The purpose of this study was to create a new system for predicting the risk of glomerular and tubular dysfunctions (GTD) in patients with disorders of carbohydrate metabolism (DCM) based on standard parameters and new molecular markers for the development of kidney damage in patients with impaired glucose tolerance (IGT) and T2DM patients with diabetic nephropathy (DN). Material and Methods: The study included 69 patients: 16 patients with IGT (Group 1), 28 T2DM patients with MAU (Group 2), and 25 T2DM patients with MacAU (Group 3), according to the inclusion/exclusion criteria in the research. All patients were stratified by the MDRD. The control group (Group 4) included 11 healthy individuals. The duration of DN was 10.5 years. At the stage of data collection and screening, the standard methods of identification of IGT, DM and DN were applied. Additional methods are included quantitative analysis of the level of α-GST and π-GST, MMP-9 in urine by ELISA. Result: Analysis of the correlation interactions of the level of standard risk factors for the development of renal damage in patients with IGT and DN with the level of new molecular markers in urine and blood allows us to identify and introduce into clinical practice new screening tests reflecting the key molecular interactions that underlie the development of GTD in patients with DCM.
In practically healthy people on the background of self-breathing, we used catheterization to obtain blood samples from Ao, PT, SC, VJI, SS, VH and VR. We believe that the standard tests of blood gases by volume (pO2 and pCO2) and their A-V gradients, quantitatively determined, are insufficient to fully assess the hypoxic states both in the whole organism and in individual organs. To estimate gas homeokinesis, we performed integral gas tests, including an additive criterion of blood gases—pressure in mmHg: 1) the summary pressure of the plasma gases, PS; 2) Gas functional, the gradient between the total indices of arterial and vein gases (Gradient D); and 3) the exchange gradient, Gradient DP [(arterial pO2 – venous (pO2+pCO2)]. Each test indicator at all studied points was determined in mmHg. Correlation analyses were carried out between the parameters of all tests. We found that the processes forming PS limit the amplitude of the PS deviation under changing parameters of the constituent components (pO2 and pCO2) due to acts of mutual replacement between them, as well as the influence of integral gas complexes under shifts in pO2, pCO2, A-V SO2. Unlike the generally accepted tests that record quantitative differences between the points studied, the integral gas tests allow us to identify vectors and mechanisms of adaptive changes in gas homeostasis, to perform a qualitative comparison of the functioning of the studied organs by gas-dynamic tests in the norm and in pathology.
The aim of this study was to make the prevention of EU-GDB more efficient in therapeutic patients admitted to a general hospital by using a multidisciplinary approach that includes a diagnostic algorithm, treatment protocol, and individual methods of EU-GDB prevention. Materials and Methods: The study included 114 patients of the therapeutic, pulmonary, and cardiology departments of the Voronezh City Emergency Care Hospital. The patients had been admitted due to destabilization of their underlying conditions and displayed signs of acute gastroduodenal erosions and ulcers during their stay in the hospital. All the patients were randomly divided into two equal groups: the main group and the comparison group. A multidisciplinary approach was applied to patients of the main group (n=58; mean age, 62.64±14.37); it included early pre-clinical diagnosis of EU-GDI by FGDS on the second or third day after their admission to the hospital, which helped to reveal in a timely manner uncomplicated EU-GDI and directly start local treatment as a part of complex therapy. An algorithm of the procedure provides for participation of a surgeon. Powder-like biologically active granular sorbents of the new generation (ASEPTISORB-A, ASEPTISORB-D, or ASEPTISORB-DT) were applied to the revealed acute erosions and gastroduodenal ulcers during the FGDS procedure to prevent hemorrhagic complications. After manifestation of the first signs of EU-GDB: during the curative endoscopy, the use of the developed minimally invasive method of endoscopic hemostasis, which provided combined application of a local haemostatic preparation Gelplastan and ASEPTISORB-D to the defect area. In the comparison group(n=56), the traditional technique of surgical consultations “on demand” was used. FGDS was performed when first symptoms appeared. Common methods of endoscopic hemostasis without local treatment of EU-GDI and application of granulated sorbents were used in this group. Conclusion: The developed program helps to prevent hemorrhagic complications, exclude emergency operations, and reduce mortality rate by 3 times.
We evaluated the special endurance (SE) of freestyle wrestlers with the help of complex tests of special working capacity, while simultaneously monitoring the change in levels of lactate concentration and LPO in the blood at the preparatory stage of the annual sport cycle. A total of 23 athletes with high sports qualification participated in the experiment. Athletes were tested in the field by "repeated marginal load" tests, including the operational test (OT) developed by the authors. The most noticeable shifts in the studied indicators were observed after the test load of OT, which indicates an increase in the glycolytic capacity of the athlete's body. Thus, our study shows the possibility of using our OT to analyze the anaerobic performance of elite athletes in freestyle wrestling.
Background: Chronic obstructive pulmonary disease (COPD) is widespread and often combined with other diseases, including metabolic syndrome (MS), which are closely related. The purpose of this study was to assess the clinical efficacy of a PR program for patients with COPD and MS, in addition to standard therapy. Materials and Methods: We examined 70 patients with COPD and MS. The patients were divided into 2 groups. Group I included 35 patients who received standard pharmacologic therapy in combination with PR. Group II included 35 patients who received only standard pharmacologic therapy. Results: Group I patients demonstrated a decrease in exacerbation events from 3.96±0.43 to 2.24±0.10 (p=0.0002), in emergency service calls from 3.80±0.37 to 1.59±0.25 (p=0.0000), and in hospital admissions from 2.93±0.11 to 1.41±0.24 (p=0.0004) per year, as well as a significant decrease in the severity of COLD symptoms, improvements in exercise tolerance, MS components and QL, compared to Group II. Conclusion: The main benefits of a comprehensive PR program for patients with COPD and MS include a decrease in symptoms (dyspnea and fatigue), improvements in exercise tolerance, and reduction in health care utilization (particularly bed-days), as well as an increase in physical activity and an improvement in MS components.
Background: Left main coronary artery (LMCA) disease is one of the risk factors that affect the outcomes of coronary artery bypass grafting surgery. In particular, this risk factor pertains to the conduct of conventional on-pump CABG. Very little is known about the effects of the presence of LMCA disease on the results of off-pump CABG (OPCABG) surgery. Material and Methods: In the Department of Cardiac Surgery of the Republican Specialized Center of Cardiology, during the period between April 2015 and April 2017, 270 consecutive OPCABG procedures were performed. Patients were divided into 2 groups depending on the presence or absence of LMCA disease. Group 1 consisted of 124(44.9%) patients with LMCA disease, and Group 2 consisted of 146(55.1%) patients without LMCA lesions (non-LMCA group). Results: The average number of distal anastomoses in both groups was more than 3 anastomoses/patient. The incidence of nonfatal intraoperative complications was 8.9% in Group 1 and 15.1% in Group 2 (P=0.1212). The conversion rate to on-pump CABG amounted to 3.2% (4 patients) in Group 1 and to 4.8% (7 patients)in Group 2. In the immediate postoperative period, 40(32.2%) patients of Group 1 and 45(30.8%) of Group 2 needed inotropic support until full restoration of normal hemodynamics with duration between 3.0 and 2.6 hours. The average duration of ventilation support was 6.4 hours in Group 1 and 5.6 hours in Group 2. Hospital mortality was 0.8% (1 patient) in Group 1 and 0.7% (1 patient) in Group 2 (P>0.05). Conclusion: Thus, the presence of left main stem lesion of LCA is not an additional risk factor that would complicate the performance of OPCABG surgery. The OPCABG operation in this group of patients is a safe method and can be performed without compromising the completeness of myocardial revascularization with the same low mortality as in low-risk patients.
This case report presents a 35-year-old female who presented with HIV-associated multidrug-resistant tuberculosis. Resistant tuberculosis in HIV-infected patients with immunodeficiency is extremely difficult for effective treatment. Nevertheless, our clinical case showed that the cure of tuberculosis is possible in the late stages of HIV infection with the correct choice of treatment tactics, taking into account the resistance of MBT with the subsequent use of antiretroviral therapy. The progression of HIV infection, against the background of the effective antituberculous therapy, was associated with the patient's refusal to treat the underlying disease.
Aim: Heart disease and emotional disorders often co-occur, but effective role in dysregulation of heart disease that is often overlooked. Evidence suggests that people with heart disease are more problems in regulating their emotions. The study compared the re-evaluation of cognitive emotion regulation commonly used two strategies- and suppression- between heart disease and the general population. Methods: Sixty men (30 with heart complaints and 30 without the condition) were selected by convenience sampling method and they responded to the Emotion Regulation Questionnaire (Gross and John) and a demographic questionnaire responded. To analyze the results and descriptive statistics such as frequency tables and inferential statistics, independent T-test was used SPSS software was used. Results: The result shows that heart disease and general population re-evaluation strategies groups (P<0.01). This is not only different from the strategy reassessment, but in different repression, too. (P <0.001). Conclusion: The results showed that heart disease and general population used different strategies to regulate their emotions. The key to finding the heart disease group prefer repression to regulate their emotions.
The aim of this study was to assess the anthropometric data of girls and young women in Yakutia, depending on the type of sexual dimorphism and ethnos. The study included 2,081 girls and young women aged from 16 to 20 years. All those examined were born and permanently resided in the territory of the Republic of Sakha (Yakutia); among them there were 1284 Yakuts and 797 Russians. Anthropometric measurements were carried out according to the method of V.V. Bunak (1941), adopted in the Institute of Anthropology of MSU. Absolute values of the main components of the body (the total amount of fat, muscle tissue, bone tissue) were calculated by the formula Matiegka (1921). The body type was determined in accordance with the Tanner index. Statistical analysis was performed using statistical software package SPSS version 17.0 (SPSS Inc, Chicago, IL) The data obtained, depending on the type of sexual dimorphism, indicate the different maturation rates of the morphofunctional structures in Yakut and Russian women in the extreme natural climatic conditions of Yakutia.