Primary Disease Prevention Research Articles

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The decline in immunization coverage in Indonesia is followed by high mortality and morbidity for toddlers, one of which is caused by Acute Respiratory Infections. The government conducted an immunization program aimed at primary prevention of diseases that cause ARI with pentabio immunization. This research aims to determine the correlation between the completeness and accuracy of pentabio basic immunization with the incidence of acute respiratory infections (ARI) in toddlers in Dinoyo Public Health Center in Malang. The design of this research was correlation analytic using documentation studies on medical records, immunization registers and infant cohorts through a retrospective approach. The sample used was all sick toddlers who checked themselves in Dinoyo Community Health Center Malang City in July-September 2019 who met the inclusion criteria of 164 respondents using total sampling technique. The results of the analysis using the Chi Square Test obtained p-value of 0,000 (? ? 0.05) followed by a Contingency Coefficient Test with a value of C = 0.426 indicating that there was a significant relationship between the completeness and accuracy of pentabio basic immunization with the incidence of acute respiratory infections at toddler at Dinoyo Public Health Center in Malang City with a moderate level of closeness. Pentabio basic immunization given precisely and completely can prevent ARI in toddlers. Health facilities and midwives are expected to increase public awareness about the importance of completeness and accuracy in providing basic immunization for pentabio according to the basic immunization delivery schedule. Keywords: Completeness And Accuration, Pentabio Basic Immunization, ARI, Toddlers

The use of the rinse aid based on a complex of natural citrus bioflavonoids for gingivitis. Clinical study

According to the Federal State Program of Primary Prevention of dental Diseases among the population of Russia in 2011 in the age group of 35–44 years, conducted by STAR, the prevalence of periodontal diseases is high – more than 80%. The high prevalence is due to the low level of oral hygiene. In addition to the standard protocol for the treatment of periodontal diseases, dentists prescribe antibacterial mouthwashes for home use. The combination of chlorhexidine 0.05% + CITROX can act as an alternative to pure chlorhexidine. This combination contributes to less plaque formation, reduces bleeding gums and has an anti-inflammatory effect. It was also noted that this rinse aid has a more pleasant taste and less pronounced side effects.

Primary and Secondary Prevention of CAD: A Review.

Coronary artery disease is the leading cause of death in both men and women, yet adequate control of risk factors can largely reduce the incidence and recurrence of cardiac events. In this review, we discuss various life style and pharmacological measures for both the primary and secondary prevention of coronary artery disease. With a clear understanding of management options, health care providers have an excellent opportunity to educate patients and ameliorate a significant burden of morbidity and mortality.

Measuring sleep literacy in healthcare students: an observational study

In recent years, research has focused on the various potentialities and functions associated with so-called restorative sleep, in the general population and not only in individuals with more serious pathologies. Thus, sleep hygiene rules have been defined in order to allow, in an accessible way, everyone to actively contribute to their quality of sleep. Health students play a key role as active agents in primary care, health promotion and disease prevention. But to assume this role, as a living example and educator, they often need to increase their health literacy, which must go far beyond specific knowledge. With this observational study, we aimed to assess the actual knowledge of higher education students in courses in the area of health (School of Health of the Polytechnic of Porto), through an online questionnaire with some factual statements on this topic. It is expected that the data collected will allow the identification of misconceptions and misconceptions about the area of sleep, thus revealing which lines of intervention still need to be invested in literacy in this area.

Transformer-based Multi-target Regression on Electronic Health Records for Primordial Prevention of Cardiovascular Disease.

Machine learning algorithms have been widely used to capture the static and temporal patterns within electronic health records (EHRs). While many studies focus on the (primary) prevention of diseases, primordial prevention (preventing the factors that are known to increase the risk of a disease occurring) is still widely under-investigated. In this study, we propose a multi-target regression model leveraging transformers to learn the bidirectional representations of EHR data and predict the future values of 11 major modifiable risk factors of cardiovascular disease (CVD). Inspired by the proven results of pre-training in natural language processing studies, we apply the same principles on EHR data, dividing the training of our model into two phases: pre-training and fine-tuning. We use the fine-tuned transformer model in a "multi-target regression" theme. Following this theme, we combine the 11 disjoint prediction tasks by adding shared and target-specific layers to the model and jointly train the entire model. We evaluate the performance of our proposed method on a large publicly available EHR dataset. Through various experiments, we demonstrate that the proposed method obtains a significant improvement (12.6% MAE on average across all 11 different outputs) over the baselines.

Efficacy of Posaconazole for Primary Prophylaxis in the Induction Therapy of Childhood Acute Lymphoblastic Leukemia

To explore the effect of posaconazole in the primary prevention of invasive fungal disease (IFD) in the induction therapy of childhood acute lymphoblastic leukemia (ALL). From August 2018 to November 2020, 144 pediatric patients with ALL treated in Department of Pediatrics, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University were selected, 88 cases received fluconazole as IFD prophylaxis (fluconazole prophylaxis group), 56 cases received posaconazole as IFD prophylaxis (posaconazole prophylaxis group). The incidence of IFD and treatment-related adverse reactions between the two groups were compared, and the safety of posaconazole was evaluated. The incidence of IFD in the fluconazole prophylaxis group was 20.4% (18/88), and in the posaconazole prophylaxis group was 7.1% (4/56). The incidence of IFD between the two groups was statistically significant different(P=0.030). There was no serious adverse reactions in the two groups. The incidence of mild adverse reactions in the posaconazole prophylaxis group (23.2%) was lower than that in the fluconazole prophylaxis group(39.8%), and the difference was statistically significant (P=0.039). There were 12 cases died in the fluconazole prophylaxis group and 4 in the posaconazole prophylaxis group, while no significant difference in the overall survival rate between the two groups (P=0.281). The effect of posaconazole in the primary prophylaxis of IFD is better and incidence of adverse reactions is lower than fluconazole. Posaconazole can be tolerated, and expected to become the first-line primary prophylaxis drug for IFD during the induction remission therapy of childhood ALL.

Selección de lo mejor del año 2021 en cardiopatías congénitas

This article shows the publications that we consider the most relevant on congenital heart disease in the last year. The COVID-19 pandemic has continued to mark scientific activity in this period. There has been concerns about the risk of complications from COVID-19 among adults with congenital heart disease (CHD). Likewise, the involvement of children with CHD has been studied. This year, the European guidelines for the treatment of CHD have been published, the second edition after 10years, that will be very useful in the treatment of these complex patients. Among the original publications, we highlight the contributions related to risk stratification in the primary prevention of ventricular arrhythmias, Fontan and liver disease, and the progress in percutaneous pulmonary valve implant techniques, the application of new drugs for advanced heart failure in complex CHD and in systemic right ventricle and long-term complications of young adults with transposition of the great arteries undergoing arterial switch surgery.

APPROACHES TO THE METHOD OF BUILDING A HYGIENE, SANITARY AND OCCUPATIONAL HEALTH MANAGEMENT SYSTEM

In transport, ensuring safe conditions and labor protection are of particular importance, as the lives ofpassengers and the safety of rail transport depend on the health of workers in this industry. The incidence of temporarydisability, occupational and chronic morbidity of employees of a number of transport professions have been studied.This assessment of diseases depending on age and length of service according to medical examination from thestandpoint of evidence-based medicine, which revealed the cause of increased morbidity associated with adverseworking conditions and assess the degree of its professional conditionality. It is established that the leading harmfulinfluences in the organization of work of railway transport workers are noise, vibration, nervous and emotional stressand a nuфmber of other factors. Studies have shown that prolonged and repeated exposure to factors of the productionenvironment leads to a violation of adaptive mechanisms, and their failure, contributes to pathological processes in thebody. On the basis of the conducted research the concept of interaction of object with hygiene and sanitation at theenterprise and model of integrated management of object as ecological and economic system is formulated. In theprocess of research the model of the organization of management of health of workers which organically fits into modelof conceptual balanced interaction of the enterprise with environment is developed. This model provides for the primaryprevention of diseases, both occupational and occupational, and is a tool that allows you to maintain and strengthen thehealth of workers through activities such as prevention of the causes of risk factors.

Abstract 13552: Mortality Trends in the United States Due to Underlying Rheumatic Heart Disease From 1999-2018

Introduction: Rheumatic heart disease (RHD) is a preventable disease which affects almost 33 million people globally. RHD was estimated to be responsible for 305,000 deaths worldwide and 11.5 million disability-adjusted life years lost in 2015. We investigated the temporal trends of RHD related mortality in the U.S. by using nationwide data. Methods: Death certificate data were retrieved from the Centers for Disease Control and Prevention’s Wide-Ranging Online Data for Epidemiologic Research (WONDER) database for 1999-2018. WONDER database reports the underlying cause of death across the United States. Mortality for Rheumatic heart disease ICD-10 (I05-I09) which includes rheumatic mitral valve diseases I05; rheumatic aortic valve diseases I06; rheumatic tricuspid valve diseases I07; multiple valve diseases I08; or other rheumatic heart disease I09; as an underlying cause of death were queried from 1999-2018. This study duration was further stratified into five-year periods. Crude mortality rate and age-adjusted mortality rate per 100,000 were calculated with a 95% confidence interval in four U.S census regions. Results: Overall AAMR showed a downward trajectory and declined from 1.3 to 0.9 per 100,000 from 1999 to 2018. AAMR for Northeast (CR-1) declined by 33%; for Midwest (CR-2) declined by 23%; for South declined by 27%, and for West (CR-4) declined by 33%. Crude mortality rate, AAMR, and % deaths are shown in table 1.Temporal trends are illustrated in figure 1. Conclusions: Regional AAMRs for U.S census regions showed a downward trajectory from 1999-2018. These trends suggest the efficacy of of primary and secondary prevention of rheumatic heart disease.

Abstract 11904: Heart Health for South Asians: Improved Cardiovascular Risk Factors and Outcomes With a Culturally Tailored Health Education Program

Introduction: The Kaiser Permanente (KP) Northern California Heart Health for South Asians (HHSA) Program is a two-hour educational class offered at KP Santa Clara, California. The class provides culturally relevant lifestyle and dietary recommendations to South Asian patients, in an effort to reduce the known disproportionate burden of cardiovascular (CV) disease in this population. We aimed to evaluate the impact of the HHSA Program on CV risk factors and major adverse CV events (MACE). Methods: A retrospective cohort study identified 1517 participants of South Asian descent, age ≥ 18 years old from 2006-2019. We evaluated the change in individual risk factors with program attendance (median follow up of 6.9 years) for the following variables: systolic blood pressure (SBP), diastolic blood pressure (DBP), triglycerides (TG), LDL, HDL, BMI, and HbA1c. We also performed a propensity matched analysis to evaluate differences in MACE including stroke, myocardial infarction (MI), coronary revascularization, and all-cause mortality. Results: Differences in individual risk factors are outlined in figure 1A and show a significant improvement in SBP, DBP, TG, LDL, HDL and HbA1c at follow up. In the propensity matched analysis, there was a statistically significant reduction in revascularization (OR 0.33, 95% CI 0.14-0.78, p= 0.011) and mortality (OR 0.41, 95% CI 0.22-0.79, p= 0.008), a trend towards reduction in stroke (OR 0.22 , 95% CI 0.05-1.03, p= 0.054), and no statistically significant difference in the rate of MI (OR 0.93 , 95% CI 0.43-1.98, p= 0.85) (Figure 1B). Conclusions: Our study demonstrates the efficacy of a culturally tailored South Asian health education program in improving CV risk factors and reducing MACE. The program highlights the importance and value of providing culturally tailored, motivational health education in primary CV disease prevention.

ЭФФЕКТИВНОСТЬ ПРОФИЛАКТИКИ ЗАБОЛЕВАНИЙ РОТОВОЙ ПОЛОСТИ У ДЕТЕЙ. ЗНАЧЕНИЕ ВОПРОСА ДЛЯ СЛАБОВИДЯЩИХ ДЕТЕЙ

Subject. Dentine pathology is widely prevalent among children in many countries around the globe, which determines the relevance of consideration, organisation and performance of different forms of health education activities for this part of the population. Programmes for dental disease prevention are represented by different methods and means, the purpose of which is creation of correct skills and abilities aimed at preservation and maintenance of oral cavity health. For blind and hyposeeing children, there is absence of special technology for teaching dental culture and rational hygiene of the oral cavity.
 Aim – studying and analysis and literature related to forms and methods of health education activities for children with consideration for their somatic status.
 Methods.The study was carried out based on the search for and analysis of original articles devoted to issues of dental disease prevention among children and adolescents in the following databases: ELIBRARY, PubMed, Medline, Cyberleninka. A total of 45 sources have been analysed (25 by Russian and 20 foreign authors).
 Conclusions. Preventive dental care programmes for conventionally healthy children at the modern stage of development are sufficiently effective, diverse in their contents, point at the necessity of further introduction of individual preventive care activities. Few organisational forms of health education activities have been developed for children with health limitations. There is no special method for organisation of health education activities for blind and hyposeeing children. These circumstances point at the necessity of development and introduction of correction methods for primary prevention of oral cavity diseases for this category of subjects.

Naturopathic practitioners’ approach to caring for people with cardiovascular disease risk factors: A cross-cultural cross-sectional study reporting the providers perspective

Backgroundand purpose: Naturopathic practitioners (NPs) in the United States (US) and Australia are consulted for the prevention and management of a range of health conditions, including cardiovascular disease (CVD). Despite this, little is known about how NPs approach the management of CVD risk factors. The aim of this study was to explore NPs approach to the care of people with CVD risk factors. Materials and methodsIn 2018, Australian and US NPs were recruited via professional representative organisations. A survey was developed containing four domains; naturopathic approaches to the clinical management of CVD risk factors, communication and sharing of information; professional-client relationship factors; and demographic information. The data analysis was conducted using the appropriate statistical tests. ResultsA total of 151 NPs completed the survey (Australia n = 75, US n = 76). NPs reported employing dietary, and multiple behavioural and natural product interventions to treat CVD risk factors. The most frequently recommended products by US and Australian NPs were fish oils (87%), magnesium (83%) and coenzyme Q10 (87%). Differences in what US and Australian NPs recommended were identified. NPs reported limited communication with medical doctors about their clients. NPs placed high importance on the relationship quality with their clients. ConclusionUS and Australian NPs represent an aspect of primary care and disease prevention that warrants further research that evaluates the potential risks and benefits of NP care, and challenges and opportunities associated with NPs integration into the healthcare systems, for populations with CVD risk factors.

Responsible use of polygenic risk scores in the clinic: potential benefits, risks and gaps.

Polygenic risk scores (PRSs) aggregate the many small effects of alleles across the human genome to estimate the risk of a disease or disease-related trait for an individual. The potential benefits of PRSs include cost-effective enhancement of primary disease prevention, more refined diagnoses and improved precision when prescribing medicines. However, these must be weighed against the potential risks, such as uncertainties and biases in PRS performance, as well as potential misunderstanding and misuse of these within medical practice and in wider society. By addressing key issues including gaps in best practices, risk communication and regulatory frameworks, PRSs can be used responsibly to improve human health. Here, the International Common Disease Alliance's PRS Task Force, a multidisciplinary group comprising expertise in genetics, law, ethics, behavioral science and more, highlights recent research to provide a comprehensive summary of the state of polygenic score research, as well as the needs and challenges as PRSs move closer to widespread use in the clinic.

Biomarkers of DNA Oxidation Products: Links to Exposure and Disease in Public Health Studies.

Environmental exposure can increase the production of reactive oxygen species and deplete cellular antioxidants in humans, resulting in oxidatively generated damage to DNA that is both a useful biomarker of oxidative stress and indicator of carcinogenic hazard. Methods of oxidatively damaged DNA analysis have been developed and used in public health research since the 1990s. Advanced techniques detect specific lesions, but they might not be applicable to complex matrixes (e.g., tissues), small sample volume, and large-scale studies. The most reliable methods are characterized by (1) detecting relevant DNA oxidation products (e.g., premutagenic lesions), (2) not harboring technical problems, (3) being applicable to complex biological mixtures, and (4) having the ability to process a large number of samples in a reasonable period of time. Most effort has been devoted to the measurements of 8-oxo-7,8-dihydro-2'-deoxyguanine (8-oxodG), which can be analyzed by chromatographic, enzymic, and antibody-based methods. Results from validation trials have shown that certain chromatographic and enzymic assays (namely the comet assay) are superior techniques. The enzyme-modified comet assay has been popular because it is technically simpler than chromatographic assays. It is widely used in public health studies on environmental exposures such as outdoor air pollution. Validated biomarker assays on oxidatively damaged DNA have been used to fill knowledge gaps between findings in prospective cohort studies and hazards from contemporary sources of air pollution exposures. Results from each of these research fields feed into public health research as approaches to conduct primary prevention of diseases caused by environmental or occupational agents.

Universal oral health coverage - Perspectives from a developing country.

Universal Health Coverage (UHC) is where people have access to health services without suffering financial hardship to pay for it, provide equitable health-care services that are appropriate, accessible and affordable for all people, particularly poor and disadvantaged communities. However, optimal intervention in relation to oral disease is not universally available or affordable specifically in developing countries because of limited resources at public sector, escalating costs of treatment and inadequate emphasis on primary prevention of oral diseases. Similar barriers also exist in utilisation of dental services among the Indian population. Integrating oral health into UHC will help improve oral health outcomes and reduce inequalities in access to care. To strengthen the oral health system towards UHC, public sector spending on oral health-care should be equally focused on primary care instead of directing mainly into only tertiary care, which could help reduce the number of complications progress to more expensive and more aggressive treatment.

Cardiorenal syndrome and death risk in patients with heart failure or chronic kidney disease: an unmet cardiorenal need?

Abstract Introduction Heart failure (HF) and chronic kidney disease (CKD) have interlinked pathophysiological pathways and patients having both conditions simultaneously are defined as having cardiorenal syndrome (CRS). Purpose To estimate the risk of CRS in patients with initial presentation of HF (without prior CKD) or CKD (without prior HF) compared to mean age overall population in a real-world clinical setting. Also, to estimate the risk of all-cause death, cardiovascular (CV) death and non-fatal major CV events (MACE) in patients with HF, CKD and CRS compared to the mean-age overall population. Methods Clinical database analysis of a single primary and secondary healthcare institution from 2008–2019. We defined 4 incident cohorts: Control - patients at age 75; HF - HF patients without prior CKD; CKD - CKD patients without prior HF; CRS - patients with HF and CKD. Patients were indexed at the date of first event and followed one year. We defined HF as either: i) Ejection Fraction (EF)≤40% and NT-proBNP≥200pg/mL (≥600pg/mL if atrial fibrillation (AF)) OR BNP≥100pg/mL (≥125pg/mL if AF); ii) EF>40% in the presence of structural cardiac abnormalities. We defined CKD as eGFR≤60mL/min using EPI-CKD formula. All definitions were constructed using laboratory-level data complemented with episode-level data. Hazard ratios (HR) and 95% confidence intervals were estimated using Cox regression models adjusted for age, sex, age-sex interaction, prior history of hypertension, myocardial infarction, stroke, peripheral artery disease and type 2 diabetes. Results We identified 3973 patients with HF, 13990 with CKD, 6784 with CRS and 16182 controls. Patients were in general 75–77 years old. The majority were females and were well treated with CV risk reducing drugs (Table 1). All-cause death risk was 4.7 (4.1–5.2) for HF and 4.9 (4.5–5.4) for CKD. CV death risk was 8.6 (6.8–10.8) for HF and 8.7 (7.1–10.6) for CKD. Non-fatal MACE risk was 7.4 (6.3–8.7) for HF, 4.6 (4.0–5.3) for CKD, and 7.1 (6.1–8.3) for CRS. CRS was associated with the highest risks of all-cause and CV death when compared with the control group- 7.1 (6.4–7.9) and 13.7 (11.7–17.0), respectively (Figure 1). More than half of events occurred in the first 90 days of follow-up for all outcomes. Conclusions Cardiorenal disease (HF or CKD) was associated with very high short-term risk (1 year) of developing CRS or death. Consecutively, patients with established CRS had the highest risk of dying. These results demonstrate serious cardiorenal risks in a real-world setting, supporting an urgent need for improved primary and secondary prevention of cardiorenal disease and cardiorenal syndrome. Funding Acknowledgement Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): AstraZeneca Produtos Farmacêuticos, Lda. Table 1. Baseline characteristicsFigure 1. Outcomes for CKD, HF and CRS

WORKSHOP MEDICAL PRACTICE IN OBSTETRICS AND GYNECOLOGY AS A MEANS OF IMPROVEMENT OF THE FUTURE SPECIALIST’S PROFESSIONAL COMPETENCE

The article highlights the main directions of students’ activities organization in the framework of the workshop medical practice in Obstetrics and Gynecology in order to form their professionalism. The effectiveness of practice and the resulting quality of professional activities of future professionals depend on the quality of this organization.
 It is determined that the practice of students is an integral part of the educational-professional training program for specialists of all educational-qualification levels. It is an essential prerequisite for training of a highly qualified specialist for future work, ensuring his competitiveness and employment opportunities in the native and European labor markets. The quality of training of specialists in medical universities is directly dependent on the level of knowledge obtained in the process of theoretical training, professional skills and abilities received during the workshop medical practice at the clinical bases of the departments.
 Modernization of the higher educational system emphasizes the role of independent students’ work, which contributes to the formation of professional competence, provides the process of developing skills of self-organization and self-control of their own activities. The application of knowledge in practice, contact with patients and the ability to perform manipulations form a sense of belonging to the professional community in the students; this increases their interest in learning theoretical material.
 The topicality of this issue is obvious, as it is difficult to disagree with the fact that well-organized and effectively performed workshop medical practice in fourth and fifth year students is a prerequisite for successful training of doctors meeting modern requirements of national health care.
 According to the program of industrial medical practice, the amount of practical skills a student has to master, will allow him to work at the appropriate professional level, regardless of the specialization, forming the basis of clinical thinking of future medical professionals.
 The distribution of practical skills is carried out according to four content modules (internal medicine, surgery, pediatrics, Obstetrics and Gynecology). The content module – is a system of educational elements, combined on the basis of compliance with a certain educational object (part of the credit). During the content modules in Obstetrics and Gynecology, the student should master the following practical skills and abilities: a special obstetric-gynecological history taking; performance of a gynecological examination; interpretation of the results of laboratory, instrumental and endoscopic research methods of patients of the obstetric-gynecological profile; substantiation and formulation of clinical diagnosis; interpretation of general principles of treatment; emergency care in urgent situations in obstetric-gynecological practice; primary and secondary prevention of the female reproductive system diseases.
 The close cooperation of practical health care doctors and teachers of medical universities plays a leading role in the preparation and adaptation of trainee students for further professional activity.
 At the present stage of higher medical education functioning, the role of practical training of students in the development of their cognitive activity and professional competence is significantly increasing. Workshop medical practice of students is the first stage of their practical training for the profession. At this stage, the foundations of professional skills and abilities, attitude to the future activities are established. Students realize and evaluate the correctness of professional choice, determine the presence of the necessary abilities and qualities.

Characteristics of heart rate variability in patients with acute coronary syndrome without ST segment elevation in comparison with clinical and biochemical parameters

BACKGROUND: The search for rational methods of primary, secondary, and tertiary prevention of coronary heart disease. To date, there are several publications on heart rate variability in ischemic heart disease.
 AIM: To study the state of the regulatory systems in the organism of patients with acute coronary syndrome without ST segment elevation based on the heart rhythm, and their relationship with the clinical, biochemical and instrumental parameters of the disease.
 MATERIALS AND METHODS: The open comparative study included 76 patients (62 men, 14 women) of mean age, 61.0 0.9 years, who were admitted to the Emergency Cardiology Department diagnosed of acute coronary syndrome without ST segment elevation. On admission, cardiointervalometry was performed using Varicard 2.51 apparatus, and a number of clinical and biochemical parameters were evaluated
 RESULTS: Multiple correlations of parameters of heart rate variability and clinical, biochemical and instrumental parameters were observed. From this, a cluster analysis of cardiointervalometry was performed, thereby stratifying patients into five clusters. Two extreme variants of dysregulation of the heart rhythm correlated with instrumental and laboratory parameters. A marked increase in the activity of the subcortical nerve centers (maximal increase of the spectral power in the very low frequency range with the underlying reduction of SDNN) in cluster 1 was associated with reduction of the left ventricular ejection fraction: cluster 147.0 [40.0; 49.0], cluster 260.0 [58.0; 64.0], cluster 360.0 [52.5; 64.5] % (the data are presented in the form of median and interquartile range; Me [Q25; Q75], p 0,05). Cluster 5 showed significant reduction in SDNN (monotonous rhythm), combined with increased level of creatine phosphokinase (CPC): cluster 5446,0 [186.0; 782.0], cluster 4141.0 [98.0; 204.0] IU/l; Me [Q25; Q75], p 0.05) and MВ-fraction of creatine phosphokinase; cluster 532.0 [15.0; 45.0], 4 cluster 412.0 [9.0; 18.0] IU/l; Me [Q25; Q75], p 0.05).
 CONCLUSIONS: In patients with acute coronary syndrome without ST segment elevation, cluster analysis of parameters of heart rate variability identified different peculiarities of regulation of the heart rhythm. Pronounced strain of the regulatory systems of the body was found to be associated with signs of severe pathology: the predominance of VLF (spectral power of the curve enveloping a dynamic range of cardiointervals in the very low frequency range) in spectral analysis with an underlying reduced SDNN is characteristic of patients with a reduced ejection fraction, and a monotonous rhythm is characteristic of patients with an increased level of creatine phosphokinase and MB-fraction of creatine phosphokinase.

Endothelial Function and Arterial Stiffness Should Be Measured to Comprehensively Assess Obstructive Sleep Apnea in Clinical Practice.

Objective: An effective clinical tool to assess endothelial function and arterial stiffness in patients with obstructive sleep apnea (OSA) is lacking. This study evaluated the clinical significance of subclinical markers for OSA management in males without serious complications.Patients/Methods: Males without serious complications were consecutively recruited. Clinical data, biomarker tests, reactive hyperemia index (RHI), and augmentation index at 75 beats/min (AIx75) measured by peripheral arterial tonometry were collected. An apnea hypopnea index (AHI) cutoff of ≥15 events/h divided the patients into two groups.Results: Of the 75 subjects, 42 had an AHI ≥15 events/h. Patients with an AHI ≥15 events/h had higher high-sensitivity C-reactive protein, tumor necrosis factor-alpha (TNF-α), vascular endothelial growth factor, and AIx75 values than the control group but no statistical difference in RHI was observed. After controlling for confounders, TNF-α was negatively correlated with the average oxygen saturation (r = −0.258, P = 0.043). RHI was correlated with the rapid eye movement (REM) stage percentage (r = 0.306, P = 0.016) but not with AHI (P > 0.05). AIx75 was positively correlated with the arousal index (r = 0.289, P = 0.023) but not with AHI (r = 0.248, P = 0.052).Conclusions: In males with OSA without severe complications, TNF-α and AIx75 are independently related to OSA. The role of RHI in OSA management requires further elucidation. These markers combined can comprehensively evaluate OSA patients to provide more evidence for the primary prevention of coronary heart disease and treatment response assessment.

Preparation of Aspirin Nanosuspension by Antisolvent Precipitation Method

Preparation of Aspirin Nanosuspension by Antisolvent Precipitation Method