Journal of V N Karazin Kharkiv National University Series Medicine最新文献

{"title":"Fibrotic changes in patients with chronic heart failure with cardiac dyssynchrony and associated type 2 diabetes mellitus","authors":"T. Rudenko, O. M. Khvysiuk, O. Godlevska, A. P. Braslavska","doi":"10.26565/2313-6693-2018-35-08","DOIUrl":"https://doi.org/10.26565/2313-6693-2018-35-08","url":null,"abstract":"The study of fibrosis markers was carried out on 72 observed patients (mean age (69 ± 10.37) years) with chronic heart failure (CHF) of ischemic genesis with manifestations of cardiac dyssynchrony (CD) and concomitant type 2 diabetes mellitus – Galectin 3 and matrix metalloproteinase 1. All patients were divided into 2 groups, depending on the presence of CD. The CD was evaluated according to a conventional technique, the volume fraction of interstitial collagen was measured using the formula of J. Shirani and co-authors, the levels of Galectin-3 and matrix metalloproteinase 1 – by the enzyme-linked immunoassay according to the manufacturer's instructions. The data were processed using parametric and nonparametric statistics. It was revealed that the level of fibrosis development was higher in the group of patients with CD than in the group without CD. This indicates the dependence of the development of myocardial sites asynchronous reduction with the presence of interstitial collagen development. That further requires the study of the effect of anti-fibrotic, anti-ischemic and hypoglycemic agents on the progression of CD to prevent subsequent myocardial remodeling.","PeriodicalId":31685,"journal":{"name":"Journal of V N Karazin Kharkiv National University Series Medicine","volume":"23 1","pages":"57-60"},"PeriodicalIF":0.0,"publicationDate":"2018-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81595266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antisynthetase syndrome: course of a rare disease on example of clinical case","authors":"H. Boateng, O. G. Babiy, R. S. Shalkova","doi":"10.26565/2313-6693-2018-35-12","DOIUrl":"https://doi.org/10.26565/2313-6693-2018-35-12","url":null,"abstract":"Systemic disorders of connective tissue refer to rare and poorly studied diseases. This group of diseases associated with the variable course and makes it interesting for either medical scientists and researchers or practitioner. Herein we report a case of antisynthetase syndrome with interstitial lung disease complicated by pulmonary thromboembolism. The patient is 71 year old female, who suffered from severe dyspnea, dry cough, intermittent wheezing. Also she had dry eyes, dry mouth, muscle weakness and intermittent pain in large joints, and low grade fever. Physical examination revealed a characteristic heliotrope eye rash, V sign, «mechanic’s hand», peripheral muscles atrophy, dry eyes and mouth, fine crackles to auscultation in basal parts of lungs, soft S1 and S2 heart sounds. Her biochemical profile showed increased creatinekinase, LDH, AsAT, and AlAT Her immunology results were positive to ANA, anti-ds-DNA, anti-ss-A, anti-ss-B and anti-Jo-1 autoantibodies. Based on the obtained data, antisynthetase syndrome was established. It was detected, that progressive dyspnea had been caused by interstitial lung disease and pulmonary thromboembolism. It was confirmed by chest CT-scan and pulmonary angiography. Treatment in this case is mainly symptomatic. It was prescribed glucocorticoids, immunosuppressant, and anticoagulants. This case illustrates the course of the antisynthetase overlap syndrome and difficulties of it management due to the lack of treatment standards and reliable data of the medicine effectiveness.","PeriodicalId":31685,"journal":{"name":"Journal of V N Karazin Kharkiv National University Series Medicine","volume":"1 1","pages":"78-83"},"PeriodicalIF":0.0,"publicationDate":"2018-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89220436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"INFLUENCE OF THE TOTAL POWER OF THE HEART RATE VARIABILITY SPECTRUM ON THE SPECTRAL PARAMETERS DISTRIBUTION IN PATIENTS WITH ARTERIAL HYPERTENSION IN A PACED BREATHING TEST","authors":"E. Golubkina, M. Yabluchansky","doi":"10.26565/2313-6693-2018-35-03","DOIUrl":"https://doi.org/10.26565/2313-6693-2018-35-03","url":null,"abstract":"To determine the effect of the total power (TP) of the heart rate variability (HRV) spectrum on the distribution of high, low and very low frequency waves, 40 patients with arterial hypertension (AH) at the age of 58 ± 9 years were divided into 5 groups according to the degree of TP decrease in the initial stage of the test: 1st – more than 3000 ms2; 2nd – 3000–2000 ms2; 3rd – 2000-1000 ms2; 4th – 1000–500 ms2; 5th – less than 500 ms2. To assess HRV parameters in each group, 3 stages of the paced breathing test with a double (light and sound) metronome were evaluated; the hardware and software complex «Cardiolab» («HAI-Medica») was used. The distribution of the parameters was estimated taking into account the median, 25 and 75 quartiles. To estimate the differences between the statistical samples, the nonparametric Mann-Whitney U-test was used, as well as the Craskell–Wallis criterion. Statistically significant differences were considered between the data at a value of p < 0.05. It was found that the greater is the degree of TP reduction, the more significant is the autonomic imbalance, as well as the decrease in the influence of paced breathing on the regulation of the heart rhythm; at TP values below 1000 ms2 not only the parasympathetic component decrease is observed, but also the transition from sympathicotonia to the neurohumoral factors prevalence. \u0000In patients with arterial hypertension, there is a tendency of decrease in the total power of the HRV spectrum, thus reflecting the decreased functional capacity of heart rhythm regulation.The lower the degree of TP, the more significant is the disturbance of HRV regulation with a decrease in the parasympathetic component of the heart rate variability spectrum and the dominant influence of sympathetic and neurohumoral factors.The influence of the paced breathing on the heart rhythm regulation falls depending on the decrease in the total power of the HRV spectrum: at TP values below 1000 ms2 not only the parasympathetic component decrease is observed, but also the transition from sympathotonia to the neurohumoral factors prevalence.Decrease in TP can be considered as an indicator of aggravation of autonomic and neurohumoral regulation.Thepaced breathing test allows determine the basic level of cardiac activity regulation and dynamic disruptions in the distribution of HRV components in the metronomized breathing, as well as the possibilities for restoring the regulatory balance of heart rate variability, which is especially important in the examination of patients with arterial hypertension.","PeriodicalId":31685,"journal":{"name":"Journal of V N Karazin Kharkiv National University Series Medicine","volume":"32 1","pages":"18-24"},"PeriodicalIF":0.0,"publicationDate":"2018-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85549685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ventricular mural thrombus in patient with left ventricular aneurysm after myocardial infarction","authors":"O. Makharynska, O. V. Lisogorska, I. Oktiabrova, Adu Albert Asare","doi":"10.26565/2313-6693-2018-35-18","DOIUrl":"https://doi.org/10.26565/2313-6693-2018-35-18","url":null,"abstract":"On the example of the clinical case of newly diagnosed mural thrombus in patient with post ST-elevation myocardial infarction chronic aneurysm formation, probable risk of further tromboembolism and anticoagulation benefit was discussed. Recommendations on lifestyle modification and medicament treatment tactics are described for prevention of new mural thrombi formation. \u0000Left ventricular thrombus is an important complication of acute myocardial infarction that impacts embolic event risk and anticoagulant therapy. Improved understanding of post-MI thrombus in the current era is critical for optimization of diagnostic testing strategies. Advances in MI management, including prompt and effective coronary reperfusion, have yielded improvements in LV function and remodeling. Widespread use of antiplatelet agents may potentiate the benefits of reperfusion, thereby lessening the likelihood of LV thrombus.","PeriodicalId":31685,"journal":{"name":"Journal of V N Karazin Kharkiv National University Series Medicine","volume":"54 1","pages":"109-112"},"PeriodicalIF":0.0,"publicationDate":"2018-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75896845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CLINICAL AND CHEST X-RAY FEATURES OF PNEUMONIA IN INJECTING-DRUG USERS","authors":"T. Butova, D. Butov, O. Martynchyk, O. S. Sinichenko, L. Martymianova","doi":"10.26565/2313-6693-2018-35-15","DOIUrl":"https://doi.org/10.26565/2313-6693-2018-35-15","url":null,"abstract":"On an example of a clinical case in a patient with drug addiction, the reviewed clinical and chest X-ray features of community-acquired pneumonia, the diagnostic algorithms and the differential diagnostics are based on the recommendations of the Ukrainian Association of Pulmonology. The treatment strategy of the patient in the conditions of an ambulatory are described. \u0000Community-Acquired pneumonia acquired by intravenous drug use is characterized by a severe course, febrile body temperature, severe specific lung disease.On the example of this clinical case, the importance of express diagnostics of pneumonia at the ambulatory stage wasconfirmed to determine the correct tactics of patient management.","PeriodicalId":31685,"journal":{"name":"Journal of V N Karazin Kharkiv National University Series Medicine","volume":"4 1","pages":"92-96"},"PeriodicalIF":0.0,"publicationDate":"2018-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80520675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PREVALENCE OF POLYMORPHISM OF THE TLR-9 TYPE GENE IN PATIENTS WITH CHRONIC EPSTEIN-BARR VIRUS INFECTION","authors":"T. Lyadova, O. Ognivenko, O. Volobueva, O. Gololobova, S. G. Malanchuk","doi":"10.26565/2313-6693-2018-35-06","DOIUrl":"https://doi.org/10.26565/2313-6693-2018-35-06","url":null,"abstract":"The prevalence of polymorphism -1486T/C of the TLR-9 gene was studied in 44 patients with chronic Epstein-Barr virus infection (CEBV). The control group for the study of the polymorphisms prevalence of -1486T/C of the TLR-9 gene was 40 healthy donors. Three main genotypes of -1486T/C of the TLR-9 gene were identified based on the obtained results – TT, TC, CC. Investigation of the occurrence frequency of individual genotypes revealed the dominance of the TC genotype, compared with the homozygous TT and CC genotypes. The study of -1486T/C of the TLR-9 gene polymorphism frequency distribution for different genotypes demonstrated the specificity of changes in the TC genotype in patients with CEBV and the absence of such for the TT and CC genotypes. These results confirm the important role of the TLR-mediated signaling in the pathogenesis of the disease, which is necessary to determine the genetic background associated with the course of the disease and its possible consequences. These are the aspects that will further enable the identification of risk groups among such patients and provide timely therapy. \u0000The analysis of the results of the -1486T/C polymorphism of the TLR-9 gene revealed three main genotypes –TT, TC, CC. Investigation of the occurrence frequency of individual genotypes revealed the dominance of the genotype TC, compared with the homozygous genotypes of TT and CC. The study of frequency distribution of the polymorphism -1486T/C of TLR-9 for different genotypes demonstrated the specificity of changes in the TC genotype and the absence of suchin the TT and CC genotypes in patients with CEBV.Our study for the purpose of determining the 1486T/C polymorphism of the TLR-9, that is associated with chronic forms of CEBV infection, confirms the important role of TLR-mediated signaling in the pathogenesis of this disease, which is necessary to determine the genetic background associated with the course of the disease and possible consequences of CEBV. These aspects will further enable the identification of risk groups among such patients and provide timely therapy.Analysis of the results allowed establishing the following:1. The 1486T/C polymorphism of the TLR-9 gene is significantly more frequent in patients with CEBV than in the control.2. The frequency distribution of the -1486T/C polymorphism ofthe TLR-9 gene allowed the establishment of the association of the genotype TC with chronic forms of the EBV infection, which is very specific for this group of patients.","PeriodicalId":31685,"journal":{"name":"Journal of V N Karazin Kharkiv National University Series Medicine","volume":"138 1","pages":"37-46"},"PeriodicalIF":0.0,"publicationDate":"2018-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86197791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"THE FREQUENCY OF USE OF COMBINATIONS OF ANTIHYPERTENSIVE DRUGS IN PATIENTS WITH DIFFICULT-TO-CONTROL HYPERTENSION ON THE BACKGROUND OF BIOFEEDBACK AND PACED BREATHING AND HEART RATE VARIABILITY","authors":"O. Tymoshenko, M. Yabluchansky, O. Bilchenko","doi":"10.26565/2313-6693-2018-35-09","DOIUrl":"https://doi.org/10.26565/2313-6693-2018-35-09","url":null,"abstract":"The frequency of administration of combinations of antihypertensive drugs and its changes at different stages of observation was studied in 60 patients with difficult-to-control arterial hypertension (DTCAH) (32 men and 28 women) aged 59.0 ± 9.4. All patients were randomly divided into two subgroups: biofeedback (BFB) in the loop of paced breathing (PB) and heart rate variability (HRV) (33 patients) – basic subgroup, subgroup of comparisons (27 patients). Determined that patients with DTCAH in the subgroup of patients with the BFB in the loop of PB there has been a reduction of four-component antihypertensive therapy to three-component and in the subgroup of comparisons the frequency of the appointment of a four-component therapy was increased. At the same time, it was found that the addition of drug therapy with regular BFB sessions in the loop of PB contributed to the potentiation of the antihypertensive effect in patients with DTCAH. It is concluded that the BFB in the loop of PB and HRV can be used as a technology to improve the efficiency of control of blood pressure in patients with DTCAH.","PeriodicalId":31685,"journal":{"name":"Journal of V N Karazin Kharkiv National University Series Medicine","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76969177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ATRIAL FIBRILLATION IN PATIENT WITH DIABETES MELLITUS 2 TYPE: CO-EXISTANCE AND THERAPEUTIC APROCHES","authors":"O. Makharynska, O. Oluwatoyin, O. Doroshenko, V. Pozhar","doi":"10.26565/2313-6693-2018-35-16","DOIUrl":"https://doi.org/10.26565/2313-6693-2018-35-16","url":null,"abstract":"On the example of the clinical case of atrial fibrillation in patient with diabetes mellitus type 2, were discussed molecular mechanisms and therapeutic perspectives, anticoagulation treatment and anti-arrhythmic treatment strategies benefit. Recommendations on lifestyle modification and medicament treatment tactics are described. \u0000Atrial fibrillation and diabetes mellitus are very common comorbidities and with high expectance they will co-exist together in the future because of the both conditions prevalence especially in older patients group. Therefore, establishing of the most effective and safe treatment it is very important to the subpopulation of patients with AF and DM. New studies with larger numbers of patients from different age and rage groups with diabetes and AF are needed to investigate the mechanisms of thisrelationship and all possible therapeutic approaches in order to determine the best possible individual management of both conditions.","PeriodicalId":31685,"journal":{"name":"Journal of V N Karazin Kharkiv National University Series Medicine","volume":"37 1","pages":"97-101"},"PeriodicalIF":0.0,"publicationDate":"2018-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79480178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"THE PROPORTION OF PATIENTS WITH HYPERTENSION IN THE GROUPS OF TERMS PROLONGED QTc INTERVALS PER DAY DATA OF AMBULATORY ECG MONITORING IN DEPENDENCE FROM CLINICAL SIGNS","authors":"N. E. Tselik, M. Yabluchansky","doi":"10.26565/2313-6693-2018-35-10","DOIUrl":"https://doi.org/10.26565/2313-6693-2018-35-10","url":null,"abstract":"The study of the proportion of patients in 82 patients with hypertension in groups of different periods of prolonged QTc per day was performed based on the data of the AM of the ECG, depending on the clinical signs. Depending on the duration of prolonged QTc per day, the patients were assigned to one of three groups: group 1 – the term extended by day of the interval QTc from 0 to 33.3 %, group 2 – from 33.4 to 66.6 %, group 3 – from 66.6 to 100 %. The proportion of patients with hypertension was determined in the groups of the prolonged QTc interval depending on age, sex, weight of patients, type of circadian heart rate index, stage, degree and prescription of EH, presence of coronary heart disease, FC and stage of CHF and diabetes mellitus. According to the AM ECG, an prolonged QTc interval occurs in each patient with hypertension, with an increase of 0 to 33.3 % per day, it is detected in 76 %, from 33.4 to 66.6 % – in 16 % and with 66.7 to 100 % – in 8 % of patients. The existence of a prolonged QTc interval in each patient indicates that in its analysis it is necessary to base on the data of the AM of the ECG taking into account, except for the elongation and lengthening for a day.","PeriodicalId":31685,"journal":{"name":"Journal of V N Karazin Kharkiv National University Series Medicine","volume":"8 1","pages":"66-71"},"PeriodicalIF":0.0,"publicationDate":"2018-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78701155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RADIOFREQUENCY ABLATION IN ATRIAL TACHYCARDIA PAROXYSM ON EXAMPLE OF CLINICAL CASE","authors":"M. Brynza, V. V. Zaporiz’ka, O. Vasylenko, D. E. Volkov","doi":"10.26565/2313-6693-2018-35-14","DOIUrl":"https://doi.org/10.26565/2313-6693-2018-35-14","url":null,"abstract":"The disappearance of atrial tachycardia paroxysms after radiofrequency catheter ablation (RFA) of ectopic focus in a left atrium is presented on example of clinical case. Atrial tachycardia paroxysms disappeared after ablation completely. \u0000In this case, the RFA of atrial tachycardia was effective. The initial high total power of the HRV spectrum in the patient after ablation decreased by 5 times, but may predict rhythm disturbances in future. In pharmacotherapy, which included cardiomagnil and bisoprolol, the reduction in HRV suggested a gradual increase of the bisoprolol dose.","PeriodicalId":31685,"journal":{"name":"Journal of V N Karazin Kharkiv National University Series Medicine","volume":"105 1","pages":"89-91"},"PeriodicalIF":0.0,"publicationDate":"2018-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85890490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}