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.

УДК 616.13/.14-008-06:[616.13-004.6:616.12-008.331.1

Актуальність. На сьогоднішній день в Україні налічується декілька мільйонів громадян з цереброваскулярною хворобою
(ЦВХ), що пов’язано з прогресуванням старіння населення, несприятливими економічними та екологічними умовами, нераці-
ональним харчуванням, гіподинамією. Проте, основною причиною розвитку ЦВХ є розлад кровотоку у речовині мозку, який
порушує механізм саморегуляції мозкового кровообігу, викликаючи кисневе голодування та негативно впливаючи на систем-
ний кровообіг. Тому проблема підвищення ефективості медичної і фізичної реабілітації пацієнтів з ЦВХ потребує вирішення
шляхом підбору комплексу дієвих відновних засобів з урахуванням її стадії і періоду захворювання, станом мозкового кровоо-
бігу, етапів реабілітації, що обумовлює актуальність напрямку дослідження.
Мета дослідження. Визначення морфофункціональних показників, стан центральної та церебральної гемодинаміки
обстежених пацієнтів з І–ІІ стадіями ЦВХ.
Методи дослідження. Теоретичний аналіз та узагальнення наукової літератури, аналіз даних історії хвороби та амбу-
латорних карток, лабораторні методи, інструментальні методи дослідження – ЕКГ, УЗДГ магістральних артерій голови
та шиї, методи математичної статистики. Предмет дослідження – структура та зміст комплексної програми медичної
та фізичної реабілітації пацієнтів з ЦВХ І та ІІ стадій, визначення її впливу на функціональний стан організму.
Результати дослідження. Наведено результати обстеження функціонального стану гемодинамічних показників по
магістральних артеріях у 100 хворих з ЦВХ, що дасть можливість раціонально скорегувати комплекс реабілітаційних захо-
дів, враховуючи індивідуальні особливості та стадії перебігу хвороби. Визначено морфофункціональні показники, стан цен-
тральної та церебральної гемодинаміки обстежених пацієнтів з ЦВХ на грунті атеросклерозу та гіпертонічної хвороби.
Висновок. Комплексна оцінка рівня структурних змін функціонального стану гемодинамічних показників по магістраль-
них артеріях голови пацієнтів з ЦВХ дасть можливість раціонально скоригувати комплекс реабілітаційних заходів, врахову-
ючи індивідуальні особливості, стадію перебігу хвороби та супутні захворювання.
Ключові слова: судинна система, цереброваскулярна хвороба, гемодинамічні порушення.

ABSTRACT
Background: Currently, a topical area of research is the multidimensional approach to both reliable tools and professional interventions aimed at improving the attitudes of Ukrainian society toward people with disabilities in the context of the armed conflict in Ukraine.
Aim of the study: The purpose of this study was to study the factor structure of the Multidimensional Attitudes Scale Toward Persons with Disabilities (MAS) questionnaire on a sample of Ukrainian students to create an adaptation of the original version (MAS-UA).
Material and methods: The main authors of the questionnaire gave their consent for the adaptation. The Ukrainian version of the MAS was developed using the method of back translation from the original language. The proposed multi-factor structure of the MAS-UA was tested in an anonymous online study of 1619 Ukrainian students.

Results: The factor analysis and a parallel exploratory factor analysis resulted in a 5-factor structure for the MAS-UA (the classic domains – cognitive, affective, and behavioral – and two additional domains, negative effects and items concentrated in the factors “Calm” and “Desire to communicate”). These five factors yielded 62.6% of the total variance score.
Conclusions: The MAS-UA was developed and presented as a reliable instrument for examining attitudes toward people with physical disabilities. The instrument can be used for the initial assessment when developing prevention and educational programs in the field of social policy, as well as to evaluate their effectiveness. Studies using the adapted version of the scale (MAS-UA) will allow the comparison of results from other countries where other language versions are used.
Keywords: Ukrainian students, MAS questionnaire, multidimensional attitudes, disability, measurement
scale, factor analysis

Abstract.
Non-thyroidal illness syndrome (NTIS) also known as euthyroid sick syndrome or low T3 syndrome is hypothyroidism caused by peripheral changes in the metabolism and thyroid hormone transport caused by severe debilitating diseases, in particular, heart failure. Recent data indicate that chronic heart failure can result in thyroid hormone metabolism disruption, which contributes to a progressive decrease in the concentration of triiodothyronine. The objective was to evaluate the effectiveness and safety of hormone replacement therapy with low doses of thyroxine in congestive heart failure in patients with low triiodothyronine syndrome. The levels of thyroid-stimulating hormone, thyroxine-binding globulin, free thyroxine, total triiodothyronine, free triiodothyronine, and reversible triiodothyronine were measured by radioimmunological assay from samples obtained from 56 patients with chronic heart failure and 19 practically healthy individuals of the control group matched by age, gender, and body mass index. Patients with low triiodothyronine syndrome were prescribed hormone replacement therapy with low doses of thyroid hormones (thyroxine 12.5-25 mcg/day) until the euthyroid state was achieved. The values of total and free triiodothyronine were significantly lower in patients with heart failure, the level of thyroxine- binding globulin was also reduced, more than twofold increase in reversible triiodothyronine level was demonstrated compared to controls. Low triiodothyronine syndrome was diagnosed in 33.9% of patients with heart failure. Hormone replacement therapy resulted in a slight improvement in contractile function in individuals with low triiodothyronine levels, 2 (10.5%) patients manifested with signs of hyperthyroidism. Advanced stages of heart failure might be linked with NTIS. Hormone replacement therapy with low doses of thyroxine can contribute to a moderate improvement in contractile function, as evidenced by the improvement in left ventricular ejection fraction.  

Keywords:  Non-thyroidal illness syndrome (NTIS),  euthyroid sick syndrome,  heart failure,  hormone replacement therapy.