UDC 616.12-002.77:616.5-003.214:616.366 

Introduction. Cardiovascular complications are the common in patients with Henoch-Schönlein purpura (HSP; IgA-vasculitis). Heart condition is strictly connected with gall bladder (GB) changes. However the heart condition in patients with HSP in dependence of gallbladder status was not studied before.
Purpose. To reveal peculiarities of heart structure and function in patients with HSP in dependence of gall bladder condition.
Material and methods. We analyzed data from 75 patients with active HSP, which underwent the treatment according to guidelines of Helsinki Declaration. Investigated patients included 57% females and 43% males, middle age – 47.7±4.3 years; middle body mass index (BMI) 27,9 kg/m2. Patients were divided into 6 groups: group 0 – normal intact GB (38.7%); group 1 – sludge, polyposis and cholesterosis of GB (14.7%); group 2 – bent GB body (10.1%); group 3 – GB neck deformations and signs of chronic cholecystitis (18.7%); group 4 – cholelithiasis (10.1%); group 5 – patients with removed GB (7.7%). Digital data was processed with the statistical methods, the quantitative variables are expressed as mean ± standard deviation. Values of р<0.05 were considered statistically significant.
Results. Patients with HSP significantly more often had some GB disorders than its intact status (61.3% vs 38.7%, р<0.05). Group 1 with sludge, cholesterosis and polyposis of GB was characterized by the normal values of EchoCG parameters. Patients with bent GB body (group 2) had bigger arrhythmia frequency and heart rate close to the maximal value but the best EchoCG. Group 3 had the most often left axis deviation and quite rare arrhythmias. Group 4 of patients with HSP and cholelithiasis was characterized by the maximal frequency of arterial hypertension, the highest frequency of arrhythmias, the most often presence of both bundle branch block and the worst EchoCG parameters. Group 5 of patients with HSP and removed GB was characterized by the maximal frequency of presence of left ventricle hypertrophy, the highest heart rate and left axis deviation. Heart structure in these patients can be estimated as better than in patients with cholelithiasis.
Conclusions. The heart and GB conditions in patients with HSP are tightly connected. The worsening of GB condition was accompanied by worsening of structural and functional heart parameters. Cholecystectomy can improve heart condition. Patients with HSP and GB disorders need more thorough examination and early correction of biliary diseases.
Keywords: Henoch-Schönlein purpura, gall bladder, heart structure and function, cholelithiasis, cholecystitis, arrhythmia, heart block. 

УДК: 616.379-008.64-07:616.155.3-097.37-085.225.27:577.112.385

У хворих на цукровий діабет (ЦД) І типу зростає функціональна активність імунних клітин, які беруть участь у запальному процесі. Ці клітини виробляють прозапальні цитокіни, що можуть пошкоджувати ендотелій судин. Система L-Аргінін-NO відіграє ключову роль у регуляції судинного тонусу та метаболічних процесів, включаючи інсулінову чутливість, тому метою нашої роботи було дослідити зв’язок між прозапальними цитокінами та функціонуванням системи L-Аргінін-NO у хворих ЦД І типу.

До дослідної групи увійшли 28 хворих на ЦД І типу. Рівень глікемії коливався в межах 8,4–10,3 ммоль/л. Контрольну групу склали 15 здорових осіб. У сироватці крові пацієнтів визначали концентрацію L-Аргініну, вміст стабільного метаболіту NO, активність іNOS. Рівень прозапальних цитокінів визначали імуноферментним методом (ІФА). Отримані результати обробляли статистично за допомогою програми STATISTICA 8.0.

Результати досліджень виявили у крові хворих на ЦД І типу достовірне підвищення активності іNOS на 635 %, зниження рівня L-Аргініну на 21 % та збільшення вмісту NO на 81 % відносно контролю.

Це супроводжувалось збільшенням рівня цитокінів першої лінії реагування IЛ-1β і ФНП-α порівняно з контрольною групою на 219% і 249% відповідно. Цитокіни першої лінії запускали цитокіновий каскад, що призводило до зростання IЛ-2 на 129 %, IЛ-6 на 30%, достовірного підвищення рівня IЛ-8 не спостерігалося, хоча була тенденція до його зростання.

Показано, що порушення балансу між прозапальними цитокінами та функціонуванням системи L-Аргініну-NO є важливим фактором, що сприяє розвитку хронічного запального процесу та оксидативного стресу у хворих на ЦД І типу. Отримані результати вказують на необхідність розробки нових терапевтичних підходів, спрямованих на корекцію порушень цитокінового профілю та відновлення функції системи L-аргінін-NO, що може допомогти знизити рівень запалення та покращити стан пацієнтів.

УДК: 612.015.11:616.69-008.1:616-001

Introduction. Most military personnel survive serious injuries, but many are left to live with long-term sexual and reproductive disorders. The injuries often result in psychological trauma and post-traumatic stress disorder, which negatively affect behavioral health and sexual function. There is emerging evidence linking erectile dysfunction (ED) to oxidative stress. Overall, combat trauma is characterized by a broad response of the body to harmful effects involving all body systems, leading to significant changes in the pro-oxidant-antioxidant balance.

Materials and Methods. The study was conducted on peripheral blood lymphocytes and serum of men with ED due to combat trauma (shrapnel and bullet wounds) and healthy men (control group). Both the study and control groups were divided into two age groups (young and middle age groups). Antioxidant activity was studied by measuring glutathione peroxidase (GP), glutathione reductase (GR) and glutathione-S-transferase (GsT).

Results. A comparison of the groups using the Kruskal–Wallis method revealed a significant decrease in the GPx and GR activity in blood lymphocytes and serum in men with ED due to combat trauma compared with healthy men of corresponding age groups. It was shown that GPx activity in peripheral blood lymphocytes of patients of the young age group was 1.64-fold lower, and in patients of the middle age group 1.70-fold lower than in the control group (P <0.001). Similar changes were observed in blood serum. GR activity in blood lymphocytes in patients of the young and middle age groups was 1.42-fold lower than in healthy men (P <0.001). In blood serum, GR activity in patients of the young age group was 1.70-fold (P <0.001) and in patients of the middle age group 1.56-fold lower than in healthy men (P <0.001). GsT activity in blood lymphocytes in both age groups increases by 1.2-fold, however these changes were not significant (P >0.05).

Conclusion. Erectile dysfunction caused by combat trauma is accompanied by a significant decrease in the activities of antioxidant defense enzymes – glutathione peroxidase and glutathione reductase. There is no difference between age groups of patients with erectile dysfunction due to combat trauma. However, the activity of glutathione S-transferase practically does not change, although there is a tendency for its increase.

Introduction: Assessment and treatment of open soft tissue injuries, in particular thermal injuries, is an important issue in surgery, as the correct choice of treatment tactics depends on the accurate determination of the wound size and depth. Reliable assessment of burn wounds allows for treatment adjustments, data storage for scientific research and improved prognosis, reducing the length of hospital stay of patients.

Objectives: Review the methods of assessing the size and depth of a skin defect and, in particular, a burn wound.

Materials and methods: To conduct the review, we analyzed literary sources in English and Ukrainian found on PubMed, Cochrane Library, ResearchGate, MEDLINE, Scopus, and Web of Science databases. Searches were performed using MeSH keywords covering burn depth, measurement of skin defects, and non-invasive imaging techniques. The analysis included publications from 2000 to 2024, but primary sources were also considered for a complete description of methods.

Results: Analysis of methods for determining planimetric characteristics and depth of burn wounds revealed certain disadvantages, including difficulty in use and high cost. Most of these techniques require considerable time and resources, which limits their practical application in clinical settings.

Conclusions: Further research should prioritize the development and implementation of more accessible, user-friendly, and cost-effective techniques for the evaluation of burn wounds. The ideal solution would be the introduction of new technologies or improvement of existing approaches to ensure the accuracy of measurements, ease of operation, and seamless integration into existing treatment protocols. This will significantly improve the diagnosis and treatment of patients with burns.

Introduction. Soluble suppression of tumorigenicity 2 (sST2) and galectin-3 are considered markers of myocardial hypertrophy and fibrosis. Changes in their concentrations are observed in cardiovascular diseases, including arterial hypertension.

The aim. To determine threshold values of hypertrophy and fibrosis biomarkers, namely sST2 and galectin-3, in patients with arterial hypertension.

Materials and methods. A prospective study was conducted on 82 patients with arterial hypertension (AH). Patients were stratified into two groups based on left ventricular mass index (LVMI) values: Group 1 with left ventricular hypertrophy (LVMI > 115 g/m² for men and 90 g/m² for women, n=33) and Group 2 with normal LVMI values (n=27).

Results. Patients with left ventricular hypertrophy exhibited significantly elevated sST2 and galectin-3 levels. Direct correlations were observed between LVMI and sST2 values (r=0.6397; p=0.000) and galectin-3 (r=0.5113; p=0.001). Both biomarkers correlated with various cardiac parameters, including interventricular septal thickness at end-diastole, left atrial diameter, left ventricular end-diastolic diameter, and posterior wall thickness at end-diastole (specifically with sST2). With a selected sST2 value of 17.0 ng/ml, the diagnostic method demonstrated 88.33% accuracy, 92.59% specificity, 93.3% positive predictive value, and 83.33% negative predictive value for hypertrophy. At the chosen galectin-3 level of 29.0 ng/ml, the proposed method achieved 72.22% accuracy, 73.68% sensitivity, 70.59% specificity, 73.68% positive predictive value, and 70.59% negative predictive value.

In conclusion, measuring sST2 and galectin-3 biomarkers facilitates the evaluation of left ventricular hypertrophy, serving as an additional tool in assessing cardiac dysfunction and indicating diverse developmental pathways.