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Changes in the Levels of Modern Biomarkers in Patients with Decompensated Heart Failure After Myocardial Infarction Under the Influence of Treatment with Succinic Acid and Arginine Preparations
Get PDFThe prevalence of heart failure in Europe and worldwide is high. This syndrome is a common cause of hospitalization and has a significant impact on morbidity, mortality and healthcare costs in highly developed countries. The study of biomarkers in heart failure is of wide interest as they can improve diagnosis, predict the development of heart failure and its decompensation, and help in assessing treatment outcomes.
The objective of the research was to study the feasibility of using multiple biomarker strategy for diagnosing decompensated heart failure in the post-infarction period and to assess changes in these markers after treatment with succinic acid and arginine preparations.
Materials and Methods. There were examined 120 patients with Q-QS wave and non-Q wave myocardial infarction complicated by decompensated heart failure. All the patients were divided into 2 groups (depending on Q-QS wave and non-Q wave myocardial infarction) and 4 subgroups (depending on rehabilitation therapy) being homogenous by age and gender.
Results. When studying the dynamics of changes in blood level of N-terminal pro-B-type brain natriuretic peptide and ST2, there was observed its significant reduction in all the patients with prior Q-QS wave myocardial infarction complicated by decompensated heart failure after treatment. The most significant changes were observed in the patients of Group IV who, on the background of basic therapy, received succinic acid and arginine preparations according to the proposed scheme. The combined use of arginine preparations and succinic acid in combination therapy for decompensated heart failure secondary to prior Q-QS wave myocardial infarction allowed reducing blood levels of N-terminal pro-B-type brain natriuretic peptide under conditions of graded exercises. Similar tendencies were observed when determining this indicator in the patients with non-Q wave myocardial infarction complicated by decompensated heart failure after rehabilitation treatment.
Conclusions. The use of succinic acid and arginine preparations when treating the patients with prior Q-QS wave and non-Q wave myocardial infarction complicated by decompensated heart failure allowed us to significantly reduce the level of immunological enzymes such as N-terminal pro-B-type brain natriuretic peptide and ST2, which indicate the presence and development of decompensated heart failure after myocardial infarction
Effect of Pathological Gestational Weight Gain on Subsequent Lactation
Get PDFThe onset, duration of lactation and exclusive breastfeeding (BF) depend on maternal factors. Objective: The aim of our study was to investigate the effect of pathological gestational weight gain (GWG) on subsequent lactation. Design: This was a prospective cohort study of 219 women, aged 18 to 43 years, who were enrolled at 9-11 weeks and were followed-up at 22-24, 37-39 weeks of pregnancy, and 1 year postpartum. Anthropometry, body mass index, GWG were calculated. The percentage of body fat mass (% FM) was calculated on the basis of bioelectrical impedance analysis (BIA) using the “Diamant-aist” analyzer (St. Petersburg). The delayed onset of lactation (more than 72 hours), the duration of lactation, exclusive BF were interviewed. The results were statistically analyzed using statistical analysis package based on Microsoft Excel and Statistica 6.0 program pack (StatSoft Inc., USA). Results: The total BF and exclusive BF median durations were 29.7±10.1 (95% Cl 25.7-33.7) weeks and 22.2±6.2 (95% Cl 18.2-26.2) weeks, respectively. A negative association between the elevation of the %FM during pregnancy and the duration of BF (r= - 0.21, p=0.001; r= - 0.32, p<0.0001; r=- 0.47, p<0.0001, respectively in the first, second and third trimesters) was diagnosed. It has been proved that excessive GWG was significantly associated with shorter duration of lactation (p<0.05), with shorter duration of exclusive BF (OR 0.5; 95% Cl 0.2-0.9, p=0.03), with increased chances of discontinuing BF before 6 month postpartum (OR 2.2; 95% Cl 1.0-4.5, p=0.04), and delayed onset of lactation (OR 2.1; 95% Cl 1.1-4.1, p=0.04) compared with the recommended GWG women. Conclusion: Informing the pregnant women about the negative effect of pathological GWG on subsequent lactation, regular assessing the dynamics of weight gain during pregnancy, and taking measures to prevent overweight and obesity in the postpartum period should be an important focus of antenatal care
Clinical Effectiveness of Cardiocytoprotective Therapy in Patients with Acute Coronar Syndrome (ACS) – Myocardial Infarction (MI), Who Were Performed Balloon Angioplasty and Coronary Artery Stenting
Get PDFThe aim of the study was to increase the efficiency of restorative treatment of patients with Acute Coronary Syndrome (Miocardial Infarction) by incorporating the protocol therapy for the course of parenteral use of L-arginine and L-carnitine (Tivorel).
It has been determined that patients with ACS (MI) after percutaneous coronary intervention often develop reperfusion syndrome with manifestations of left ventricular insufficiency and rhythm disturbances. Substantial clinical and functional improvement was noted under the influence of standard medical treatment in patients of control group. At the same time postinfarction remodeling with systolic and diastolic function of the heart, with the development of heart failure syndrome and endothelial dysfunction of blood vessels, and also remained resistant to extrasystole therapy, progressed.
Patients in the experimental group under the influence of complex medical treatment with the inclusion of L-arginine and L-carnitine marked a significant decrease in the frequency of violations of rhythm and conduction for the second day of observation, as well as a decrease in the manifestations of post-infarction remodeling of LV, which ultimately manifested a significant improvement in myocardial contractility (EF increased by 13%) and decreased diastolic dysfunction. Improvement of the inotropic function of the heart and a significant reduction in the frequency and severity of reperfusion arrhythmias was achieved precisely due to cardiometabolic effects of L-carnitine. In addition, in patients undergoing additional treatment with L-arginine and L-carnitine after 10 days of treatment, the activity of ET-1 was significantly lowered and the concentration of nitrogen oxide metabolites in the blood plasma increased and reach the level of healthy subjects (p>0.05). So, they recovered the endothelial function of the vessels
Study of Complications in Patients Using Removable Dentures Over Different Periods
Get PDFThe topicality of the problem is related to the ever-increasing volumes of provision of prosthodontic assistance to the patients with removable dentures. During the dental examination we’ve noted 300 patients, who used removable dentures, the increased number of complications because of these constructions’ use. In particular, there is a growing number of patients who aren’t using the already made removable dentures. A significant percentage of patients don’t know or don’t fully care properly for the existing constructions and the oral cavity itself. This leads to a number of serious complications. We consider perspective the identification of opportunities to reduce the number of complications and extend the period of the use of removable denture structures by improvement the techniques for selecting denture base materials depending on the microbiological status of the oral cavity
Psychological Adaptation of Patients with Ischemic Heart Disease at the Stages of Rehabilitation after Reperfusion Interventions
Get PDFPsychological adaptation is a necessary component of rehabilitation of patients with ischemic heart disease. Post-infarction period is a special adaptation period for the patient, which requires a holistic approach taking into account both medical, physical and psychological components. High levels of anxiety in patients, both before surgical interventions, and in the postoperative period, worsen the prognosis that requires to improve the methods of rehabilitation.
The objective of the research was to study the peculiarities of psychological adaptation in patients with ischemic heart disease, depending on reperfusion approaches and applied methods of rehabilitation.
Materials and methods. There were examined 450 patients with ischemic heart disease using different methods of reperfusion interventions. Depending on the methods of rehabilitation, the patients were divided into three subgroups. The determination of levels of reactive and personal anxiety was performed at the beginning of treatment, 1 week, 1 month and 6 months after treatment.
Results. There were revealed high levels of reactive and personal anxiety in patients with ischemic heart disease, which differed depending on the applied reperfusion interventions. The use of psychological methods at the stage of rehabilitation contributed to a decrease in anxiety levels a week after using suggestive therapy methods, and the effect of learning was noted a month and 6 months after the observation.
Conclusions. One of the constituents of a cardiologic patient is his psychological status, namely the level of anxiety. For the effective adaptation, it is important to use the suggestive methods of therapy and training of patients. In patients, who are scheduled for surgical operation due to ischemic heart disease, a pre-rehabilitation with an individual approach is necessary
Model of Teacher’s Readiness for Educational Work with Students at Higher Education Institution
Get PDFThe importance and prospects for developing a model of teacher’s readiness for educational work with students at higher education institutions are determined by social factors such as: firstly, the educational influence of both the teacher and educational institution on the formation of the student’s personality, his/her initiative, creative approach to the organization of the teaching and educational process; secondly, the use of collective forms of educational activity where pedagogical education and the students’ independent activity are organically combined; thirdly, the development and improvement of the teacher’s educational activity, especially its organizational and communicative components.
The developed model of teacher’s readiness for educational work is a system subordinated to certain tasks of methodological work which simultaneously allows teacher to successfully increase his/her readiness for educational work at the particular higher education institution.
The model itself is a specific form of reflection, which contains information about the object. A characteristic feature of such models is their simplicity in comparison with the original or real-life situation which is modelled
Morphofunctional Peculiarities of Endocardium of the Ventricles, Main Arteries Normally and Under the Influence of Various Factors (Literature Review)
Get PDFThe article analyzes the data of literary sources about the histological and ultramicroscopic structure of the endocardium of the ventricles and arteries of various types and caliber normally, as well as under the influence of various endo- and exogenous factors. The data on changes in the structure of the endocardium and major arteries in diabetes mellitus, atherosclerosis, ischemia, hypoxia, infectious endocarditis, poisoning with heavy-density metal salts, and also in hypothyroidism, which has recently been considered as one of the main factors in the development of complications in the cardiovascular system
The State of Periodontal Tissues in Patients with Rheumatoid Arthritis Who Live in Environmentally Unfavourable Areas
Get PDFThe aim of the work was to compare the condition of periodontal tissues in patients with rheumatoid arthritis who live in ecologically favorable and environmentally unfavorable territories. There was performed a dental examination of 21 patients with rheumatoid arthritis who live in environmentally favorable territories and of 21 patients with rheumatoid arthritis who live in environmentally unfavorable areas. There was given the index evaluation of the condition of periodontal tissues, the level of oral hygiene. It has been determined that the course of generalized periodontitis in patients with rheumatoid arthritis who live in ecologically contaminated territories is more difficult than in a group of patients who live in environmentally favorable territories
Diagnostic Value of Leptin in Chronic Obstructive Pulmonary Disease of the Iii Degree in Patients with Excessive Body Weight
Get PDFChronic obstructive pulmonary disease (COPD) still remains a serious problem for the public health care system, since it commonly causes disability and mortality among the working population. Frequent combination of COPD with concomitant diseases is a key factor in predicting COPD consequences. Recently, the number of patients with a combination of COPD and overweight is on the increase, which is considered as a mutual aggravating factor and negatively affects the prognosis of the disease in such patients.
The objective of this study was to investigate the diagnostic value of leptin in progression of COPD (III degree of bronchial obstruction in patients with overweight) course by studying its level in blood serum.
Materials and methods: There were examined 112 patients with chronic obstructive pulmonary disease (COPD GOLD III) in different phases of pathological process. The pulmonary function (PF) test was performed by means of “SPIROKOM” device (Ukraine). The degree of overweight was determined by calculating the body mass index (BMI) using the formula І = m/h² (m – body mass in kilograms, h – height, in square meters (kg/m²). The level of leptin of systemic inflammatory markers was determined by a solid phase enzyme-linked immunosorbent assay in blood serum: “DRG Leptin Elisa” (Germany).
Results and conclusions: The study revealed that overweight leads to a more severe course of COPD (III degree of bronchial obstruction), and the determination of leptin may serve as a diagnostic criterion in the progression of this pathology