Mann-Whitney Criterion Research Articles

Features of the relationship between indicators of oxidative stress and lipid metabolism in adolescent boys with hypoandrogenism

Objective — to study the relationship between indicators of oxidative stress and lipid metabolism in adolescent boys with hypoandrogenism (HA).Materials and methods. A survey of 29 adolescents aged 13—18 years with HA was conducted. The comparison group consisted of 84 boys of similar age with normal sexual and physical development. The concentration of testosterone, indicators of free radical oxidation, antioxidant system and lipid metabolism were measured. The results were aggregated using the Wilcoxon—Mann—Whitney criteria, the Fisher angular transform, and the Pearson coefficient.Results and discussion. It has been established that the majority of adolescent boys with HA have type IIa dyslipidemia,which is recorded 2.5 times more oftenwith a high level of oxidative stress. Various interrelationships between pro­ and antioxidant systems with indices of blood lipid spectrum in adolescent boys with HAare revealed, the pattern depends on the degree of oxidative stress. In boys, with normal (physiological) value of the oxidative stress coefficient, multiple intersystem interactions were found indicating the main role of the antioxidant defense system in regulating lipid metabolism, which indicates a suffici­ently high compensatory and adaptive capabilities of the body to maintain the functional state at the proper level. With an increase in the degree of oxidative stress, there are other relationships between the studied parameters with the connection of the mechanisms of the regulatory influence of testosterone and free radical oxidation. In boys, with normal (physiological) value of the oxidative stress coefficient, multiple intersystem interactions were found indicating the main role of the antioxidant defense system in regulating lipid metabolism, which indicates a sufficiently high compensatory and adaptive capabilities of the body to maintain the functional state at the proper level. With an increase in the degree of oxidative stress, other relationships between the studied parameters occur, withemergence of regulatory influence of testosterone and free radical oxidation.Conclusions. With an increase in the degree of oxidative stress, the detected correlation between the indicators of free radical oxidation, antioxidant system and lipid metabolism suggests the development of maladaptive processes and emerges as an unfavorable prognostic factor for an increased risk of atherosclerosis and cardiovascular diseases, which requires timely and effective correction of metabolic changes.

PREDICTORS OF CHEMORESISTANCE TO PLATINUM-CONTAINING NEOADJUVANT CHEMOTHERAPY IN ADVANCED OVARIAN CANCER

Chemoresistance is one of the main causes of treatment failure in advanced ovarian cancer (OC). In order to identify predictors of chemoresistance, 30 patients with ascitic form of OC, who received neoadjuvant chemotherapy (NACT) according to AP regimen, were examined. In the epithelial cells of ascites and in tumor tissue after NACT, expression of the VEGFa, ABCB1 and ERCC1 genes was assessed by PCR-RT. The effectiveness of NACT was assessed using the criteria of therapeutic pathomorphosis, survival - using the Kaplan-Meier criterion, the relationship of clinical and molecular parameters - using the Mann-Whitney criterion. Results. We established that in 43% of patients the response to NACT was absent (CRS1), the significant response (CRS2) was in 35% of cases, and the complete response (CRS3) was in 21% of cases. VEGFa expression was increased in ascites in 17% of cases, in tumor tissue - in 33% in the CRS1 group. In groups with CRS 2,3, overexpression of VEGFa in ascites was detected in 25% of cases, in tumor tissue in 37.5%. ABCB1 mRNA expression was increased after NACT in 50% of cases in the CRS1 group and in 25% of cases in the CRS 2,3 group. Thus, platinum-based NACT initiates an increase in the expression of VEGFa and ABCB1 in tumor tissue. We established that in case of high expression (ERCC + / VEGF + / ABCB1 +) in ascites, there is a statistically significant increase in relapse-free survival compared with the group with low or absent expression (p = 0.012). The overall survival rate was 41.8 months in patients with overexpression of the studied genes in the tissue of the primary tumor after NACT and 25.3 months in patients with low expression (p = 0.058). Conclusion. The levels of ERCC1, VEGFa and ABCB1 mRNA in ascitic cells before NACT and in the primary tumor after NACT according to the AP scheme can serve as a predictor of the effectiveness of this treatment in ascitic OC.

Влияние толерантности к неопределенности на психическую адаптацию военнослужащих

The article presents the results of a comprehensive psychological and psychophysiological study of the impact of tolerance on uncertainty on mental adaptation among officers of the Armed Forces of the Russian Federation. The instrumental and diagnostic complex consisted of activity-behavioral, personal, emotional-volitional, psychophysiological methods. The definition of the psychophysiological features of the response to stress and the assessment of the state of the autonomic nervous system was carried out using Biofeedback. Following methods were used during the research — statistical method of clustering by the k-means method, Kolmogorov-Smirnov criterion, nonparametric Mann-Whitney criterion U for independent samples, construction of classification trees with moderation of significant factors. Also the article contains the description of the psychological profiles of officers with high and low meanings of tolerance for uncertainty. During the research it was found that the level of tolerance to uncertainty has an influence on the level of the mental situation, depending on the conditions of service. So, the group of people with high meanings of tolerance for uncertainty will show mental stability and professional reliability in a situation of extreme profile. It is found that high tolerance to uncertainty in the conditions of service in peacetime is associated with severe symptoms of emotional burnout, and such personal features as impulsivity, incontinence, risk appetite, and self-dissatisfaction. And the group with a low level of tolerance to uncertainty under extreme conditions will have high professional reliability and mental stability in conditions of service in peacetime.

Serum adiponectin and expression of adiponectin receptor 1 in the arterial muscular tissue in young and middle-aged hypertensive patients

Objective. To evaluate the serum adipokines and the degree of expression of adiponectin type 1 receptors (AdipoR1) in the brachial arteries with small and medium diameter of the muscular tissue in young and middleaged patients with hypertension (HTN).Design and methods. We included 50 patients with HTN 1–3 degree (18 to 60 years old), 30 underwent surgery due to trauma-related fractures on the shoulder. The control group included 20 otherwise healthy non-smoking volunteers, 10 underwent surgery due to trauma-related fractures of the shoulder. The serum levels of adiponectin and leptin were determined by the method of enzyme immunoassay. The biopsy of the muscle tissue were analyzed by the immunohistochemistry using primary polyclonal rabbit antibodies against AdipoR1 (Santa Cruze, sc‑99183, USA, 1:500). The data were processed using software Statistica 6.0. The Mann–Whitney criterion U, and Spearman’s correlation analysis were applied. Differences were considered statistically significant at p < 0,05.Results. Young and middle-aged patients with HTN had higher body massindex (BMI), waist circumference (WC), cholesterol, low-density lipoprotein cholesterol than control group. The serum adiponectin level was 5.48 (4,11; 6,95) μg/ml in HTN patients (p > 0,05), the leptin — 3,0 (2,2; 3,5) μg/ml (p > 0,05). Women with HTN showed higher leptin level — 3,4 (2,7; 3,6) μg/ml (р < 0,05). Women had a positive relationship between leptin and BMI (r = 0,6; p = 0,001), WC (r = 0,5; p = 0,02). The control group demonstrated normal vascular wall structure. Patients with HTN had two types of muscle vessel remodeling. The elastofibrosis was found in small vessels, circular hypertrophy was found in medium diameter vessels. Expression of AdipoR1 was the highest in the area of hypertrophy, reaching 14,1% (12,22; 16,83). Expression of AdipoR1 in the muscular wall of the vessels of the control group was the lowest and constituted 1,09% (0,37; 1,41). The increase in AdipoR1 correlated with the glucose level (r = 0,5; p = 0,02) in women with HTN and AdipoR1/high density lipoprotein (HDL) (r = –0,6; p = 0,04) in men and women with HTN.Conclusions. Women with HTN had increased serum leptin. Leptin directly correlated with BMI and WC. HTN patients demonstrate two types of vascular remodeling: arteriolosclerosis in small vessels and hypertrophic circular remodeling in vessels of medium diameter. There were 14% AdipoR1 labels in hypertrophic area. No significant relationship between serum adiponectin and AdipoR1 were found in the patient groups. Glucose level positively correlated with AdipoR1 in the arteries of medium diameter in hypertensive women, while serum HDL level negatively correlated with AdipoR1 in all patient groups.

Mathematical Modeling of Cooling of a Continuously Cast Ingot for Reducing Heat Losses

We consider thermal processes running in the course of cooling of a continuously cast ingot in a continuous billet casting machine with regard for the heat of phase transformations. For the solution of the problem of rational utilization of the heat of melts, we propose to improve the technology of continuous casting of steel, which would make it possible to use the heat of the liquid core of an ingot for leveling the temperature field over its cross section and guarantee the minimum losses of the heat at the exit of the continuous billet-casting machine. We develop a mathematical model of cooling of continuously cast ingots in a two-dimensional space representation with regard for the release of the heat of crystallization in the two-phase zone. The numerical realization of the model is performed with the help of the implicit difference scheme of coordinate-wise splitting. The adequacy of the model is checked by analyzing the convergence of the experimental and numerical data according to the Fisher, Student, and Mann–Whitney criteria. In modeling, we simulated the control action in the zone of secondary cooling. It is established that, in the case of application of the control action in this zone, the surface temperature increases by 160°C, while the average mass temperature increases by 100–160°C. We choose criteria for the rational modes of cooling of continuously cast ingots. To preserve the heat content of an ingot, it is proposed to use heat insulation after the zone of water–air cooling. We determine relationships between the parameters affecting the surface temperature of the ingot and represent them in the form of nomograms. It is shown that, before the machine of gas cutting, as a result of heat insulation in the zone of air cooling, the ingot is thermostatted as a result of which the temperature of its most vulnerable zones (corners and surfaces) increases. It is established that, for the rational modes of casting of steels, the ratio of the length of the zone of heat insulation to the total length of the continuous billet casting machine varies within the range 0.3–0.6. To determine the heat losses in the process of subsequent cooling of the ingot in air after leaving the zone of machine gas cutting, according to the existing technology of transportation of slabs to compression, the time of modeling was set equal to 90–105 min. To preserve the heat content of the ingot and level temperatures over its cross section, it is also necessary either to use a thermally insulated transmission roller conveyer or to hold ingots in a thermostat.

A research on efficacy of rehabilitation for post-stroke patients in Krasnoyarsk region performed upon the programme of the ministry of health of Russia in 2016

Krasnoyarsk Region is among the largest regions of Russia. Its population amounted 2,875,790 by January 1, 2017. A three-stage rehabilitation system for patients after stroke has been created in the region. Over 6000 patients received successive rehabilitation in 2016. The purpose of the research was to assess efficacy of complex successive post-stroke rehabilitation in Krasnoyarsk Region in 2016. A total of 163 patients after stroke (12 months), were enrolled into the unblinded study among which were 103 male and 60 female patients. The age varied from 32 to 91 years (57 ± 12.4). Ischaemic stroke was revealed in 144 patients while haemorrhagic stroke was revealed in 18. The study was conducted in the regional vascular centre at Stage I, in the Centre of neurorehabilitation of the FSSRCC of FMBA of Russia at Stage II and in the clinic of Krasnoyarsk Medical University at Stage III. Glasgow Coma Scale (Stage I only), modified ranking scale, NISSH, Ashworth spasticity, pain, dysarthria assessment scales, Wasserman test, MASA, HADS, MOCA, Rivermead Mobility Index, BBS, Hauser Ambulation Index, Frenchay Arm Test, FIM, EQ-5D were used. Statistical analysis was performed using non-parametric Wilcoxon and Mann-Whitney criteria. The patients were divided into 3 groups after examination: group I ( n = 39) included patients after only rehabilitation stage I. Group II ( n = 61) included patients after stages I and II, and group III ( n = 63) included patients after all stages. It has been found that best statistically significant results according to clinical scales were found in group III patients as manifested by disablement and neurological deficit decrease and motion activity value enhancement. In Krasnoyarsk region, the best efficacy has been shown by the complex successive rehabilitation for patients after stroke performed in stages.

N-TERMINAL PROPEPTIDE OF COLLAGEN TYPE III AS A PROPOSED MARKER OF MYOCARDIAL FIBROSIS IN TYPE 2 DIABETES

Aim. To evaluate the role of N-terminal procollagen type III propeptide (P3NP) as a proposed marker of myocardial fibrosis in type 2 diabetes (DM2) patients.Material and methods. In the study, 2 groups of patients participated: with DM2 and non-DM2 (both n=32). All patients underwent clinical and laboratory assessment, including P3NP, electrocardiography, echocardiography. Statistics was done with Mann-Whitney criteria and Spearman correlation.Results. The level P3NP is significantly higher in DM2 patients (р<0,00001). In DM2 patients, the level of P3NP significantly correlates with increased myocardial mass of the left ventricle (р=0,00026) and myocardial mass index of the left ventricle (р=0,03685).Conclusion. Echo- and electrocardiographic signs characteristic for myocardial fibrosis (mass increase, voltage decline) in DM2 patients are concomitant with the increase of P3NP. Significant correlation of P3NP and the size of myocardium makes it to propose P3NP as one of possible markers of myocardial fibrosis in DM2 persons.

THE ROLE OF MRI SCAN WITH CONTRAST AMPLIFICATION AT MULTI-PARAMETRIC MRI IN OPTIMIZATION OF X-RAY THERAPY OF RECURRENT CANCER OF PROSTATE

The purpose of study is to evaluate the role of dynamic contrast intensification as a constituent of multi-parametric MR-therapy in diagnostic of clinical recurrence of prostate cancer and optimization of salutary X-ray therapy. Materials and method. The sampling consisted of 89 patients with marker (prostate specific antigen) prostate cancer recurrence after radical prostate ectomy. The preliminary examination established no distant metastases. The multi-parametric MR-imaging of pelvis minor was applied both before salutary X-ray therapy and 6 months later after with purpose of applied treatment control. In 44 patients’ analysis was applied to data of dynamic MR-imaging with contrast intensification constituent to multi-parametric MR-imaging with intravenous injection of various MR-mediums (1M Gadobutrol, ½M Gadodiamid and ½M Gadoversetamid). The results. The model of multiple linear regression was applied to demonstrate that square of substrate of clinical recurrence statistically reliably correlates with level of marker of prostate specific antigen (R = 0,74; p < 0,0008) independently of type of injected various MR-mediums. The sensitivity of multi-parametric MR-imaging in detection of clinical recurrence of prostate cancer was evaluated by comparison with levels of prostate specific antigen and amounted to 92%, specificity - to 82%, accuracy - to 88%. The application of technique of hypo-fractionating of radiation dose on area of clinical recurrence of prostate cancer detected by multi-parametric MR-imaging demonstrated more progressive decreasing of marker of prostate specific antigen as compared with standard scheme of salutary X-ray therapy (according McNemarre criterion p < 0,03). The statistically reliable dependence (Mann-Whitney criterion p < 0,018) of alteration of signal in case of dynamic MR-imaging with contrast intensification after intravenous injection of various MR-mediums from square of substrate of clinical recurrence of prostate cancer and initial concentration of injected various MR-mediums between 1M Gadobutrol and ½M Gadodiamid and ½M Gadoversetamid. Conclusion. The multi-parametric MR-imaging has high sensitivity, specificity and accuracy in detection of substrate of clinical recurrence of prostate cancer. The application of in initial concentration of 1M (Gadobutrol) reliably increase validity of detection of local clinical relapse of prostate cancer especially in case of detection of substrate of recurrence of enough little and extra-little sizes. The application of multi-parametric MR-imaging using various MR-mediums marker in initial concentration of 1M (Gadobutrol) prior to course of salutary X-ray therapy enables to plan a supposed zone of X-ray impact with the purpose of more personalized brining of of high tumorocide dose of radiation at the area of clinical recurrence of prostate cancer needed for full resorption of recurrent tumor.

INDICATORS OF THE ELEMENT RANGE OF RAT’S BLOOD IN TERM ARTIFICIAL HYPOBYOSIS

The promising method of anesthesia and anesthesia is the state of artificial hypobiosis. Hypercapnia is a prerequisite for creating an artificial carbon dioxide hypobiosis, along with hypoxia and hypothermia. Adhering to the conditions under which the state of artificial carbon dioxide hypobiosis is created, animals reduce the level and intensity of metabolic processes both in the body as a whole and in separate organs. In order to investigate the safety of the hypobiological state and evaluate its applicability in clinical practice, it is necessary to investigate the functional characteristics of the blood. One of the most important indicators is the change of elemental composition. After all, the set of micro-and macro-elements is involved in the enzymatic reactions of the organism, its metabolic processes. Therefore, the aim of the study was to investigate the elemental changes in the blood of rats for artificial hypobiosis. In experiments, white non-breeding male rats weighing 180–200 g were used, which were maintained under standard vivarium conditions. Animals were divided into 2 groups: control and experimental (the state of artificial hypobiosis). Each group had 7 animals. Measurement of the content of macro- and micronutrients was carried out using a mass spectrometric ionization method in an inductively coupled plasma on an IRIS Interband II XSP device manufactured by Thermo Scientific, USA. The results of the study were processed and presented using the methods of statistical analysis, namely: the method of descriptive statistics; Shapiro-Wielka's criterion for choosing a statistical criterion for comparing groups; Student's criterion; Mann-Whitney's criterion. Results of evaluation of dynamics in the experimental (hypobiotic) group using the criterion of sign-marks of Wilcoxon. As a result of the studies, increased levels of Sodium, Ferrum, Calcium were observed, while the content of Nickel and Barium reduced. The results of the analysis of the dynamics of blood parameters in the experimental group by the methods of descriptive statistics showed significant changes in such elements as: Potassium, Sodium, Ferrum, Calcium, Magnesium. The heterogeneity of the results of the experimental and control groups according to the Mann-Whitney criterion was demonstrated in the following elements: Potassium, Sodium, Ferrum, Calcium, Chromium, Strontium.

POSSIBILITIES OF MULTIPARAMETRIC MAGNETIC RESONANCE IMAGING IN THE PERSONALIZATION OF SALVAGE RADIATION THERAPY IN PATIENTS WITH PROSTATE CANCER RECURRENCE

Objective. To identify the possibility of multiparametrical magnetic resonance imaging (mpMRI) in the diagnosis of clinical recurrence of prostate cancer, with the aim of optimizing salvage radiation therapy (SLT). Material and methods. In this prospective study, the results of 89 patients with marker relapse (PSA) of prostate cancer (PCa) after radical prostatectomy was examined. mpMRI of the pelvis was performed before the SLT and 6 months later. Separately, in 44 patients, the data of dynamic contrast enhancement (DCE) with different contrast agents (gadobutrol, gadodiamide and gadoversetamide) were analyzed. Results . According to the model of multiple linear regression, the area of the substrate of clinical recurrence is statistically significantly correlated with the PSA level (R=0.74, p<0.0008), regardless of the all type of DCE administered. The sensitivity of mpMRI in detection of clinical recurrence of PCa was 92%, specificity 81%, accuracy 88%, which was assessed by comparison with PSA level. The use of the hypofractive radiation dose to the area of clinical recurrence of PCa, detected with mpMRI, showed a more progressive drop of the marker (PSA), compared to the standard SLT scheme (McNemarre test, p<0.03). A statistically significant correlations (by the Mann–Whitney criterion with p<0.018) from the signal change in DCE after the injection of contrast agents (different types) and the substrate area. Conclusion. mpMRI has high sensitivity, specificity and accuracy to detecting the substrate of the clinical recurrence of PCa. The use of DCE for concentration of 1.0 mmol (gadobutrol) significantly increases the reliability of detecting clinical recurrence of PCa, especially when the substrate is found to small and ultrasmall sizes. The application of DCE with the contrast agents at the concentration of 1.0 mmol (gadobutrol) prior to initiation of SLT course, helps to plan the proposed radiation exposure zone, with the aim of providing the necessary for a complete resorption of the recurrent tumor, a high tumor dose of radiation to the clinical recurrence region.

Peculiarities of Stressors Experienced by Physical Education Teachers at Work

Research background and hypothesis. The article focuses on assessment of stressors experienced by physical education teachers in their work. As surveyed researchers notice, stress at work can cause a depressive mood, anxiety, tiredness and, eventually, serious illnesses. Under constant and overwhelming stress, a real threat of formation of the burnout syndrome appears. This is a condition of emotional, psychic and physical exhaustion formed under long-lasting unsolved stresses arising in work-related situations. Stress also significantly influences work efficiency, creativity and competitiveness. It is very important to notice that the change of personality features in a teacher experiencing stress or, even worth, the burnout syndrome, leave traces on the other person. Thus, it is necessary to go deeper into this scientific problem: what stressors are characteristic to the work of physical education teachers, what are the correlations with the socio-demographic variables The aim of the research was to assess work-related stressors of physical education teachers and their relation with socio-demographic variables. Teachers of physical education (n = 118 in comprehensive schools took part in the research. Research methods applied in the research: the data was collected using questionnaires on work-related stressors and socio-demographic information; the data obtained was processed by applying the parameter statistics, Mann-Whitney (U) criterion was employed as well. Research results. The research showed that teachers of physical education listed the following as the most important sources of stress at work: abundance of various documents and other “papers”, reforms of the educational system and high responsibility for pupils. Unfavourable work conditions, psychological climate at school, work with groups of pupils of different genders, problems with pupils’ parents almost did not cause stress to teachers of physical education. Younger teachers or those less experienced in pedagogical work felt more stress about high numbers of pupils in a sports hall than their senior or more experienced colleagues did. Senior and more experienced teachers of physical education emphasised that they underwent the following more intensive work-related stressors: high responsibility for others, abundance of various documents and other “papers”, underestimation of physical education teachers’ work. Men were unsatisfied with low salaries, and women indicated that the attitude of teachers in other subjects towards physical education caused dissatisfaction with work. Male teachers’ low salaries and female teachers’ perceived unappreciated attitude towards physical education caused stress to them. Teachers working in cities, towns assessed pupils’ disrespect and high numbers of pupils in forms as a bigger stressor than teachers of physical education in districts. Physical education teachers working in gymnasiums assessed competition inside an educational institution as a stronger stressor rather than educators working in the main or secondary schools.Discussion and conclusions. In the aspect of work-related stressors of physical education teachers, teachers list abundance of various documents and reforms of the educational system as main sources of stress at work. Negative attitude of other colleagues towards teachers of physical education as well as competition among staff at school, and, on the other hand, negative attitude of pupils towards physical education have been revealed. Analysis of correlations between work-related stressors and socio-demographic variables suggests that younger pedagogues experience higher stress caused by reforms of the educational system and a high amount of pupils in a sport hall during lessons in comparison to their senior colleagues; while senior teachers of physical education emphasise responsibility as a higher work-related stress.Keywords: physical education, teachers’ stress, burn out.

Взаимосвязь школьной тревожности и мотивации учебной деятельности на этапе адаптации к обучению в 5-х классах

The article presents results of an empirical study of the relationship between school anxiety and motivation of learning activity at the stage of adaptation in students of 5th classes.The study involved 82 students of Bryansk state school aged 10—11 years, 46 boys and 36 girls.The techniques used in the study included Phillips' school anxiety test and M.R.Ginsburg’s technique for studying learning motivation.The obtained data was analysed using the methods of mathematical statistics (Mann-Whitney criterion and Pearson's criterion).As it was revealed, play motives of learning activity are associated with fear of not meeting the expectations of others and with low physiological resistance to stress.Positional motives are correlated with an individual’s fear of self-expression, of not meeting the expectations of others, with problems and fears in relationships with teachers, with the general level of school anxiety, with learning and social motives.The results of the study can be used by school counselor to reduce school anxiety and increase learning motivation of schoolchildren.

Социально-психологические особенности лидеров несовершеннолетних осужденных

The problem of role differentiation of leadership among juvenile convicts is a socially significant and poorly studied problem in modern psychological science. The results of a study of 60 young men serving sentences in young offenders' institutions of the Federal penitentiary service of Russia in the age from 16 to 18 years are presented in the paper. “Leadership style” Questionnaire of R. Bale-K. Schneider (modification T.V. Bendas), “Leadership abilities” Questionnaire of E. Zharikova, E. Krushelnitskogo, “Communicative and organizational tendencies” Questionnaire of V.V. Sinyavsky and V.A. Fedoroshin, “Communicative control” Questionnaire of M. Schneider, “Emotional intelligence” Questionnaire of N. Hall, “Progressive matrix” of Raven were used to diagnosis of socio-psychological qualities of juvenile convict, as well as observations psychologists institutions and educators. The nonparametric Mann-Whitney criterion and factor analysis were applied. The results show that there are formal and informal leaders among juvenile convicts. Formal leaders stand out only in the business sphere and have a positive focus, informal leaders can be positive and negative, business and emotional. Leaders are more focused on solving problems, have developed leadership qualities, organizational and communication abilities. However, the prognostic qualities to identify a leader among juvenile convicts are not only leadership tendencies, but also the qualities of emotional intelligence, allowing to assess the situation, manage their emotions, to have a psychological impact on the state of others.

Сhoice of a thrombolytic for pulmonary thromboembolism treatment

Aim of the study was to choose the optimal thrombolytic therapy for massive and submassive TEPA.Materials and methods. 102 patients with massive and submassive embolism of lungs (Miller index > 17) were arbitrarily divided for administrating 100 mg of the recombinant tissue activator of plasminogen (r-tPA) or 3 mln of UN of streptokinase. The control multi-spiral computer tomography of breast organs (MSCT BO) or angiopulmonography (APG) was realized in 2–3 days after thrombolysis. For calculating the statistical importance of the difference of the number of patients by the concomitant pathology and sex, there was used χ2 with Ets correction. Mann-Whitney criterion was used for calculating the difference by age.Results. There was established the advantage of using r-tPA in hemodynamically unstable patients. There was established the advantage of using streptokinase in patients with the disease duration more than 1 day. There was proved the effectiveness of repeated sessions of thrombolysis. There was established, that it’s possible to prevent hemorrhagic complications of thrombolysis if to reveal its contraindications accurately.Conclusions. Alteplase must be used in hemodynamically unstable patients due to the faster effect comparing with streptokinase. Alteplase or streptokinase must be used for hemodynamically stable patients with massive and submassive pulmonary embolism. The repeated TLT is equally effective as thromboembolectomy at insufficient effectiveness of thrombolysis. For preventing hemorrhagic complications, the detail examination of patients is necessary to reveal possible sources of fatal bleeding and determination of contraindications to TLT

Comparative clinical characteristics in patients with chronic heart failure and reduced left ventricular ejection fraction in relation to gender status

The objective : to compere the main clinical characteristics and the structure of supporting pharmacotherapy in men and women with chronic heart failure (CHF) and reduce left ventricular ejection fraction (LVEF). Patients and methods: 356 patients with ischemic CHF and reduced LVEF < 40% were examined, including 259 (73%) men and 97 (27%) women. All patients were examined and treated according of recommendations to the Association of Cardiologists of Ukraine with relevant recommendations to the European Society of Cardiology. The statistical data were calculated by Excel, Statistica, Stat Soft applica tion package. The type of distribution of the trait was determined by Lilliefors and Shapiro–Wilks criteria. The hypothesis about the reliability of differences in the values in the groups was tested by nonparametric Mann–Whitney criterion. Results . In the group of patient with CHF and LVEF women in compare to men were characterized by older age, a little bit higher level of systolic blood pressure, a larger of the left ventricular ejection fraction. Women were more likely than men to present in higher NYHA class. There are more patients in women with hypertension and angina pectoris but fewer patients with atrial fibrillation and history myocardial infarction. Chronic obstructive pulmonary disease was frequently revealed in men, and the number of cases of type II diabetes mellitus was frequently confirmed in women. Renal dysfunction III IV degree prevailed in women than in men. Data on differences in the structure of treatment for men and women were obtained. Dose of в blockers was significantly higher in women than in men with the same number of their prescriptions. However, more often Angiotensin Converting Enzyme Inhibitors were prescribed for men unlike women. Conclusion . Groups of men and women with CHF and reduced LVEF differ in the course of the disease, attendant pathology and the structure of treatment, which can be used to develop recommendations for dispensary observation of such patients in the format of personalized medicine.

Analysis of epidemiological situation of iodine deficiency in Tomsk region from 1998 to 2014

The purpose of the present research is the comparative analysis of the epidemiological situation of iodine deficiency in the Tomsk region from 1998 to 2014. There were examined 9901 and 15174 children of the school age including within the medical examination of the children’s population in 1998 and 2014 in Tomsk. At all school pupils there were analyzed anamnestic data and carried out anthropometrical measurements, ultrasonography of the thyroid gland was carried out using the portable scanner "Aloka SSD 500" with the linear sensor of 7,5 MHz frequency in the real time, the thyroid volume was evaluated according to Delange (1997). The excretion of inorganic iodine was determined at 264 in 1998 and at 120 children in 2014, respectively, in a one-time portion of urine by the cerium–arsenic method. There was additionally carried out the analysis of results of determination of TSH at 10717 in 1998, and at 15091 in 2014 in a spot of the whole blood at newborn children on the 4-5 day after birth at full-term and on the 7-14 day at prematurely born children. Neonatal TSH in the dried-up samples of capillary blood was determined by the method of the fluorometric immune-ferment analysis with the use of sets of TSH-Neonatal: Delfia, Finland. Statistical processing of the data obtained was carried out with the use of the applied software package pspp. The descriptive analysis included calculation of the median for the quantitative and the calculation of frequencies for qualitative data. The comparative analysis included calculation of distinctions reliability by the Mann-Whitney criterion for independent and to Wilcoxon’s criterion for dependent data. The comparative analysis of epidemiological situation of iodine deficiency in Tomsk and the Tomsk region in 1998 and 2014 specifies decreasing the iodine deficiency diseases in the Tomsk region, increasing the iodine provision of the population within 15 years by 27%, decreasing neonatal hyperthyroidism by 1.5 times.

RELATION OF HYPERURICAEMIA, RENAL FUNCTION AND ARTERIAL HYPERTENSION IN A LARGE REGION OF THE EASTERN SIBERIA INHABITANTS

Aim . To investigate on the prevalence of hyperuricaemia (HU) among citizens and rural areas inhabitants of Krasnoyarsk region, and to assess possible relation of HU with arterial hypertansion (AH), HU and renal function. Material and methods. The study was done under the framework of ESSE-RF, included 1603 persons of age 25-64, had been selected by the random three-stage stratified selection. All participants underwent questionning, office BP measurement. Uric acid level (UA) was measured with urease method on Architect 8000 (USA) equipment. Statistics was done on IBM SPSS v. 22, StatSoft STATISTICA v. 10 and LibreOffice v. 5. Significance of differences by quantitative criteria was checked with Mann-Whitney criteria, by qualitative criteria — by hi-square. Differences were significant at p<0,01. Results . The prevalence of HU in general was 30,2% among participants, with the mean UA level 338,5 mM/L (males had significantly higher). The significant higher levels were revealed in citizens than in rural inhabitants. There was no significant difference in UA level through age subgroups. Part of hypertensives was 1,27 times more than in those with normal UA (57,7% versus 45,7%), and 1,36 more prevalent in females (57,1% versus 42,1%). The similar was found in comparison of hypertensives among hyperuricaemics, and AH prevalence in Krasnoyarsk region (57,7% versus 49,4%), and almost completely due to females prevalence (57,1% versus 43,7%). The calculated glomerular filtration rate was significantly lower in HU persons than in those with normal UA. Conclusion. A relatively high prevalence of HU was found in the territories of Krasnoyarsk region, showing higher levels than those by ESSE-RF results. In males the disordered UA level is higher than in females and more prevalent. Citizens have HU more prevalent than rural inhabitants. The relative risk of hypertension development increases in HU more than in persons with normal UA. In HU functional kidney condition is significantly impaired.

USING VIRTUAL REALITY AS A METHOD OF ACCELERATED REHABILITATION AMONG THE PATIENTS AFTER STROKE

Aim - exploring the effect of displaying the motion from the first-person’s point of view in virtual reality on the recovery of motor disorders among patients in the acute period of cerebrovascular disorder. Materials and methods. 45 patients with acute cerebrovascular disorder aged 58±7 years were analyzed. Patients were randomized in two groups. The first group received either standard rehabilitation or training with virtual reality equipment. The second group received only standard rehabilitation. Training included displaying the motion from the first-person’s point of view in the virtual reality during 3-7 sessions, 15 minutes each. In this exercise a patient could see his “virtual legs”. Speed range was 2-5 km/h. Berg’s balance assessment was used to score movement function (14 questions, where max score - 56 points - means that there is no dysfunction to notice). Assessment method for comparing groups with unusual distribution (Mann-Whitney criteria) was used as statistical analysis. Results. Exercises with the virtual reality equipment show their efficiency on 15th-19th day after stroke. The most significant outcome can be achieved in 5-9 days after stroke (p=0,022). The rate of movement function recovery depends on the duration of training (p=0,001); the highest outcome can be achieved during the first 3-5 sessions. Conclusion. Additional exercises with the virtual reality equipment help to improve outcomes of movement function recovery among patients with acute cerebrovascular disorder.

The possibilities of serum cystamine C in diagnostic of pyelonephritis in pregnant women Hematology.

The cystamine C is considered as one of markers of functional condition of pregnant women. The actual study was carried out to assess possibility of applying cystamine C as a biological marker of pyelonephritis in pregnant women. The sampling consisted of 126 pregnant women with various terms of gestation. The participants were separated in two groups. The group I included 64 women with pyelonephritis and the group II included 62 women without pyelonephritis. Te serum values of cystamine C were detected using enzyme-linked immunosorbent assay. The statistical analysis was implemented using non-parametric methods, including Kruskal-Wallis criterion for comparison of 3 independent groups and Mann-Whitney (Wilcoxon) criterion for a posteriori comparisons. The comparative analysis of values of cystamine C in pregnant women discovered, depending on term, increasing of its level since term II - 0.815 (0.622; 0.914) and even higher values in term III - 1.076 (0.917; 1.463) (p=0.0007). This trend repeats at minute analysis of indices of cystamine C in each group separately. The differences in values of cystamine C in two groups in total and between terms were lower statistically significant levels. However, in the group of women with pyelonephritis its values in terms I and III were higher than in the group of women without pyelonephritis. The highest values of content of cystamine C in pregnant women (p=0.0007) were observed in term III. The inter-group differences of serum values of content of cystamine C were absent that does not allow to recommend it as a early marker of damage of kidneys in pregnant women with pyelonephritis.

Impact of new methods of respiratory support on postoperative restrictive syndrome and gas exchange after ventral hernias plasty

The concept of respiratory support in anesthesiology underwent significant changes for last decade. The aim of these changes was the decrease of frequency of postoperative pulmonary dysfunction development. In the research was considered an impact of the new strategies of respiratory support on the state of external respiration and pulmonary gas exchange in early postoperative period at large and giant ventral hernias plasty.Methods. 77 patients underwent the prospective clinical examination after nonstrain methods of ventral hernias plasty. Patients receive the standard respiratory support in postoperative period, lung recruitment maneuver (RM) 40/10 and positive end-expiratory pressure (РЕЕР) 7–10 sm. water column, postoperative constant positive airway pressure (СРАР). There were studied the next parameters: oxygen saturation of arterial blood (SpO2), partial oxygen pressure in arterialized capillary blood (PaO2), gradient of carbon dioxide end-expiratory partial pressure in arterialized capillary blood (Р(а-et)CO2)), respiratory volume (RV), forced vital capacity (FVC)of lungs. The Kruskal-Wollis method with Mann-Whitney criterion assessment was used at intergroup analysis. Statistical analysis - STATISTICA AS for Windows (version 5.5).Results. Statistical analysis demonstrated statistically significant (р&lt;0,05) increase of oxygenation parameters (SpO2 , PaO2), spirogram parameters (RV, FVC), gradient decrease Р(а-et)CO2 in СРАР, RМ+СРАР groups in first 48 hours of postoperative period after large and giant ventral hernias plasty.Conclusions. Postoperative СРАР and its combination with intraoperative RМ improve the state of oxygenation, decrease the restrictive syndrome in the first 48 hours after large and giant hernias plasty