The aim of this study was to assess the level of nitric oxide production and arginase activity in patients with arterial hypertension and type II diabetes mellitus during infection with SAR S-CoV-2. The study groups included patients with arterial hypertension, patients with arterial hypertension combined with a severe course of COVID-19 and patients who, in addition to arterial hypertension and COVID-19, were suffering from type II diabetes mellitus. The volunteers without any clinical signs of diseases and normal blood pressure formed the control group. It has been established that arterial hypertension, combined with COVID-19 occurs along with reduced L-arginine, nitric oxide, superoxide dismutase activity and increased arginase activity. At the same time, the presence of arterial hypertension in patients with diabetes and coronavirus disease is accompanied by a decline in the content of L-arginine and arginase activity. Our study’s results may help scientists find new pharmacological targets in the future treatment of coronavirus disease and comorbid disorders.
About 200 million cases of viral community-acquired pneumonia occur every year-100 million in children and 100 million in adults [3, p. 1265]. In children, respiratory syncytial virus, rhinovirus, human metapneumovirus, human bocavirus, and parainfluenza viruses are the agents identified most frequently in both developed and developing countries. Presence of viral epidemics in the community, patient's age, speed of onset of illness, symptoms, biomarkers, radiographic changes, and response to treatment can help differentiate viral from bacterial pneumonia [1, p. 5]. No clear consensus has been reached about whether patients with obvious viral community-acquired pneumonia need to be treated with antibiotics. Further studies are needed to better understand the cause and pathogenesis of community-acquired pneumonia. Furthermore, regional differences in cause of pneumonia should be investigated, in particular to obtain more data from developing countries. In addition to well-known symptoms, such children are also characterized by disorders of the autonomic nervous system. There are the cause of a decrease in the quality of life in children, which leads to a lengthening of the recovery period of adaptation after the disease.
Insulin resistance is the major sign of etiology and pathogenesis of type 2 diabetes mellitus and metabolic syndrome and can precede its development for many years. Early identifying the beginning of insulin resistance in children is important to prevent diabetes mellitus in adult life. The purpose was to identify metabolic and somatic changes in children with insulin resistance.
Material and methods. Out of 182 children of the general sample, who was estimated fasting plasma insulin and glucose, HOMA-IR, and glucose/insulin ratio, 2 groups were formed: group 1 — children with IR — 56 (30.8 %) and group 2 — 126 (69.2 %) children with normal insulin sensitivity. In children anthropometric data, lipid metabolism (total cholesterol, triglycerides, HDL-C, LDL-C, VLDL-C), blood pressure, leptin were determined.
Results. From examined subjects 56 children were generally obese (BMI > 95th percentile), 71 children were abdominally obese (WC > 90th percentile), 55 children were with normal body mass (BMI < 90th percentile). Insulin resistance was identified in 21 (37.5 %) children with general obesity more rarely, than in 38 (39.4 %) children with abdominal obesity (p = .049) and in 7 (12.7 %) children with normal BMI (p = .003). In insulin-resistant children BMI, waist and hip circumference was larger than in children with normal insulin sensitivity. The lipid profile in children with different insulin sensitivity did not differ, but in insulinresistant children an association of basal glucose with TG/HDL-C ratio (r = .53; p = .001), blood insulin with TG (r = .34; p = .018), and TG/HDL-C ratio (r = .54; p = .001) was estimated. The HOMA-IR significantly correlated with VLD-C (r = .40; p = .005), TG (r = .49; p = .001), TG/HDL-C ratio (r = .43; p = .002). The glucose/insulin ratio was in significant association with the TG/non-HDL-C ratio. The incidence of hypetension (> 95th percentile) diagnosis in insulin-resistant children was by 33.8 % higher (p = .001). Blood leptin concentration was 1.8 falled higher in insulin-resistant children and significantly correlates with waist circumference, fasting insulin, HOMA-IR, and diastolic blood pressure.
Conclusions. Insulin resistance is related to cardiometabolic risks, such as general and abdominal obesity, hypertension, dyslipidemia, hyperleptinemia, and leptin resistance, and is a screening biomarker for children and adolescents with an increased risk of cardiometabolic diseases.
Інсулінорезистентність є базовим фактором етіології та патогенезу цукрового діабету 2-го типу та метаболічного синдрому і може передувати їм за багато років. Раннє виявлення початку інсулінорезистентності та пов’язаних з нею метаболічних факторів ризику у дітей запобігає розвитку цукрового діабету в дорослому житті. Мета: виявити метаболічні і соматичні зміни у дітей з інсулінорезистентністю.
Матеріали та методи. З 182 дітей загальної вибірки, у яких визначено рівень базального інсуліну і глюкози, HOMA-IR та індексу глюкоза/інсулін сформовано дві групи: група 1 — 56 (30,8 %) дітей з інсулінорезистеністю, група 2 — 126 (69,2 %) дітей з нормальною чутливістю до інсуліну. Дітям проведено антропометрію, ліпідограму (загальний холестерин, тригліцериди, ХС ЛПВЩ, ХС ЛПНЩ, ХС ЛПДНЩ), лептин.
Результати. З обстеженої когорти 56 дітей мали генералізоване ожиріння (ІМТ > 95-го перцентиля), 71 дитина — абдомінальне ожиріння (окружність талії > 90-го перцентиля), 55 дітей — нормальну масу тіла (ІМТ < 90-го перцентиля). Інсулінорезистентність виявлена у 21 (37,5 %) дитини з генералізованим ожирінням, 38 (39,4 %; p = 0,049) дітей з абдомінальним ожирінням і 7 (12,7 %) дітей з нормальним ІМТ (p = 0,003). У інсулінорезистентних дітей ІМТ, окружність талії і стегон були більшими, ніж в інсуліночутливих дітей. Ліпідний профіль у дітей з різною чутливістю до інсуліну не відрізнявся, проте встановлена висока кореляційна залежність ранішньої глюкози з індексом тригліцериди/ХС ЛПВЩ (r = 0,53; p = 0,001), базального інсуліну з тригліцеридами (r = 0,34; p = 0,018) та індексом тригліцериди/ХС ЛПВЩ (r = 0,54; p = 0,001). HOMA-IR корелював з ХС ЛПДНЩ (r = 0,40; p = 0,005), тригліцеридами (r = 0,49; p = 0,001), індексом тригліцериди/ХС ЛПВЩ (r = 0,43; p = 0,002). Індекс глюкоза/інсулін перебував у тісній залежності з індексом тригліцериди/ХС ЛПВЩ. Частота діагностики артеріальної гіпертензії у дітей з інсулінорезистеністю на 33,8 % перебільшувала аналогічний показник у інсуліночутливих дітей. Рівень сироваткового лептину у дітей з інсулінорезистентністю був в 1,8 раза вищим.
Висновки. Інсулінорезистентність пов’язана з кардіометаболічними факторами ризику, такими як генералізоване та абдомінальне ожиріння, гіпертензія, дисліпідемія, гіперлептинемія і лептинорезистентність, і є біомаркером скринінгу кардіометаболічних захворювань.
Abstract
Introduction
The aim of our study was to conduct a comparative analysis of the opinions of pharmaceutical professionals and senior students of pharmaceutical faculties of Ukraine and Poland on awareness of the "ten-star pharmacist" concept.
Methods
An anonymous survey was conducted among Ukrainian and Polish pharmaceutical workers (n = 614 and n = 209) and students (n = 516 and n = 475). The analyzed period in Ukraine was February-April 2020, in Poland - June-September 2020.
Results
This study revealed differences of opinion between the respondents and a lack of proper knowledge about the above concept. On the one hand, they have a high level of awareness of some professional roles, but on the other part, the rest of them cause hesitation and lack of affirmative opinion.
Conclusions
Inadequate awareness of professional roles indicates the need to create effective mechanisms for implementing the "ten-star pharmacist" concept in the practical and educational systems of both countries.
17 bladder cancer patients, stage T3N0M0 (main group), were included in the study. There were 10 men (mean age 58.2 ± 6.2 years) and 7 women (mean age 59.5 ± 2.4 years). Clinical data of 12 healthy individuals were used as a control. According to statistic data, the average level of VEGF in bladder cancer patients urine was 246.55± 6.90 pg/ml which significantly exceeded this indicator in the control group (129.21± 7.60 pg/ml), the difference was statistically significant At bladder cancer diagnosis the sensitivity and specificity of the urinary level of TNF-α was low and amounted to 30% and 20%, respectively, and the level of TNF-β was even lower - 25% and 20%, respectively, which is not representative for the pathology under study.