Видання іноземною мовою. Кафедра пропедевтики внутрішніх хвороб та терапії

Peculiarities of bone remodelling and bone tissue status in postmenopausal women with type 2 diabetes mellitus

Mon, 01 Jan 2024 00:00:00 GMT

Peculiarities of bone remodelling and bone tissue status in postmenopausal women with type 2 diabetes mellitus Yakymenko, O. O.; Chorniy, O. P.; Якименко, О. О.; Чорній, О. П. Postmenopausal women with type 2 diabetes mellitus (T2DM) have increased bone fragility and fracture risk, despite higher bone mineral density as measured by dual-energy X-ray densitometry (DEXA). Therefore, although DEXA is a standard method for detecting decreased bone mass and osteoporosis, and given that bone fracture may be the first symptom of osteoporosis, DEXA does not reflect changes in bone metabolism.The aim of the article is to study the features of bone metabolism according to clinical and laboratory data in postmenopausal women with T2DM to identify additional markers of BMD and osteoporosis decline.Materials and methods. The study included 160 postmenopausal patients divided into two groups, group 1 – 80 women diagnosed with T2DM, group 2 – 80 women without T2DM. All patients underwent a general clinical examination, densitometry, functional assessment, and biochemical markers: glycosylated blood hemoglobin, estradiol, ionised calcium (iCa2+), 25-hydroxyvitamin D (vitamin D), total alkaline phosphatase, osteocalcin (OC), Beta-CrossLaps (bCTx), parathyroid hormone (PTH), tartrate-resistant acid phosphatase (TRAP5b) in the blood serum.Results. Postmenopausal women with type 2 diabetes mellitus have a higher risk of falls, decreased muscle strength while maintaining muscle mass, decreased bone metabolism, which is manifested by decreased bone formation parameters such as iCa2+, vitamin D and OC and decreased resorption parameters such as TRAP5b and bCTx. A negative correlation was found between glycemia levels and bone formation markers vitamin D and OC, and a negative correlation with bCTx.; Метою дослідження було вивчення особливостей кісткового метаболізму за клінічними та лабораторними даними у жінок у постменопаузі, хворих на цукровий діабет 2 типу (ЦД2), для визначення додаткових маркерів зниження кісткової маси та остеопо-розу. В обстеження було включено 160 пацієнток у постменопаузі, котрі розділені на дві групи: групу 1–80 жінок зі встановленим діа-гнозом ЦД2, групу 2–80 жінок без ЦД2. Всім пацієнткам проводилось загальноклінічне дослідження, денситометрія, функціональна оцінка, визначення глікозильованого гемоглобіну крові, рівню естрадіолу, маркерів формування та резорбції кісток. Жінки в постменопаузі з ЦД2 мають вищий ризик падіння, зниження сили м’язів за збереження м’язової маси, зниження актив-ності кісткового метаболізму.

Studies of asthma control in patients with metabolic syndrome

Mon, 01 Jan 2024 00:00:00 GMT

Studies of asthma control in patients with metabolic syndrome Lahoda, D.; Maznichenko, Ie.; Neziraj, Je. Every day, a practitioner is faced with the problem of patient comorbidity. Bronchial asthma is a common problem, as is metabolic syndrome. Due to the increase in allergic diseases and lifestyle changes, patients may have a combination of metabolic syndrome and bronchial asthma. This combination has been shown to aggravate the course of asthma. Therefore, we wanted to confirm or refute this with our study. The study design included 94 patients with a diagnosis of asthma. A comparative analysis of the spirographic study data revealed that patients with asthma + MetS had statistically significant differences (p˂0.05). The analysis of anthropometric data revealed that patients with the highest BMI and body weight had a significantly more severe course of asthma (p˂0,05), which is consistent with the data of available world studies [24, 25], and a positive correlation was found between BMI, percentage of body fat and lower percentage of body fat in patients with severe asthma (ρ=0,89, ρ=0,90, ρ=0,87; r=0,88, r=0,91, r=0,90, respectively). The data obtained indicate the need for individual management of patients with comorbidities, including MetS and asthma, to prevent severe asthma, which is associated with inadequate asthma control and poor quality of life.

The metabolic syndrome in the setting of general medicine

Mon, 01 Jan 2024 00:00:00 GMT

The metabolic syndrome in the setting of general medicine Yakimenko, O. O.; Oliynyk, D. A.; Oliynyk, A. A. The study was carried out with the data-mining tool of the Medico2000 software on the medical records of 83 patients, aged between 52 and 69 years, divided into 44 males and 39 females, examined at the GP’s office. Among 83 subjects studied 34 were without MetS (Group 1) and 49 with MetS diagnosed by ATP III criteria during the first outpatient visit (Group 2). The same 49 patients underwent re-evaluation after 12 months of multifactorial treatment (Group 3). Results. After treatment, in Group 3 the integral D indicator improved from 0.221 to 0.539, which corresponds to the “Acceptable” qualitative evaluation, but still remained compared to the control control Group 1, where the D indicator corresponded to the qualitative evaluation “Good”.

Evaluation of treatment efficacy in patients with non-alcoholic steatohepatitis and heterozygotic familial hypercholesterolemia

Tue, 01 Jan 2019 00:00:00 GMT

Evaluation of treatment efficacy in patients with non-alcoholic steatohepatitis and heterozygotic familial hypercholesterolemia Yakimenko, O.; Maznichenko, I.; Якименко, Е. А.; Мазниченко, Е. А. The aim of the study was to increase the efficacy of treatment of patients with HFHC and NASH by developing a personified approach to the therapy with rosuvastatin 20 mg/day and combined hepatoprotector at the inpatient and outpatient stages of treatment. 124 patients with clinical HFHC were examined. The object of the study was 55 patients (age 55.45±5.5 years) with a clinical diagnosis of HFHC, NASH. All patients underwent a detailed physical examination, laboratory-instrumental (general clinical, biochemical (hepatic transaminases, lipidogram, ultrasonography of the abdominal organs), molecular genetic examination (polymorphism of the SLCO1B1 gene). Two groups of study were formed, in the first group patients received rosuvastatin 20 mg/day, in the second group - rozuvastatin 20 mg/day and combined hepatoprotector 2 capsules 3 times a day for 90 days. The patients treated with rosuvastatin 20 mg/day and hepatoprotector were revealed a reliable decrease in the level of TC by 46%, which was 5.1±0.59 mmol/l (p<0.005), the level of LDL significantly decreased by 68.5% - 2.23±0.58 mmol/l (p<0.005), the level of HDL increased by 73% and amounted to 2.56±0.29 mmol/l (p<0.005). On the 90th day of therapy, the activity of hepatic transaminases reached reference values: ALT 32.16±7.83 units/l, AST – 30.11±6.32 units/l (p<0.005). Based on the complex examination and determination of polymorphism of SLCO1B1, a personified dose of statin was selected.; Целью исследования явилось повышение эффективности лечения пациентов с гетерозиготной семейной гиперхолестеринемией (ГСГХ) и неалкогольным стеатогепатитом (НАСГ) путем разработки персонифицированного подхода к терапии с применением розувастатина 20 мг/сутки и комбинированного гепатопротектора на стационарном и амбулаторном этапах лечения. Обследовано 124 пациента с клинической ГСГХ, из них 55 пациентов в возрасте 55,45±5,5 лет с клиническим диагнозом ГСГХ и НАСГ. Всем пациентам проведено детальное физикальное обследование, лаборатно-инструментальные общеклинические и биохимические (печеночные трансаминазы, липидограмма, УЗД органов брюшной полости), молекулярно-генетические (полиморфизм гена SLCO1B1) исследования. Сформировано две группы больных: в I группе пациенты получали розувастатин 20 мг/сутки, во II группе - розувастатин 20 мг/сутки и комбинированный гепатопротектор по 2 капсулы 3 раза в сутки 90 дней. У пациентов, получавших терапию розувастатином 20 мг/сутки и гепатопротектором, выявлено достоверное снижение уровня общего холестерина (ОХ) на 46%, что составило 5,1±0,59 ммоль/л (р<0,005), уровень липопротеидов низкой плотности достоверно снизился на 68,5% - 2,23±0,58 ммоль/л (р<0,005), уровень липопротеидов высокой плотности увеличился на 73% и составил 2,56±0,29 ммоль/л (р<0,005). На 90 сутки терапии активность печеночных трансаминаз достигла референсных величин: АЛТ - 32,16±7,83 ед/л, АСТ - 30,11±6,32 ед/л (р<0,005). На основании комплексного обследования и определения полиморфизма SLCO1B1 подобрана персонифицированная доза статина.

Pharmacoeconomics as a tool to enhance efficency of health care services

Mon, 01 Jan 2018 00:00:00 GMT

Pharmacoeconomics as a tool to enhance efficency of health care services Zakritov, D. O. Today's cost-sensitive healthcare environment has created a competitive and challenging workplace for clinicians. Competition for diminishing resources has necessitated that the appraisal of healthcare goods and services extends beyond evaluations of safety and efficacy and considers the economic impact of these goods and services on the cost of healthcare. A challenge for healthcare professionals is to provide quality patient care while assuring an efficient use of resources. Defining the value of medicine is a common thread that unites today's healthcare practitioners. With serious concerns about rising medication costs and consistent pressure to decrease pharmacy expenditures and budgets, clinicians/prescribers, pharmacists, and other healthcare professionals must answer the question, “What is the value of the pharmaceutical goods and services I provide?” Pharmacoeconomics, or the discipline of placing a value on drug therapy, evolved to answer that question.

Additional opportunities for antihypertensive therapy improvement in young patients with arterial hypertension and concomitant obesity

Sat, 01 Jan 2022 00:00:00 GMT

Additional opportunities for antihypertensive therapy improvement in young patients with arterial hypertension and concomitant obesity Chernyshova, K.; Yakimenko, O.; Bondar, V.; Chernyshova, H.; Kolomiets, S.; Oliynyk, D.; Tbileli, V.; Maznichenko, I. E. The high prevalence of arterial hypertension (AH) and concomitant obesity in young patients is not only a medical but also a social problem. It is important to develop additional modern approaches to the management of young patients with AH and obesity, which will increase the effectiveness of existing antihypertensive (anti-AH) medical therapy and prevent early damage of target organs and complications. The purpose of the research was to evaluate the antihypertensive efficacy of the proposed complex treatment and its impact on quality of life in young patients with AH and obesity (or overweight).

Electrocardiography : a manual

Sat, 01 Jan 2022 00:00:00 GMT

Electrocardiography : a manual Yakymenko, O.; Kolomiiets, S.; Smal, V.; Sebov, D.; Tbilieli, V.; rev. Zharinov, O. Y.; rev. Ignatiev, O. M.; Якименко, О. О.; Коломієць, С. М.; Смаль, В. Д.; Себов, Д. М.; Тбілелі, В. В.; рец. Жарінов, О. І.; рец. Ігнатьєв, О. М. The manual covers the most important aspects of theory of the electrocardiography and formation of the mechanisms of the electrocardiogram, the principles of its interpretation when there is hypertrophy of the heart chambers, arrhythmias and conduction disorders, coronary heart disease, and other diseases and pathological conditions. For undergraduate students of the higher medical institutes, pregraduate interns, doctors-interns specializing in therapy and recent graduate practitioners.; У навчально-методичному посібнику йдеться про найбільш важливий аспект теорії електрокардіографії та створення механізму електрокардіограми, принципи її інтерпретації у випадках гіпертрофії серцевих камер, при аритміях, порушеннях провідності, ішемічній хворобі серця та інших патологіях. Для студентів останніх курсів медичних вищих закладів освіти, переддипломного навчання, лікарів-ординаторів, що спеціалізуються з терапії, і дипломованих практикуючих фахівців.

Changes in vasoconstructor-vasodilation potential of vessels in experimental antiphospholipid syndrome

Fri, 01 Jan 2021 00:00:00 GMT

Changes in vasoconstructor-vasodilation potential of vessels in experimental antiphospholipid syndrome Yakymenko, O. O.; Savytskyi, V. I.; Klochko, V. V.; Savytskyi, I. V.; Badiuk, N. S. As a result of our study, the development of endothelial dysfunction in experimental antiphospholipid syndrome is confirmed: an increase in the marker of ED (endothelin-1) and a pathological increase in vasoconstrictor potential on the background of weakening of vasodilatation. There was a pathological increase in the vasoconstrictor potential of blood vessels in animals simulated antiphospholipid syndrome, as evidenced by an increase in endothelin-1 levels in the blood of rats (p <0,001). Violation of nitric oxide synthesis was detected against the background of the development of experimental antiphospholipid syndrome, which is confirmed by a marked decrease in the level of Snitrosothiols. The most pronounced normalization of vasoconstrictor-vasodilatory potential of vessels was found in rats, whose simulated antiphospholipid syndrome was corrected with warfarin, immunoglobulin and L-arginine solution.

Comprehensive treatment of osteoarthritis peformans with concomitant metabolic syndrome

Fri, 01 Jan 2016 00:00:00 GMT

Comprehensive treatment of osteoarthritis peformans with concomitant metabolic syndrome Bohdan, N. М. Osteoarthritis peformans is the most common pathology of the musculoskeletal system. OAP, combined with metabolic syndrome (MS), leads to an overuse of the knee joints operation, and is one of the main causes of premature disability in people. Combined treatment using electrophoresis with neocaripasin in patients with OAP and concomitant MS reduces pain, the severity of inflammatory responses and improves quality of life.

Genetic and biochemical markers of endothelial dysfunction in young patients with arterial hypertension and concomitant obesity

Fri, 01 Jan 2021 00:00:00 GMT

Genetic and biochemical markers of endothelial dysfunction in young patients with arterial hypertension and concomitant obesity Yakimenko, O. O.; Chernyshova, K. S.; Bondar, V. M.; Tiron, O. I.; Maznichenko, Ie. A.; Якименко, О. О.; Чернишова, К. С.; Бондар, В. М.; Тірон, О. І.; Мазніченко, Є. О. The total of 123 young hypertensive patients were examined with normal weight, overweight and obesity (average age 32.83±0.58 years old). They were performed genetic analysis of endothelial NO-synthase gene polymorphisms – T(-786)C and G894T as genetic markers of endothelial dysfunction. The frequency dominance of G894T polymorphism “pathological” genotypes was revealed in all groups. Cases of combination of T(-786)C and G894T polymorphisms were significantly more frequent in young hypertensive patients with concomitant obesity. Homocysteinemia and daily microalbuminuria were checked as biochemical markers of endothelial dysfunction. These markers were more expressed in concomitant overweight and obesity compared with normal-weight young hypertensive patients. A significant positive correlation was revealed between the levels of homocysteinemia and microalbuminuria, and also between these markers and the body mass index. It was found that “pathological” genotypes of both studied eNOS gene polymorphisms are associated with a higher level of homocysteinemia and daily microalbuminuria. arterial hypertension, obesity, homocysteine, microalbuminuria.; Обстежено 123 пацієнта молодого віку з артеріальною гіпертензією із нормальною вагою, надмірною масою тіла та ожирінням (середній вік 32,83±0,58 років). Був проведений генетичний аналіз поліморфізмів гена ендотеліальної NO-синтази – T(-786)C та G894T, як генетичних маркерів ендотеліальної дисфункції. Було виявлено частотне переважання «патологічних» генотипів поліморфізму G894T у всіх групах. Випадки комбінації поліморфізмів T(-786)C та G894T були значно частішими у молодих гіпертензивних пацієнтів із супутнім ожирінням. Як біохімічні маркери ендотеліальної дисфункції були визначені гомоцистеїнемія та добова мікроальбумінурія. Ці маркери були більш вираженими при супутній надмірній масі тіла та ожирінні порівняно з молодими гіпертензивними пацієнтами нормальної маси тіла. Було визначену значну позитивну кореляцію між рівнями гомоцистеїнемії та мікроальбумінурії, а також між цими маркерами та індексом маси тіла. Було виявлено, що «патологічні» генотипи обох досліджених поліморфізмів гена eNOS пов'язані з вищим рівнем гомоцистеїнемії та добової мікроальбумінурії.артеріальна гіпертензія, ожиріння, гомоцистеїн, мікроальбумінурія.