The aim: To evaluate anthropometric, hemodynamic parameters, as well as changes in blood and leptin lipid spectrum in children and adults with overweight and obesity.
Materials and methods: We examined 68 overweight children and 90 patients with obesity in combination with stage 2, grade 2 AH who were electively inpatient. The control group consisted of practically healthy individuals – 20 adults and 55 children.
Results: Obesity in childhood isaccompanied by the development of dyslipidemia, hypercholesterolemia, hyperleptinemia and hypertension, and in adulthood may be an additional risk factor for cardiovascular disease, in particular AH. According to the study, total leptin level in overweight children was significantly higher compared to the control group (p<0.01). The concentration of leptin in patients with hypertension in combination with obesity was 3 times higher compared to the control group (p<0.01)
Conclusions: Thus, obesity or overweight, accompanied by hyperleptinemia and an increase in the proatherogenic fractions of the blood lipid spectrum, is an important problem that needs to be addressed in childhood to prevent cardiovascular disease in adulthood.
УДК 611.843.018:615.212.7].08
Метою представленої роботи було з’ясування фундаментальних питань, що стосуються динаміки змін у шарах сітківки на ранніх термінах опіоїдного впливу на організм. Дослідження проведене на 15 статевозрілих, безпородних щурах- самцях масою 100,0-160,0 г, віком 4 місяці. Опіоїдний вплив моделювали шляхом щоденної ін’єкції препарату налбуфін внутрішньом’язово, 1 раз на добу в одному проміжку часу (10-11 година ранку) впродовж 7 діб. Початкова доза налбуфіну становила 0,212 мг ̸кг.
Гістологічні препарати сітківки готували за загальноприйнятими методиками з використанням барвників (гематоксилін, еозин та азан за методикою Гайденгайна). Усі тварини знаходились в умовах віварію, дослідження проводили з дотриманням положень «Європейської конвенції про захист хребетних тварин, які використовуються для експериментальних та інших наукових цілей» [Страcбург, 1985]. Під час експериментального дослідження встановлені зміни структури шарів сітківки при однотижневому введенні опіоїду. На ранніх термінах введення малих доз опіоїдного анальгетика виявлено впродовж першого тижня появу перших патоморфологічних змін, які проявлялися початковими явищами вакуольної дистрофії пігментного епітелію та дистрофії гангліонарних клітин сітківки, ознаками мікрокістозної дегенерації зовнішнього сітчастого та нервоволокнистого шарів.
Ключові слова: мікроструктура, шари, сітківка, опіоїд, сьома доба, щур.
PATHOMORPHOLOGICAL CHANGES IN THE RETINAL LAYERS AT THE END
OF THE SEVENTH DAY OF EXPERIMENTAL OPIOID EXPOSURE
Abstract. The aim of the work was to clarify the fundamental issues regarding the dynamics of early changes in the retinal layers under experimental exposure of opioids. Research was done on 15 adult 4-months-old mature male mongrel rats, having 100.0-160.0 g weight. Opioid eff ects were modelled by daily intramuscular injections of nalbuphine 1 time per day in one period of time (10-11 am) for 7 days. The initial dose of nalbuphine was 0.212 mg ̸kg. Histological slides were prepared according to generally accepted methods using the dyes, as hematoxylin, eosin and azan according to the Heidenhain method.
All animals were kept in the vivarium and the work was carried out according to the European Convention for the Protection of Vertebrate Animals used for experimental and other scientifi c purposes [Strasbourg, 1985].
During the experimental opioid administration after one week of research the changes in the structure of the retinal layers were established. In the early stages of low-dose opioid analgesia administration, the first pathomorphological changes were de tected during the fi rst week, in the form of initial manifestations of vacuole dystrophy of the pigmental epithelium, signs of microcystic degeneration of the outer retinal and neurofi brous layers with the vacuole dystrophy of retinal ganglion cells appearance.
Key words: microstructure, layers, retina, opioid, seventh day, rat.
The aim: To evaluate the structural changes of the brain in relation to the formation of cognitive disorders (CD) in patients with arrhythmias
Materialsand methods: 147 patients with different clinical forms arrhythmias against the background of ischemic heart disease were examine. At the first stage, all patients with arrhythmias assessed cognitive functions. At the second stage, patients were distributed divided into two groups: the main group patients with CD, control – patients without CD. These groups underwent computed tomography examination of the brain.
Results:CD were established in 83% patients with arrhythmias. Mild CD were more often diagnosed in patients with persistent form of atrial fibrillation (AF), severe CD – in patients with permanent form of AF and atrioventricular blockade ІI-III degrees. Neuroimaging changes were found in 73.8% patients with CD and in 36% patients without CD. They were manifested by atrophic changes of the cortex, internal hydrocephalus, a decrease in the density of the brain sub- stance of the periventricular area. In patients with CD, compared to patients without CD, showed lacunar foci with predominant localization in the parietal and frontal lobes of the brain, periventricular and subcortical leukoaraiosis. Multiple correlations were established between CD and structural changes of the brain.
Conclusions: The increase in the severity of CD in patients with arrhythmias is associated with atrophic changes at the cortical-subcortical level, accompanied by the phenomena of internal hydrocephalus, periventricular and subcortical LA, lacunar foci, with a predominant localization in the frontal-temporal-occipital lobes, in the visual hump and basal ganglia of both cerebral hemispheres.
UDC 616.12-008.313:073.96:616.89-008.45/.46/.47
Background. The purpose of our work was to find out the dependence of changes in the cognitive sphere on the features of the structural and functional state of the heart and central hemodynamics in patients with arrhythmias.
Material and methods. We have examined 139 patients with different clinical forms of arrhythmias. All of them underwent extended neuropsychological testing and central hemodynamic studies. The state of central hemodynamics was assessed by an ultrasound examination of the heart. The state of intracardiac hemodynamics, structural changes in various parts of the heart were evaluated; based on this, the type of heart remodeling was determined. Correlations of hemodynamic indicators with the results of neuropsychological testing were evaluated.
Results. In patients with mild cognitive disorders (CD), the left ventricular myocardial contractility index did not differ significantly from that in patients without CD, but in people with moderate CD it was 9.6 % lower (p = 0.044). With moderate CD, the dilatation of the left parts of the heart increased (end-diastolic volume — by 16.5 %, p = 0.049; left atrium — by 9.9 %, p = 0.049), which, along with increased hypertrophy of the interventricular septum by 12.8 % (p = 0.048) and of the left ventricular posterior wall by 12.9 % (p = 0.048), led to an increase in the pulmonary artery pressure by 24.8 % (p = 0.015). Among patients with CD, concentric (42.2 %) and eccentric (22.6 %) left ventricular hypertrophy was more often detected (p = 0.048 and p = 0.027); in those without CD, concentric remodeling of the left ventricle prevailed (p = 0.037). In patients with mild CD, higher stroke volume was recorded — by 8.3 % (p = 0.049) compared to those without CD. However, according to indicators of cardiac output, cardiac index and total peripheral vascular resistance, differences were unreliable (p > 0.05). Patients with moderate CD reported an increase in stroke volume and cardiac output by 7.6 (p = 0.043) and 14.9 % (p = 0.014), respectively, compared to those without CD. Indicators of central hemodynamics had the greatest impact on the sphere of attention, regulatory functions, visual-spatial and mnestic deficits. The highest odds ratio for the development of CD were found for left ventricular ejection fraction (2.52, 95% confidence interval: 1.82–3.29, p < 0.001).
Conclusions. The identified associations of cognitive dysfunction, central hemodynamics and heart remodeling are important for optimizing an individualized approach to patient management and predicting the development of CD.
Type 2 diabetes mellitus (T2DM) patient outcomes, treatment options, and corresponding healthcare expenses are affected by the presence of different comorbidities. The aim of this work was to develop an algorithm for predicting the risk of hypothyroidism development in patients with T2DM according to a mathematical model obtained by regression analysis, for the timely implementation of appropriate preventive measures among T2DM patients. We analyzed 538 medical records of T2DM patients. It was found the following risk factors influencing the occurrence of hypothyroidism in patients with T2DM: hemoglobin, total cholesterol, non-HDL-cholesterol, glycated hemoglobin, and thyroid stimulating hormone levels. Prognostic model of the risk of hypothyroidism development in T2DM patients was built using multiple regression analysis. In order to stratify the risk of hypothyroidism development in T2DM patients, the following criteria were proposed: no risk at RC HT ≤ 5.0; low risk at 5.1≤ RC HT≤14,9; high risk at RC HT ≥15.0; where RC HT — risk coefficient for the hypothyroidism development in T2DM patients. Therefore, the developed algorithm and mathematical model for predicting the development of hypothyroidism in T2DM patients are highly informative and allow to determine in advance the contingent of patients with a high probability of hypothyroidism risk based on routine laboratory data.