Wilcoxon Criterion Research Articles

IMPROVEMENT IN THE APPROACHES TO THE TREATMENT OF EMIGRANTS AND RE-EMIGRANTS WITH DEPRESSIVE DISORDERS

Background. Social and clinical relevance of emigration and re-emigration is determined by a significant amount of Ukrainians that emigrate and re-emigrate. Clinical features of depressive disorders have not been studied; as well as risk factors and antiriscs of various forms of depression have not been established yet. Development of comprehensive approaches to the treatment and rehabilitation of these patients is an effective way of resolving of this problem and is of significant scientific, practical, medical and social importance.Objective. The development of measures for treatment of depressive disorders in emigrants and re-emigrants is based on investigation and analysis of clinical-psychopathological phenomenology of depression.Methods. We examined 196 emigrants, 191 re-emigrants and 198 not emigrants with final clinical diagnosis of depressive disorder according to ICD-10 criteria. Examination was conducted by means of depression rate according to M. Hamilton, the Montgomery-Asberg and Symptom Checklist-90-Revised and the scale of life quality by WHO QOL-26. Statistical analysis of the results was performed using nonparametric methods: Mann-Whitney test, Wilcoxon criterion of signs.Results. It was found that the maximum content of organic acids is accumulated in grass Hyssopus officinalis L. (Lamiaceae), and the minimal is in the leaves of Chrysánthemum xhortorum L. variety Apro (Asteraceae). The dominance of aliphatic acids was determined by means of gas chromatography. Benzoic is predominant among aromatic acids.Conclusions. The suggested therapy schemes proved higher effectiveness compared with the traditional one, and also allowed to improve the life quality of emigrants and re-emigrants.

THE DYNAMICS OF LIFE QUALITY PARAMETERS WITH NICORANDIL USAGE IN STABLE CORONARY HEART DISEASE PATIENTS (RESULTS OF THE OBSERVATION STUDY “NIKEA”)

Aim. In the circumstances of real clinical practice, to evaluate the changes in life quality (LQ) parameters of the patients with coronary heart disease and stable angina with addition of nicorandil to standard treatment. Material and methods. Study design — prospective, observational, multicenter. In the trial, the physicians participated, from 14 institutions in a range ofRussia regions. Totally, 590 included: 261 (44,2%) females, 329 (55,8%) males. All patients, in addition to the standard antianginal treatment, were prescribed with nicorandil. At the visits V0 (baseline) and V3 (3 months of therapy) they completedSeattle questionnaire (SAQ) of LQ assessment. Five parameters were assessed: exercise intolerance, attacks frequency, stability, attitudes toward disease, treatment satisfaction. At the visit V0 417 questionnaires were completed (response 71%), at V3 — 454 (response 82%). Results. The significant increase was demonstrated, for parameters by SAQ in 3 months of observation, the highest parameters, except the scale exercise intolerance, were found in the group taking nicorandil during 3 months of follow-up (p<0,05 for all scale SAQ comparing to the group refused taking nicorandil at baseline or stopped at various stages of the study). By 3 months of follow-up, 3 times increase was noted of the patients with minimal number of angina attacks or absence, and the part of patients found that their life quality is “excellent”. Almost 4 times the part of patients raised by the stability parameter, and the amount by the score “treatment satisfaction” increased to 50,2%. Comparison of ranged SAQ parameters at V0 and V3 visits with Wilcoxon criteria, showed significant differences by all the scales of SAQ (р<0,0001). Conclusion. Under the real practice circumstances there was significant increase of all LQ parameters by SAQ in 3 months of observation. Most prominent positive changes were noted in patients taking nicorandil during whole follow-up period, comparing to those not taking nicorandil or discontinued at various stages of the study.

ISH NIA PS 02-09 MONOTHERAPY EFFECTS OF TELMISARTAN ON MICROCIRCULATION IN PATIENTS WITH UNCOMPLICATED ARTERIAL HYPERTENSION (AH)

Objective: To evaluate telmisartan monotherapy effects on microcirculation in patients with uncomplicated arterial hypertension. Design and Method: 20 patients (age 50,2 ± 12,8 years; male - 65%) with untreated uncomplicated grade I-II AH are included into the study. All patients were treated by telmisartan 80 mg during 8 weeks. At baseline and after 8 weeks the parameters of microcirculation were measured. The parameters of microcirculation were evaluated at baseline and after 8 weeks by laser Doppler flowmetry: index of microcirculation (IM, perf.units), which characterizes basal blood flow; occlusion test - capillary blood flow reserve (CBFR), which characterizes the reversibility of remodeling microvasculature; difference index of microcirculation (DIM), which indicates the degree of reduction in blood flow during occlusion; half-recovery time of capillary blood flow (T1/2,s), which characterizes the reactivity of the vascular bed; index of increase in capillary blood flow (IICBF, perf.units), which indicates an increase in vasoconstriction. Data presented as M ± m. Wilcoxon criteria for by-pair comparisons was used. p < 0,05 was considered significant. Results: After 8 weeks of treatment BP decreased from 154,4 ± 2,5/98,4 ± 1,8 mmHg to 136,2 ± 3,1/84,9 ± 2,5 mmHg (p = 0,0077). 55% of surveyed have reached target BP levels < 140/90 mmHg. 25% responded to treatment determined as decrease in systolic BP > 20 mmHg or diastolic BP > 10 mmHg. Significant increase (p < 0,05) of IM from 2,93 ± 0,39 perf.units to 4,22 ± 0,75 perf.units was observed. CBFR decreased from 391,1 ± 25,5% to 295,4 ± 29,2% (p < 0,05). According to the occlusion test were observed recovery of normal type reactions to arterial occlusion: DIM increased from 1,63 ± 0,30 perf.units to 2,27 ± 0,68 perf.units (p < 0,05). IICBF and T1/2 were not significantly changed. Conclusions: Telmisartan monotherapy (dose – 80 mg), 8-weeks course, contributes to restore normal hemodynamic type of microcirculation, normalizes microcirculation response to arterial occlusion and improves capillary blood flow reserve.

Dose-dependent esomeprasole antisecretory effect: results of long-term intragastric pH monitoring

Aim of investigation. To study antisecretory activity of the first dose of esomeprazole (20 or 40 mg) (Emanera®, «KRKA», Slovenia) by long-term intragastric pH monitoring. Material and methods. Long-term intragastric pH monitoring was carried out in 20 patients with acidrelated diseases by «Gastroskan-24» device («IstokSistema», Fryazino, Russia). In the first 24 hours patients received no antisecretory agents, in the morning of the next day - they received esomeprazole 20 or 40 mg orally 30 min. prior to the breakfast. Median pH, both time with various pH values and area under pH distribution curve, percent of this time with values from 1,0 to 10,0 per day before and after esomeprazole administration were estimated. The respective scores were compared, using Wilcoxon criterion. Differences were considered to be significant at р<0,05. Results. At intake of esomeprazole in a dose of 20 mg higher antisecretory effect in comparison to several earlier investigated omeprazole generics by all studied parameters was found. Intake of 40 mg of esomeprazole was followed by more significant and long-lasting acid suppression, i. e. the dose-dependent antisecretory response was received. The dispersion of individual values was minimal. Conclusions. Esomeprazole generic drug Emanera® in a dose of 40 mg complies requirements to the degree of secretion suppression and predictability required for eradication treatment, treatment of severe gastroesophageal reflux disease (GERD), GERD with extraesophageal manifestations, Barret's esophagus and gastro-intestinal bleeding (after iv treatment stage) and can be considered as a drug of choice in these states. According to its antisecretory activity Emanera 20 mg has advantages over omeprazole generics that allows to recommend it for application at functional dyspepsia, non-erosive reflux disease, mild GERD, for GERD maintenance therapy, and also for the treatment and prophylaxis of NSAID-associated gastropathies.

ДИНАМИКА ПЕРЕЖИВАНИЯ КРИЗИСНЫХ СИТУАЦИЙ У СТУДЕНТОВ НА НАЧАЛЬНОМ ЭТАПЕ ОБУЧЕНИЯ В ВУЗЕ

One of the priority tasks in the education system is the training of competent specialists. The researchers note that the experiences of crisis situations at various stages of studying in the higher education institution can impede the successfulness in the educational program completion. The psychologists consider the period of study from the first until the third years to be the richest in various difficulties. During this period, the students pass through the range of personal changes that are closely connected with each other as well as with the crisis processes taking place in the world. The analysis of the dynamics of crisis situations experiences during the richest in crises period of study for the first-third years is of special interest and will allow improving the effectiveness of psychological support of the students. Thirty-five students of Novosibirsk State Medical University participated in the research. The study was carried out with the help of longitudinal section method used with the students of the first to third years of study. For statistical processing of the results, the Statistica 12.0 software was used. The Wilcoxon criterion for dependent samples was used to carry out the assessment of the dynamics of crisis situations experience. The results of the study allow making a conclusion that the main dynamics of the experiences is connected mostly with the crisis of entering the maturity period. Depending on the stage of the study, the increase and the decrease in certain crisis experiences were noted. While studying from the first until the third years, the intensity of the experience of loneliness, separation from the childhood friends, longing for schoolmates and friends, and the inability to combine two equally significant needs decreases. The intensity of experiences concerned with the formation of professional identity increases. Along with the standard crises typical for the stage of the university study, the dynamics of the “second-year student’s crisis” that is scarcely considered in scientific literature is determined.

Prognostic markers of efficiency of immunosupressive therapy in patients with myelodysplastic syndrome

Introduction: There is no “gold standard” of the treatment of myelodysplastic synfrom (MDS) for today. Use of the different directions of therapy at MDS is caused by the prognosis of clinical course, age and general state of patient, donor presence and possibility for an adequate attendant therapy. That is why the search of standards of treatment at MDS continues Aim: To analyze an efficiency of the therapy with cyclosporine A in patients with MDS of the low risk and to detect the new prognostic factors of response to treatment. Methods: 25 patients with MDS RA were examined according to FAB-classification, 15 women and 10 men whose mean age was 55 years. Statistical analysis of material was carried out using packages of applications STATISTICA for Windows 5,0 and NCSS. Parametric indicators were described as a median [lower-upper quartile] (minimum-maximum). The dynamics of parametric indicators in every group was assessed using Wilcoxon criterion. Results: During the treatment with cyclosporine A the complete clinical and hematological remission was received in 28 % of patients, the partial remission was fixed in 25 % of patients and hematological improvement according to criteria of the system of International working group (IWG) – in 28 % of treated patients. It was revealed the reliable decrease of TNF-α, TGF-β and IL-6 in the process of treatment that prove the target mechanism of an effect of preparation at myelodysplastic syndrome. An influence of cytokines on the probability of positive result of treatment was not confirmed. It was established that the young age of patients, hypo- or normocellular marrow, an increased rate of lymphocytes in myelogram, an absence of hemotransfusion dependence and the level of hemoglobin higher than 80 g/l cause the better response to treatment with cyclosporine A. TNF-a concentration higher than 8 mg|ml is a marker of an early relapse in patients treated with cyclosporine A

IMPACT MECHANISMS RESEARCH IN THE CONTACT NETWORK ON RAIL TRACK CIRCUITS

Purpose. Еlectromagnetic processes in «contact network-rails-earth»system should be researched for the purpose of electromagnetic compatibility rail circuits with traction power supply system providing and improving traffic safety on railway transport. Methodology. The methods of scientific analysis, mathematical modeling, experimental investigation, scale modeling have been applied to achieve this goal. Findings. Conducted theoretical and experimental investigations, indicate that electromagnetic processes in the «contact network-rails-earth» system in nearest zone in frequency range up to 1 MHz and it give us an opportunity to consider, that electromagnetic field of hindrance consists of two components: electric and magnetic. Each of them has its own mechanism to influence the rail circuits. In consequence of research the theoretical and experimental dependences of electromotive force induced in wire-receiver from the hindrance current frequency have been received. The frequency graph of relative error according to data «theory-experiment» has been received. The adequacy by Wilcoxon criterion of mathematical model to experimental data has been proved. Originality. The results of theoretical and experimental investigations of magnetic influence between two contours gives us a concurrence in frequency range up to 1000 Hz with average relative error 2, 33 %. With hindrance current frequency one can observe certain increasing the average relative error between calculated and measured values of electromotive force induced in the wire-receiver. Practical value. The adequacy by Wilcoxon criterion of mathematical model to experimental data has been proved on significance level 5 %. It gives an opportunity to use this mathematical apparatus for the investigation of electromagnetic processes in lines with plenty of wires and in «contact network-rails-earth»system in range up to 1000 Hz. The obtained results can be useful in designing, researching and providing electromagnetic compatibility of rail circuits with traction power supply system.

7D.12

Objective: To evaluate telmisartan monotherapy effects on structural and functional characteristics of small-caliber vessels in patients with uncomplicated arterial hypertension (AH). Design and method: 20 patients (age 50,2 ± 12,8 years; male - 65%) with untreated uncomplicated grade I-II AH are included into the study. All patients were treated by telmisartan 80 mg during 8 weeks. At baseline and after 8 weeks the parameters of microcirculation were measured. The parameters of microcirculation were evaluated by laser Doppler flowmetry: index of microcirculation (IM, perf.units), which characterizes basal blood flow; occlusion test - capillary blood flow reserve (CBFR), which characterizes the reversibility of remodeling microvasculature; difference index of microcirculation (DIM), which indicates the degree of reduction in blood flow during occlusion; half-recovery time of capillary blood flow (T1/2,s), which characterizes the reactivity of the vascular bed; index of increase in capillary blood flow (IICBF, perf.units), which indicates an increase in vasoconstriction. Data presented as M ± m. Wilcoxon criteria for by-pair comparisons was used. p < 0,05 was considered significant. Results: After 8 weeks of treatment BP decreased from 154,4 ± 2,5/98,4 ± 1,8 mmHg to 136,2 ± 3,1/84,9 ± 2,5 mmHg (p = 0,0077). 55% of surveyed have reached target BP levels < 140/90 mmHg. 25% responded to treatment determined as decrease in systolic BP >20 mmHg or diastolic BP>10 mmHg. Significant increase (p < 0,05) of IM from 2,93 ± 0,39 perf.units to 4,22 ± 0,75 perf.units was observed. CBFR decreased from 391,1 ± 25,5% to 295,4 ± 29,2% (p < 0,05). According to the occlusion test were observed recovery of normal type reactions to arterial occlusion: DIM increased from 1,63 ± 0,30 perf.units to 2,27 ± 0,68 perf.units (p < 0,05). IICBF and T1/2 were not significantly changed. Conclusions: Telmisartan monotherapy (dose – 80 mg), 8-weeks course, contributes to restore normal hemodynamic type of microcirculation, normalizes microcirculation response to arterial occlusion and improves capillary blood flow reserve.

PP.41.07

Objective: To evaluate valsartan monotherapy effects on structural and functional characteristics of small-caliber vessels in patients with uncomplicated arterial hypertension (AH). Design and method: 35 patients (age 52,4 ± 2,1 years; male – 54,3%) with untreated uncomplicated grade I-II AH are included into the study. All patients were treated by valsartan 320 mg during 8 weeks. At baseline and after 8 weeks the parameters of microcirculation were measured. The parameters of microcirculation were evaluated by laser Doppler flowmetry: index of microcirculation (IM, perf.units), which characterizes basal blood flow; occlusion test - capillary blood flow reserve (CBFR), which characterizes the reversibility of remodeling microvasculature; difference index of microcirculation (DIM), which indicates the degree of reduction in blood flow during occlusion; half-recovery time of capillary blood flow (T1/2,s), which characterizes the reactivity of the vascular bed; index of increase in capillary blood flow (IICBF, perf.units), which indicates an increase in vasoconstriction. Data presented as M ± m. Wilcoxon criteria for by-pair comparisons was used. p < 0,05 was considered significant. Results: In patients with uncomplicated arterial hypertension was dominated spastic hemodynamic type of microcirculation (SHTM), identified in 68,6% of patients. After 8 weeks of treatment BP decreased from 158,5 ± 2,0/99,8 ± 0,6 mmHg to 142,2 ± 3,4/86,6 ± 2,0 mmHg (p < 0,001). 51,4% of surveyed have reached target BP levels < 140/90 mmHg. 21,9% responded to treatment determined as decrease in systolic BP >20 mmHg or diastolic BP>10 mmHg. Significant increase (p < 0,05) of IM, DIM, IICBF, T1/2 was observed: IM increased from 3,25 ± 0,22 perf.units to 3,89 ± 0,26 perf.units, DIM increased from 1,29 ± 0,37 perf.units to 2,22 ± 0,43 perf.units, IICBF increased from 5,82 ± 0,91 perf.units to 7,47 ± 0,51 perf.units, T1/2 increased from 22,8 ± 3,2 sec to 33,7 ± 3,0 sec. CBFR decreased from 393,7 ± 23,2% to 322,8 ± 29,3% (p < 0,05). Conclusions: Valsartan monotherapy (dose – 320 mg), 8-weeks course, contributes to reduction in microvascular reactivity, to increase of functioning microvessels and normalizes microcirculation response to arterial occlusion.

Night diuresis stimulation increases efficiency of alarm intervention

The prevalence of primary monosymptomatic nocturnal enuresis (PMNE) varies from 1.6% to 15%. Although treatment with enuretic alarms has been used for a long period of time, there are many disadvantages, including the necessity for long-term use and the high percentage of children who are resistant to such therapy. We hypothesized that more intense use of the alarm system would accelerate the process of forming the conditioned response to awakening, caused by the desire to urinate and, probably, increase the percentage of patients with positive results. Increased fluid intake will cause more frequent awakenings, so the use of alarm system will be more intense (Figure). To study the effect of increased fluid intake, prior to going to bed, on the efficacy of alarm therapy. The treatment group consisted of 294 children (178 boys) average age: 11.3 (9.1-11.9) years. All participants completed an overactive bladder questionnaire (OAB-q) and a bladder diary, and underwent uroflowmetry, blood and urine testing. Group A (n = 141, mean age 10.9 (9.1-11.6) years), used the alarm system traditionally (Wet Stop/BYE-WET, USA). Group В (n = 153, mean age 11.5 (9.3-11.9) years) drank either water or any other transparent non-colored fluid (any table mineral water with mineralization of less than 1 g per dm³) once immediately prior to sleep at a volume of 4-5 ml/kg of body weight. The effectiveness of therapy was assessed by the change in frequency of urination episodes during sleep per week, episodes of spontaneous awakenings, caused by the desire to urinate per week. Data were analyzed using JMP SAS Statistical Discovery 8.0.2. Wilcoxon criterion was used for comparison of results between groups; correlation of changes in groups was analyzed using the Spearman coefficient. Complete resolution of NE, 2 weeks after the end of alarm therapy, was found in 34 patients (24%) in Group A and 59 (39%) in Group B. This difference was statistically significant with a confidence level of 95%. Having searched the publication databases, including PubMed and Scopus, we failed to find any publication presenting evidence or recommendations on the ideal management of fluid intake in patients with PMNE. Although a limitation of fluid intake is commonly recommended, there is no evidence showing an increase in dry night frequency when such fluid restriction is used as monotherapy. In contrast, our study has shown an improvement in outcome when an increased fluid intake is used in combination with enuretic alarm therapy. We were able to prove that increased fluid intake improved the efficiency of alarm therapy intervention during the treatment of PMNE in children.

Automatic two-digit number processing by people of different age groups and sex

Currently, there is a growing body of papers on the topic about two-digit (2D) number processing. Separate studies revealed the importance of subjects’ age (e. g., Nuerk, Kaufmann et al., 2004) and sex (Pletzer et al., 2013) in a 2D number representation. The aim of this study was to investigate an automatic 2D number processing in people of different age and sex. 2nd graders (average age 8 years and 5 months), 4th graders (average age 10 years and 5 months), and adults (average age 27 years and 2 months) performed two experimental tasks in which they had to judge the numeric or monetary value of presented stimuli (e. g., which is more, 82 ct or 14 Lt). Results were obtained by totalizing the reaction time and error rate. In statistical analysis, the Wilcoxon criteria were used to distinguish the difference in each participants’ group between blocks of different stimuli. In addition, the results were counted for each participant individually. As in previous studies (e. g., Chan et al., 2011), 2nd graders, 4th graders and adults processed 2D numbers automatically. In this study, 2nd graders processed two-digit numbers in a holistic fashion, while 4th graders and adults used a decomposed parallel processing. The ‘holistic’ 2D number processing in children can be explained as a ‘transition’ stage between decomposed sequential and decomposed parallel. The ‘holistic’ result may derive from approximately equal frequency in using sequential and parallel ways of processing.The data did not support the hypothesis that during adulthood, males process two-digit numbers in a different fashion from females. In this study, both sexes processed 2D numbers in the same way (decomposed parallel). In contrast, Pletzer et al. (2013) found the holistic 2D number processing to prevail in males. In this paper, potential influences on this difference are discussed. First, it could be due to different languages, or it could be due to experiment arrangement. The probability of the same participant using different strategies in response to different (simple or more complex) stimuli is suggested.

Visual acuity dynamics after phacoemulsification in patients with “wet” form of age-related macular degeneration, treated by intravitreal angiogenesis inhibitor injections

Design: prospective non-randomized experimental longitudinal cohort study. The aim of the study: to evaluate the visual acuity after phacoemulsification in patients with the “wet” form of age-related macular degeneration, treated by intravitreal angiogenesis inhibitor injections. Materials: 48 patients (48 eyes) with the “wet” form of AMD, treated by intravitreal angiogenesis inhibitor injections, and incipient cataract. All eyes in the study had a diagnosis of “wet” AMD and underwent cataract surgery. They were followed for a minimum of two years after the cataract surgery. The mean age of patients was 78.16 ± 5 years. There were 36 female (75 %) and 12 male (25 %) patients. Results: All patients were retrospectively divided into two groups. Group No. 1 consisted of 23 patients — operated within a year of the diagnosis of “wet” AMD, and group No. 2 which consisted of 25 patients who had a diagnosis of “wet” AMD for longer than one year prior to the cataract surgery. The mean preoperative visual acuity in the 1st group was 0.16 ± 0.07 (median 0.15), and in patients of group 2 — 0.23 ± 0.06 (median 0,2). Mean visual acuity immediately before surgery in the 1st group was 0.13 ± 0.04 (median 0.09), in the 2nd group — 0.12 ± 0.04 (median 0,08). After surgery, in the 1st group, mean visual acuity was — 0.28 ± 0.08 (median 0.25), in the 2nd group —0.18 ± 0.07 (median 0,15). The difference between the two groups was statistically significant, p 0.01, t-test. Statistically significant visual acuity increase after surgery was registered in both groups and was preserved after one and two years, when compared to the data before surgery: for the 1st group — 0.13 and 0.1; for the 2nd group — 0,1 and 0.07, respectively (p 0,01, Wilcoxon criterion). Conclusions: Phacoemulsification is reasonable for eyes with the “wet” form of age-related macular degeneration. Patients with shorter “wet” AMD duration obtain a higher visual acuity increase after cataract surgery. Statistically significant visual acuity increase after surgery is preserved in the majority of patients during next 2 years of follow-up.

Low Interhemispheric and High Intrahemispheric EEG Coherence in Migraine

Twenty women with migraine were evaluated by EEG coherence analysis. In comparison with controls, the migrainous subjects showed lower interhemispheric coherence values at C3-C4 for the delta band (P=0.0030) and at F3-F4 (P=0.0055) and C3-C4 (P=0.0018) for the beta band frequency (Wilcoxon criterion). In contrast, 22 intrahemispheric coherence pairs were significantly higher in the migraine group than in the control group (P<0.01). The subjects with visual aura showed lower interhemispheric coherence at O1-O2 and T5-T6 for the alpha band than the subjects without the aura. Discriminant analysis revealed that 95% of the subjects with migraine and 85% of the controls were correctly classified into their proper groups. We suggest that EEG coherence analysis is a sensitive parameter in the detection of electrophysiological abnormalities in patients with migraine.