results according to the WOMAC scale allows us to identify significant differences at all periods of observation with the prevalence of results in the BMAC group. Evaluation of the efficacy of therapy according to the Leken index indicated a more than twofold decrease in the index in the first month of observation. Subsequently, we noticed insignificant negative dynamic up to the 12th month of observation. When checking data between groups, the statistical data was significantly better in BMAC group. Conclusion. A single intraosseous injection of BMAC has an advantage at all control periods of observation in comparison with a similar injection of PRP. Both treatments do not cause serious complications.

Lurasidone Augmentation of Clozapine in Schizophrenia—Retrospective Chart Review

The aim of our study was to evaluate the effectiveness of lurasidone augmentation of clozapine in treatment-resistant schizophrenia (SZ) in a retrospective chart review. From the medical records of 916 SZ patients, we identified 16 individuals treated with a combination of clozapine and lurasidone. The detailed clinical data are described separately for each patient. We compared the Clinical Global Impression-Severity (CGI-S) scores between three points of observation: before the treatment and one month and two months after its initiation. CGI Improvement (CGI-I) scores were used to evaluate the treatment response between the first and last points of observation. The vast majority of patients (14/16, 87.5%) responded to lurasidone augmentation of clozapine (CGI-I scores 1 or 2). Therapeutic effects were observable after 3-12 weeks of treatment (median 6 (4-6)). A reduction in CGI-S scores was observed after the first month of observation. There was an observable reduction in positive, depressive and anxiety symptoms, as well as an improvement in psychosocial functioning. Two patients discontinued treatment due to side effects. Our study suggests that lurasidone augmentation of clozapine may lead to improvements in a broad range of SZ symptom dimensions.

Anaesthesia in SARS-CoV-2 infected children - single-centre experience. Acase-control study.

Although manifestation of SARS-CoV-2 infection in children is gene-rally mild or asymptomatic, anaesthetic implications of the infection in children are still a matter of concern. Single reports suggest that patients with SARS-CoV-2 infection are at higher risk of anaesthetic complications. We performed a retrospective, case control study analysing the risk of general anaesthesia in SARS-CoV-2 infected children admitted to a tertiary paediatric university hospital for the purpose of urgent procedures requiring anaesthesia between April 1st and September 30 th , 2021. The control group consisted of SARS-CoV-2 negative children consecutively anaesthetised for the same reasons during the first month of observation. Our hypothesis was: general anaesthesia can be safely performed in SARS-CoV-2 infected children. Study endpoints: primary - anaesthetic respiratory complications (bronchospasm, laryngospasm, intraoperative desaturation below 94%, desaturation below 94% after awakening, unplanned postoperative mechanical ventilation); secondary - hospital length of stay, thrombotic, cardiac, haemorrhagic events, ICU admission, deaths during hospitalisation. The examined group consisted of 58 SARS-CoV-2 infected children, the matched control group of 198 patients. The rate of complications in both groups was very low, with no significant difference between the groups. The only differences observed were a higher frequency of desaturations in the awakening period and longer time of hospitalisation in SARS-CoV-2 infected patients. Multivariate logistic regression analysis showed that physical status of the patient and duration of the procedure were the main factors influencing the risk of complications. In our experience anaesthesia of SARS-CoV-2 infected children can be safely performed.

Declined peat heterotrophic respiration as consequences from zeolite amendment simulation: coupling descriptive and predictive modelling approaches

Nowadays, halting greenhouse gasses (GHG) emission is the world's major concern to mitigate global climate change. In oil palm cultivated tropical peatland, GHG emission is primarily constituted of CO<sub>2</sub> flux emitted from aerobic heterotrophic respiration (R<sub>h</sub>), the natural degradation process of organic material in an oxidative environment. By coupling descriptive and predictive statistical approaches, this study attempt to gain an in-depth understanding of the effects of zeolite rates and incubation time on CO<sub>2</sub> emission that came from aerobic R<sub>h</sub> in peat, as well as their decomposition process. This study found that zeolite amelioration up to 30% of the peat at field capacity and starting from the first month of observation (month-1) significantly restricted peat R<sub>h</sub>, denoted by a reduced amount of observed CO<sub>2</sub> flux (0.021 and 0.019-0.012 mg m<sup>-2</sup> sec<sup>-1</sup>, respectively). Both factors and several soil variables exhibited some non-linear relationships with R<sub>h</sub> at different magnitudes and importance, showing the limitation of the traditional linear-based approach to interpreting their complex interrelationships, as well as predicting CO<sub>2</sub> flux. This study highlights the vital role of a polynomial (GAM) and artificial intelligence (Cubist and GBM) -based pedotransfer models in improving our understanding regarding the dynamic of the peat decomposition process as affected by zeolite amendment.

A study of efficacy, safety, and acceptance of two combined oral contraceptive pills containing 150 mcg Levonorgestrel and 30 mcg Ethinyl Estradiol at Dr. Kariadi Hospital, Semarang, Indonesia

Background: Combine Oral Contraceptives (COCs) pills is one of the many popular contraceptives worldwide, with 100 million women who use contraceptive pills. To increase the choice of oral contraceptives, COCs Novadiol® (Pill A) domestic production, which has the same dosage as Microgynon® (Pill B), are still imported drugs. This study aims to determine Pill A's efficacy, safety and acceptance level compared to Pill B for 3 months. Methods: The study was a randomized control clinical trial, an open-label trial in 200 women of childbearing age who met the inclusion and exclusion criteria from July to November 2015. Data were analyzed using SPSS version 20 for Windows. Results: About 300 participants were selected and 200 met the inclusion and exclusion criteria who participated study from the beginning to the end of the study period. In the first month of observation, 1 complaint of dizziness in pill A and 2 from pill B. One nausea complaint was found in the participant from Pill A. These differences were not statistically significant (p>0.05). In the second month of observation, 1 complained of dizziness from pill B and 1 nausea from Pill A. In the third month, observation found no complaints about using Pill A and pill B. There were changes in menstrual patterns in both pills and bleeding outside the cycle during the use of 3 months, but they were not statistically significant (p>0.05). Conclusion: Pills A has the same efficacy, safety and acceptance when compared to the use of birth control pills B for 3 months.

Feсal microbiota transplantation in the format of complex therapy in obesive siblings: clinical case

Obesity and associated metabolic diseases are often accompanied by changes in the gut microbiota leading to metagenome gene diversity decrease. Fecal microbiota transplantation (FMT) is one of the most effective methods for correcting the intestinal microflora. FMT obtained from healthy donors has been proven to be an effective treatment of infections caused by Clostridium difficile. The use of FMT for correction of metabolic disorders is promising, however, data on its application is limited and has contradictory results. In our work, two patients (siblings) presented with obesity grade II and various types of diabetes mellitus (DM): the older brother (44 years old) with diabetes mellitus type 2 (DM 2), a younger brother (39 years old) with diabetes mellitus type 1 (DM 1). Both patients underwent FMT as part of complex antidiabetic therapy. During the course of treatment, a decrease in body weight was noted in both patients (4–5 kg for the first month of observation, then -1–2 kg per month). One year after FMT, a patient with type 2 diabetes showed a decrease in the severity of insulin resistance (IR), measured by the hyperinsulinemic euglycemic clamp test (initial M-index 2.42 mg/kg*min, after 1 year — 3.83 mg/kg* min) as well as the maintenance of satisfactory carbohydrate metabolism compensation against the diminishing the hypoglycemic therapy. In a patient with DM 1, no significant dynamics of carbohydrate exchange indices, including detected glycated hemoglobin (HbA1c), insulin dose and IR were during the observation period. Metagenomic sequencing of stool samples (n = 20) collected from both patients before and within 1 year after FMT showed no significant changes in the taxonomic profile of the microbiota at the level of microbial families. Metabolomic analysis of the composition of feces showed no directed changes in the composition of metabolites after the FMT procedure, the nature of changes within the samples from each patient during the entire study period was random. Thus, FMT had no effect on the course of DM1, but served as a starting point for weight loss and improvement glucose profile in DM2. However, convincing data confirming a causal correlation between FMT and improvement in the course of T2DM have not been obtained.

Growth performance of Bali Cattle with Lamtoro Taramba (Leucaena leucocephala) feed in Kupang Regency, Nusa Tenggara Timur

This research aimed to develop a Bali cattle farming system in Nusa Tenggara Timur (NTT) with Lamtoro Taramba feed’s main base. The research was conducted in the Raknamo farmer group, Kupang Regency, Nusa Tenggara Timur. The livestock used in this study were 8 (eight) Bali cattle, age 12-15 months, with an average initial body weight of 134.38 – 146,63 kg. The observation activity was to collect data on Bali cattle’s body weight, which were given the main feed of Lamtoro Taramba for three months and always feed available in cattle-shed, then calculated the daily body weight gain. The research results showed that Bali cattle’s average body weight from the first month of observation is 134.38 kg, the second month is 140,69 kg, the third month is 146,63 kg. The results of the research showed for the daily bodyweight gain from the first to second month (ADG 1) was 0.18 kg/day, the third month increased (ADG 2) by 0.19 kg/day; the statistical data was significant (P < 0.05). So, the daily body weight gain of Bali cattle increases with Lamtoro Taramba main feed.

Efficacy and Safety of Transcatheter Ventricular Septal Defect Closure Using Nit-Occlud Le VSD coil in Short-term Observation

Nit-Occlud Le VSD coil, an alternative device for closing VSD transcatheter, started to be used in dr. Soetomo Hosptal in 2017, but no research has been done on the results of closure with this device. This study aims to evaluate the efficacy and safety of the Nit-Occlud Le VSD coil. Descriptive observational method was used. The results are as follow: Of the 17 patients who underwent transcatheter closure during January to December 2018, 10 (58, 8%) cases were closed with Nit- Occlud Le VSD coil. The success of implantation is 100%, 8 cases were closed with Nit-Occlud Le VSD coil, 2 plus an amplatzer (ADO 1 and AVSO). Type of VSD: perimembranaous 7 (70%), subaortic 2 (20%) and mid muscularis 1 (10%). Immediate complete closure in 7/10 (70%), while 3 (30%) obtained residual DSV. The closure rate at the first month of follow up becomes 80%. Median length of post-catheterization was 2 days (2 - 3 days). Complications: 1 (10%) mild aortic regurgitation, 1 (10%) hemolysis and 2 (20%) with additional second device (ADO 1 and AVSO): first case: moderate residual VSD and severe aortic regurgitation; second case: severe tricuspid regurgitation and residual VSD that disappeared in first month. The residual VSD altered from 30% to 10%, and closure rate was 80% at the first month of observation. VSD closure with Nit-Occlud Le VSD coil provides good efficacy and safety for patients.&#x0D; Keywords: VSD, Nit-Occlud Le VSD coil.

Liver Transplantation Activity in the Eurotransplant Area Is Recovering Slowly During the COVID-19 Crisis.

The Eurotransplant (ET) network serves a total population of approximately 137 million people, allocating more than 7000 organs every year, including 1500 livers. Because of the expected wave of severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2)-positive patients in mid-March 2020, elective surgeries were drastically reduced in ET countries, a fact that presumably also affected transplant activities. We therefore compared the number of liver transplantations (LTs) conducted in the ET area from mid-March until mid-June 2020 with the number of LTs performed during the corresponding period from 2015 to 2019. For a more detailed analysis of LT activities, we divided the observation period into 3 time periods. From mid-March to mid-April 2020, 99 LTs were performed, compared with 139 LTs (95% CI, 129-150) during the same period in the years 2015–2019. This represents a 29% (Exact Poisson’s test, P < 0.001) decrease and is congruent to early reports from Italy during the first month of the coronavirus disease 2019 (COVID-19) outbreak.1 Limited knowledge about the characteristics of SARS-CoV-2 and its impact on morbidity and mortality of transplanted patients may have been a reason for this decline.2 In addition, concerns about the validity of the SARS-CoV-2 tests and about donor-to-recipient transmission and staff exposure, as observed during the SARS-CoV outbreak,3 may have played a role. Recommendations on how to ensure the safe continuation of a transplant program were not available during the early phase of the COVID-19 crisis, and uncertainties about the severity of the outbreak may have led to a rather reserved approach toward perpetuation of transplantations during this time.4 Our data revealed that compared with the other ET countries, LT programs in Germany continued almost at the same pace during the initial phase of the COVID-19 crisis. One possible explanation could be sufficient resources, especially with regard to intensive care beds (29.2 beds per 100 000 inhabitants) compared with Luxembourg (24.8/100 000), Austria (21.8/100 000), Belgium (15.9/100 000), Croatia (14.7/100 000), Hungary (13.8/100 000), and Slovenia and the Netherlands (both 6.4/100 000).5 This high number of intensive care beds may have facilitated the preservation of COVID-19-free transplant units in Germany. Another possible explanation why countries such as Austria, Croatia, and Slovenia more drastically reduced their transplantation activities could have been earlier and stricter precautions in organ procurement and transplantation due to the proximity of Italy. By mid-March, Italy had already reported more than 23 000 SARS-CoV-2 positive patients and >1800 COVID-19 associated deaths.6 In the following 2 months, that is, from mid-April to mid-May and from mid-May to mid-June 2020, 123 and 132 liver transplants were performed, respectively. Even though the numbers of LTs increased compared with the first months of observation, they were significantly lower than during the corresponding periods from 2015 to 2019 (Figure 1), suggesting that transplant activity is recovering quite slowly. In light of the current waitlist mortality rate of about 16% in the ET area, these data suggest an accumulated death on the waiting list.FIGURE 1.: LTs performed in the Eurotransplant area from mid-March to mid-June in the years 2015–2020. The dark gray, gray, and light gray bars represent the number of LTs in the first, second, and third month of observation, respectively. Above the 2020 bars, the mean values and the 95% CIs for the years 2015–2019 are shown. CI, confidence intervals; LT, liver transplantations.The other concern is that this pandemic will not only cause a short-term decline in LTs but will lead to a longer-lasting decrease in donor recruitment. The transplant community must, therefore, undertake every effort to reestablish the volume of LTs to limit the mortality of patients with life-threatening liver failure. ACKNOWLEDGMENTS We would like to thank Arne van Kins, Data Services, Eurotransplant International Foundation for providing the data. The work was funded by the “In Memoriam Dr Gabriel Salzner Stiftung; Normothermic Liver Preservation and Conditioning Trial (Oncologic Transplant Surgery Project).”

Endothelial function indicators in patients with critical limb ischemia compared to patients with limb claudication – one-year follow-up period after endovascular revascularisation

Abstract Background Critical limb ischemia (CLI) is the most advanced stage of peripheral arterial disease. Limb revascularization is considered the first line of treatment. Purpose The aim of the study was to compare endothelial function and clinical outcomes in CLI and non-CLI patients during a 12-month follow-up period after endovascular treatment (PTA). Methods The study was conducted as a prospective, single-centre, follow-up evaluation. The authors recruited 30 CLI and 40 non-CLI patients. The following markers of endothelial dysfunction were evaluated: flow-mediated dilatation (FMD), reactive-hyperaemia index (RHI), arterial pulse-waveform analysis (aPWA) indices and clinical markers such as ankle-brachial index, toe-brachial index and Rutherford scale. Results Better clinical improvement may be observed in patients with CLI - the mean Rutherford grade significantly decreased in the CLI group (p&amp;lt;0.001). These patients also have better endothelial response to revascularization – CLI patients continue to have improved RHI up to 6 months after PTA, where in non-CLI patients, improvement was only noted during the first month. The mean FMD value did not change significantly during the follow-up in either of the groups. When comparing selected intervals, the FMD values in the CLI and non-CLI groups improved during the first month of observation and then decreased between the 1st and 6th month of follow-up. Finally, in CLI patients, baseline intima-media thickness predicts the number of reinterventions and major adverse events. Conclusions Patients with CLI differ significantly from patients with claudication based on clinical response and endothelial changes after revascularization. Figure 1. A) Kaplan-Meier survival curves according to CLI and non-CLI status for all study endpoints. B) Kaplan-Meier survival curves according to CLI and non-CLI status for reinterventions. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Collegium Medicum of Jagiellonian University - internal grant

Pharmacoepidemiological Research of the Efficacy of Fixed Dose Combinations in the Treatment of Patients with Arterial Hypertension in Ambulatory Practice

Aim. To study the pharmacoepidemiological features of the prescription of antihypertensive fixed dose combinations and their efficacy in hypertensive patients in the real outpatient practice in Vladivostok city. Material and methods . Hypertensive patients aged 1 8 years and older (n=268) observed in Vladivostok polyclinics from October to December 2017 were included into the study. All patients did not have target blood pressure (BP) levels. The analysis of the medical prescriptions of antihypertensive fixed dose combinations in Vladivostok polyclinics was performed. Two-component (perindopril + amlodipine) or three-component (perindopril + amlodipine + indapamide) fixed dose combinations were prescribed by physician in accordance with instructions for medical use and their pharmacological characteristics. The study was non-interventional and included 3 visits for the initial examination, prescription and correction of therapy, considering its efficacy. All patients were determined for glomerular filtration rate using CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration Formula), changes in BP. Patients performed self-esteem on a 1 0-point visual analogue scale (VAS). Results. Only 23.4% of patients reached target BP levels in the first month of observation, and 84.5% of patients after 3 months of observation. 30 (1 1.2%) patients had replacement with double antihypertensive fixed dose to triple combination combinations during the study. 68.6% of patients did not have a replacement for the initial prescribed antihypertensive fixed dose combinations due to the achievement of target BP. The number of patients with moderately and markedly reduced glomerular filtration rate was reduced significantly. Initially, the patients included into the study assessed health (according to adapted VAS) for 5.6±1.4 points, and after 3 months of follow-up - for 7.9±1.7 points. Conclusion. The use of antihypertensive fixed dose combinations containing ACE inhibitor (perindopril), calcium channel blocker (amlodipine) and thiazide-like diuretic (indapamide) resulted in achievement of target BP levels in 84.5% of patients after 3 months of follow-up. Also, the use of double and triple fixed dose combinations had a nephroprotective effect, manifested in an increase in the number of patients ( + 19.3%) with a glomerular filtration rate more than 60 ml/min/1,73 м 2 and a positive effect on the patient's well-being.

How many injections did you miss last month? A simple question to predict interferon β-1a adherence in multiple sclerosis

Objectives: Adherence to treatment is of utmost importance in multiple sclerosis (MS) to achieve full benefits from disease-modifying treatments. Thus, we investigated predictors of adherence to interferon β-1a.Methods: 114 relapsing-remitting MS subjects were recruited and followed-up during 1.536 ± 0.961 years. RebiSmart® (Ares Trading SA, Coinsins, Switzerland), an electronic auto-injector, allows real-time recording of adherence which was retrospectively evaluated, and subjects were categorized accordingly: fully adherent (if no doses were missed), early or late missing (if missing the first dose during the first month of observation or later). The occurrence of clinical relapses and the annualized relapse rate (ARR) were prospectively recorded.Results: Adherence was 95.0 ± 9.0%. Early missing (n = 17, 14.9%) was more likely to be associated with the occurrence of a clinical relapse (OR = 4.155; p = 0.018), but not late missing (n = 54, 47.4%) (OR = 1.454; p = 0.408), as compared to fully adherent (n = 43, 37.7%). Adherence was lower in early missing, as compared to late missing (p < 0.001). The ARR was higher in early missing, as compared to late missing and to fully adherent (p < 0.001).Conclusion: MS subjects missing an injection early presented lower adherence, and a fourfold chance of having a relapse, suggesting a simple way to assess and categorize adherence in a clinical, real-life setting, where lack of time often prevents more thorough evaluations.

Identification of irradiated dried fruits using EPR spectroscopy

Abstract The dominating carbohydrates in fruits are monosaccharides like fructose, glucose, sorbose and mannose. In dehydrated fruits, concentration of monosaccharides is higher than in fresh fruits resulting in the formation of sugar crystallites. In most of dried fruits, crystalline fructose, and glucose dominate and appear in proportion near to 1:1. Irradiation of dried fruits stimulates radiation chemical processes resulting in the formation of new chemical products and free radicals giving rise to multicomponent EPR signal which can be detected for a long period of time. For that reason, it is used as a marker for the detection of radiation treatment of dried fruits. It has been found that EPR spectra recorded in dried banana, pineapple, papaya, and fig samples resemble the EPR spectrum obtained by computer addition of fructose and glucose spectra taken in proportion 1:1. The decay of radiation induced EPR signals proceeds in dried fruits fast during the first month of observation and becomes much slower and almost negligible after prolonged storage. However, it remains intense enough for EPR detection even one year after processing. The radiation induced EPR signal is easily detected in dried fruits exposed to 0.5 kGy of gamma rays. Thus, the EPR method of the detection of irradiated fruits can be used for the control of dried fruits undergoing quarantine treatment with 200-300 Gy of ionizing radiation.

Effect of housing conditions with environment enrichment on physiological state of young pigs when weaning from sows

Complex estimation of welfare of piglets after weaning from sows and regrouping by behavioral, hormonal, and hematological indices when adding sawdust into the cages (as an improvement of the environment enrichment) was conducted. Behavioral activity in pigs from the experimental group was higher than in the control group; they spent more time on the feeding (22% of total time). In the first month of observations, fights account for 1.8% of total time in the control animals and 0.8% in the experimental animals. Less contact between piglets was registered in the experimental group. The level of cortisol in their blood was lower by 26.5 nmole/L in the beginning of the experiment and by 18.2 nmole/L in a month; glucose concentration was lower by 8% (while differences were insignificant in a month); however, the level of glucose was higher by 3% in piglets from the control group.

Vulnerability of Zostera marina seedlings to physical stress

Eelgrass coverage in Odense Fjord (Denmark) has declined by 90% since 1983, due to eutrophication and its associated pressures, and the state of low eelgrass coverage has remained sta- ble despite 10 to 15 yr of reduced nutrient loading and improved water quality. We hypothesize that the survival of eelgrass seedlings, and thus recolonization through reproductive dispersal, is nega- tively affected by physical disturbances. The 3 most likely physical mechanisms involved are uproot- ing or burial through drifting macroalgae, Arenicola marina sediment reworking and current-driven sediment resuspension. Our hypothesis was tested by field observations during the summer of 2009, when the mortality of seedlings was followed through time. The density of seedlings decreased dra- matically by 80% during the first month of observations, and no seedlings survived past August, cor- responding to an average seedling mortality of 1.5% d -1 . This was >3 times higher than the mortal- ity for seedlings protected from physical disturbance by enclosures (0.4% d -1 ), indicating that physical disturbance contributed to high seedling mortality. A significant correlation (p = 0.02) between macroalgal drift and seedling mortality suggested that ~40% of seedlings were lost due to the physical disturbance of drifting algae. In contrast, no correlations were found between A. marina reworking or resuspension and seedling mortality, despite a mobility of up to 400 cm 3 sediment m -2 d -1 by these mechanisms. Given the observed intensity of macroalgal drift, we speculate that this

First record of Mnemiopsis leidyi A. Agassiz, 1865 in the Gulf of Gdańsk (southern Baltic Sea)

We report the discovery of Mnemiopsis leidyi A. Agassiz, 1865 in the Gulf of Gdansk (southern Baltic Sea, Poland) in October 2007. During the first month of observations the species was found in many areas of the Gulf of Gdansk, from the surface to a depth of 42 m. The length of individual M. leidyi varied from 1.8 to 8.0 cm.