Abstract.

Introduction. Functional capacity is important parameter of activity of a person. It can be assessed with different methods, including interviewing, walk tests, cardiopulmonary exercise testing. According to the recommendations of the European Society of Cardiology, the assessment of functional capacity is an important step in the perioperative management of a patient with concomitant cardiovascular pathology during non-cardiac surgery. Purpose of our study was to implement assessing of functional capacity in clinical practice, including perioperative management of patients. And also, to compare the practical value of self-reported methods of assessing functional capacity and exercise testing. Materials and methods. 15 healthy men aged 33±5.4 years and 172 patients with documented pathology of the cardiovascular system aged 65±2.8 years were included in the study, among them 51% were male. We compared the value of different methods and the expediency of assessing the functional capacity of a patient with concomitant pathology of the cardiovascular system before planned non-cardiac surgery. Results. All healthy individuals gave a positive answer to the question about ability to climb two flights of stairs. The average Duke Activity Status Index score was 52.47±5.96, which corresponded to the calculated value of METs 9.19±0.73. During cardiopulmonary exercise testing, the average value of VO₂max in these individuals was 47.56±11.34 mL/(kg·min). A direct strong correlation between Duke Activity Status Index values and VO₂max was established (r=0.91, р˂0.01). 36 patients (21%) reported inability to climb two flights of stairs added. The average DASI in these persons was 12.84±4.38 and the level of NTproBNP was 1116±75. On the contrary in the rest of the patients the DASI was 28.18±7.72 and NTproBNP 302±42 with statistically significant difference (p˂0.01). The dynamics of troponins in the examined subjects did not show any increase in the postoperative period. The values of the EF in patients reported inability to climb two flights were lower by 9.78% compared with others (56.57±12.34% and 62.71±6.35%, p˂0.01). The average number of days spent in the hospital was 22 in patients with inability to climb two flights and 12 in the rest. 32 patients (19%) died, 28 deceased belonged to the group with inability to climb two flights of stairs. The average time of death was 29.86 days. Correlation analysis revealed a direct relationship of average strength between the Duke Activity Status Index and EF (0.42, p 0.007), an inverse relationship of average strength between the Duke Activity Status Index and NTproBNP (-0.42, p=0.01) and the number of days spent in a hospital (-0.39, p=0.005). In conclusion we found that healthy men with an active lifestyle have higher average VO₂max parameters and confirmed that the VO₂max obtained during the cardiopulmonary exercise testing was comparable to questionnaire methods for assessing functional capacity. One fifth of patients with confirmed cardiovascular pathology self-reported inability to climb two flights of stairs. These individuals had a lower EF, a higher concentration of NTproBNP, a longer stay in the hospital, and significantly higher mortality. the Duke Activity Status Index correlates with left ventricular systolic function and NTproBNP level.

Keywords: noncardiac surgery, concomitant cardiovascular pathology, perioperative assessment, functional capacity 

UDC 616-018: 616-097

This study addresses the current need for vaccine adjuvants able to induce an immune response to novel or mutated pathogens. It exploits the ability of nanodiamonds (ND) to induce the formation of neutrophil extracellular traps (NETs) triggering inflammation, accompanied by immune response to co-injected
antigens. Hydrophobic nanodiamonds 10 nm in diameter were covered with 194 a.a. sequence of the receptorbinding domain of Spike protein of SARS-CoV-2 via passive adsorption. It was shown that antigen-covered ND induce activation of human neutrophils and stimulate NETs formation and ROS production. When used for immunization antigen-covered ND induce a long-lasting immune response in mice with prevailing IgG1 among antibody subclasses. The injected nanoparticles were sequestered by NETs and safely covered with connective tissues when examined 1 year after injection.

УДК: 612.014.484:012.015.1]-078.73-037-092.9

The development of oxidative and nitrative stress and the processes of free radical oxidation are associated with many pathological processes. Damage of any origin leads to the activation of free radical processes not only in the place of damage, but also in the whole organism. The aim of the study is to assess the state of lipid peroxidation, content of GSH and GSSG and the activity of NO-synthase and arginase in lymphocytes and peripheral blood serum in men with erectile dysfunction due to combat trauma. The research was conducted on peripheral blood lymphocytes of men injured as a result of combat operations (shrapnel and bullet wounds) in the Russian-Ukrainian war, and who were treated at the Military Medical Clinical Center of the Western Region (Lviv, Ukraine). The research group of men with combat injuries was divided into two age groups: men aged 20–39 years and men aged 40–53 years. The MDA content in the blood serum of patients of both age groups was 1.35 times higher than in the control group. In peripheral blood lymphocytes, the MDA content in patients of the young age group was 1.27, and in patients of the middle age group in 1.39 times higher than in the control group. Simultaneously, no significant changes in the concentration of oxidized glutathione in blood serum and blood lymphocytes were found between men with erectile dysfunction due to combat trauma and healthy men. GSH content in blood serum in patients of both age groups was
significantly lower than in the control group. The arginase/NOS ratio in blood serum was 9.75 times lower in the young age group and in 20.45 times lower in the middle age group compared to healthy men. It was established that in the blood serum and blood lymphocytes of men with erectile dysfunction due to combat trauma, processes of lipid peroxidation were intensified and the GSH level was reduced. The GSH/GSSG ratio was reduced only in blood serum. It was found that the oxidative stress is associated with development of nitrative stress. The arginase/NOS ratio was shifted towards increased NOS activity. Activation of iNOS was accompanied by significant inhibition of cNOS. Further study of biochemical mechanisms is important to understand the triggers of erectile dysfunction due to combat trauma.
Keywords: trauma; erectile dysfunction;MDA content; glutathione;NO-synthase; arginase. 

УДК: 612.014.484:012.015.1]-078.73-037-092.9

Erectile dysfunction and the associated quality of life are a pressing social and medical problem for millions of people. The basis of the work was the results of a survey of 298 men injured as a result of combat operations (shrapnel and bullet wounds) using the questionnaires of the International Index of Erectile Function-5 (IIEF-5) and the SF-36 Health Status Survey (SF-36) questionnaire to characterize the quality of life. The research group was divided into two: men aged 20-39 years (group 1) and men aged 40-53 years (group 2). The control group consisted of 48 clinically healthy men without complaints of sexual dysfunction or cardiac, neurological or endocrinological pathology. It is shown that men aged 20-39 years have a mild form of ED where the total score is 19.57 ± 0.44. Men of the 2nd group aged 40-53 years also have a mild form of ED, but the total score is much lower and is 17.74 ± 0.41. Patients of both age groups affected by hostilities suffer from both mental and physical health components. Indicators such as general health, role functioning due to physical condition, and pain intensity have probably lower values compared to the contol group. Lower indicators of role functioning due to physical condition indicate limitations in everyday life due to unsatisfactory physical condition. The decrease in the physical functioning index has statistically significant differences only in patients of the 2nd observed group. Thus, a mild form of erectile dysfunction is observed in men injured as a result of hostilities. No significant differences in the severity of erectile dysfunction were found betweenmale war victims of two age groups. All IIEF-5 domains were significantly reduced in men affected by combat operations. It has been proven that the physical and mental components of health suffer in victims of hostilities. Against the background of a decrease in all indicators on the scales of the physical component of health, general health and role functioning caused by physical condition lag behind the most. In the psychological domain, the most pronounced changes are recorded in such components as mental health, vital activity and social functioning. Сorrelation analysis revealed the significant correlation between physical functioning and role functioning caused by emotional state (r =+0.64; P < 0.05).
Keywords: men with shrapnel and bullet wounds; erectile dysfunction; quality of life;SF-36.

Abstract

УДК 616.12-005.4:616-008.9+616-056.5+616.379.-008.64+616.12-008.331.1-092:612.15]-074

For many years, and to this day, cardiovascular disease has been and remains the leading cause of death worldwide. Cardiovascular diseases mainly affect people in countries with middle and low living standards.

The aim of the study was to find out the peculiarities of lipid, carbohydrate, and hormonal changes in patients with coronary heart disease against the background of metabolic syndrome.

Materials and methods: 120 patients with verified coronary heart disease were examined, including 60 patients with coronary heart disease without metabolic syndrome and 60 patients with coronary heart disease with metabolic syndrome. The control group consisted of 30 practically healthy individuals of appropriate age and sex. The content of HbA1c, glucositol C-peptide, triacylglycerols, total cholesterol, leptin, HDL-cholesterol, and LDL-cholesterol in blood serum was determined by modern methods.

Results: The analysis of the results of laboratory tests of patients' blood revealed more pronounced changes in carbohydrate and lipid metabolism in patients with coronary artery disease against the background of metabolic syndrome, which indicates the severity of the clinical course in such patients. The results obtained indicate that in coronary heart disease with metabolic syndrome, there are more pronounced dysmetabolic changes: hyperleptinemia, glucosemia, elevated HbA1c, and decreased C-peptide content. Studies have shown that obesity is accompanied by high levels of leptin, which exacerbates insulin resistance and is a trigger for the development of coronary heart disease.

Conclusions: 1. Leptin resistance is a potential cause of insulin resistance and, consequently, obesity, which ultimately leads to metabolic syndrome and the development of coronary heart disease. The data obtained indicate a greater tendency to obesity in women with coronary heart disease complicated by metabolic syndrome.

1. The data obtained may indicate a latent disorder of carbohydrate metabolism in patients with coronary artery disease without metabolic syndrome.
2. The detected deviations in lipid metabolism indicate the presence of type II dyslipoproteinemia in patients of group 1 and type IV dyslipoproteinemia in patients of group 2.