Family medicine. European practices最新文献

{"title":"Profile of Risk Factors for Hypertension Among Overweight Patients","authors":"V. Potaskalova, Mariana Seliuk, Y. Kleban, Maryna Savchuk","doi":"10.30841/2786-720x.1.2023.277482","DOIUrl":"https://doi.org/10.30841/2786-720x.1.2023.277482","url":null,"abstract":"A third part of the world’s population has a steady increased blood pressure (BP). According to scientific data, there is a tendency to increase the incidence of arterial hypertension (AH) up to 60 %. It is important in AH treatment to perform an optimal control of BP level, for this purpose it is necessary to consider both the risk factors for the disease development and the risk factors for the development of pathology complications.\u0000The objective: to identify risk factors in patients with AH and body mass index (BMI) more than 25 kg/m2.\u0000Materials and methods. The study included 339 patients with AH. The I group involved 299 persons with BMI≥25 kg/m2, and 40 patients with AH and BMI <25 kg/m2 were included in the II group. The average age of the patients was 49.4±10.7 years, the average duration of the disease – 7.5 years.\u0000Anthropometric data, daily monitoring of BP, morphological and functional state of the heart, biochemical parameters of the blood (lipidogram, transaminase and bilirubin, urea and creatinine, glucose level) were determined in all patients. The levels of interleukin-1β, interleukin-10 and homocysteine were also detected. The speed of glomerular filtration was determined accord ing to the Cockroft–Hault formula, a psycho-emotional examination was done (a questionnaire for determining of anxiety and depression levels, the presence of alexitimia).\u0000Results. The analysis of the lipidogram indicators demonstrated a higher level of atherogenicity index in patients with excess body weight (respectively 3.4±1.3 versus 3.1±1.4; p<0.05). Among patients with AH and overweight or obesity compared to patients with normal body weight, significant differences have been revealed about the frequency of complications of targetorgans (AH stage II was 2 times more common among patients in the II group). Glycemia level on empty stomach was higher in patients with overweight (5.5±1.8 mmol/l versus 4.8±0.8 mmol/l; p>0.05) and 3 times more common among patients in the I group (35.6 % versus 11.5 % of patients; p<0.05). Hyperuricemia was found in 48 % of patients. In patients with normal BMI, the level of uric acid was within reference values (p=0.015).\u0000In 27 % of patients with overweight the increased IL-10 was determined, in 45 % – IL-1β, while in patients with normal BMI these indicators were normal (p<0.05).\u0000Patients with AH had increased levels of anxiety, and patients with excess weight had a risk of depression.\u0000Conclusions. The results of the study showed that there is a clear association of increased blood pressure (BP) with weight gain. Patients with AH and high body mass index (BMI) had additional risk factors that can cause high BP and require personalized treatment.\u0000Excessive body weight causes an acceleration of the development of target organs (1.5 times more often), in particular increases the risk of progression of systolic and diastolic dysfunction of the left ventricle and sudden cardiac arrest, leads the development of atherosclerosi","PeriodicalId":364588,"journal":{"name":"Family medicine. European practices","volume":"117 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129054814","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":"Effectiveness of Differentiated Hepatotrophic Therapy in Complex Management of Patients with Comorbidity of Chronic Pancreatitis and Chronic Viral Hepatitis С","authors":"H. Khomyn, Liliia Babinets","doi":"10.30841/2786-720x.4.2022.274662","DOIUrl":"https://doi.org/10.30841/2786-720x.4.2022.274662","url":null,"abstract":"An important problem of the combined course of chronic pancreatitis (CP) and chronic hepatitis C virus (HCV) is the study of the effects of chronic HCV, even after the treatment, in particular for the condition of the pancreas and liver in patients with CP. Often hepatotrophic therapy is used for this purpose, which should be differentiated depending on the needs of patients with comorbidity of CP and chronic HCV.\u0000The objective: to analyze the functional and structural condition of the pancreas and liver in patients with CP after the chronic HCV treatment by the proposed complex treatment with additional inclusion of hepatotrophic drugs.\u0000Materials and methods. 80 patients with a combined course of CP and chronic HCV were examined. According to the methods of treatment the patients were divided into three groups. The 1st group included 20 patients with CP and chronic HCV, who received a common complex for treatment (CCT) by protocol for 3 months. In the 2d group 25 patients with CP and chronic HCV received CCT with additional inclusion of hepatotrophic agent for 3 months. The 3d group included 35 patients with CP and chronic HCV with CAGE≥2.0, who took CTC with additional inclusion of hepatotrophic agent for 3 months and metadoxine for 3 months.\u0000Results. The more significant level of efficiency of therapeutic complex with the additional inclusion of hepatotrophic agent was determined when metadoxine was prescribed. It was found that the content of fecal α-elastase increased by 19.6 %, 37.5 % and 66.9 %, glucose level decreased by 13.4 %, 11.0 % and 28.4 %, glyconized hemoglobin – by 12.3 %, 22.1 % and 25.8 %, HOMA index – by 16.3 %, 21.9 % and 56.0 %, coprogram score – by 12.8 %, 18.3 % and 88.7 %, the total index of the pancreas structure – by 7.2 %, 15.1 % and 85.7 %, and the total indicator of liver structure – by 11.7 %, 17.5 % and 44.7 %, respectively in groups (p<0.05).\u0000It was established that the inclusion of the hepatotrophic medicine in the standard therapy of CP with chronic HCV improved the results of treatment for the restoration of the functional and structural condition of the pancreas.\u0000Conclusions. The additional prescription of the hepatotrophic agents combination significantly increased the effectiveness of treatment according to the dynamics of the functional capacity of pancreas and restoration of its structure (p<0.05). It was confirmed that a complex medical program with additional use of polysubstrate hepatoprotector exceeded the efficiency of the protocol treatment for the structural condition of the liver by 36.0 %, and with a combination of hepatotrophic agents – by 51.9 %; regarding the pancreas condition – by 22.3 % and 38.3 %, respectively (p<0.05). The combined use of hepatotrophic agents was also more effective than monotherapy with one drug.","PeriodicalId":364588,"journal":{"name":"Family medicine. European practices","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125373453","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":"Efficiency of Complex Correction of Endotoxicosis in Chronic Pancreatitis During Renewal Treatment","authors":"Z. Sabat, Liliia Babinets","doi":"10.30841/2786-720x.4.2022.274657","DOIUrl":"https://doi.org/10.30841/2786-720x.4.2022.274657","url":null,"abstract":"Clinical manifestations and features of endogenous intoxication syndrome (EIS) in severe and critical conditions are described in the literature. EIS is one of the defining typical clinical and pathogenetic syndromes of the formation and severity of chronic pancreatitis (CP).\u0000The objective: to analyze the EIS parameters by CP in patients outside of exacerbation and their impact on the quality of patient’s life and the dynamics under the influence of the proposed treatment programs with the inclusion of ginkgo biloba drugs and bioregulatory therapy.\u0000Materials and methods. 100 patients with diagnosis of CP who had outpatient treatment took part in the study. The age of the patients ranged from 25 to 73 years old, the average age was 51.0±1.1 years. EIS was determined based on the concentration of medium molecular weight peptides with maximum absorption at the wavelength 254 nm and 280 nm and circulating immune complexes. Patients’ quality of life was assessed using the SF-36 questionnaire.\u0000The patients were divided into three 3 groups. The persons in the 1st group (n=34) received generally accepted treatment (GAT) in accordance with the clinical diagnosis and the protocol proposed by the Ministry of Health of Ukraine (Order No. 638 of 09/10/2014), the patients in the 2nd group (n=33) received GAT together with a course of ginkgo biloba (memoplant), the individuals in the 3rd group (n=33) received the GAT with a course of memoplant and bioregulatory therapy (BRT).\u0000Results. In the examined patients with CP a decrease in all indicators of the quality of life according to the SF-36 was found, the parameters of the role (33.7±3.4) and emotional (37.0±3.9) functioning scales decreased mostly, the average value of physical health was 51,1±7.2, psychological one – 45.1±3.9. An increase in EIS indicators was determined, which were reliably correlated with indicators of quality of life. In the patients who received GAT and ginkgo biloba the more significant dynamics of EIS regression were established at the levels of the studied indicators, however, their normalization to the control level was observed only in the 3rd group of patients who received an additional course of BRT (p<0.001).\u0000Conclusions. The results of the study determined a negative impact of EIS on parameters of quality of life according to the SF-36 in patients with CP, which justifies the necessity for the correction.\u0000A more severe EIS according to the levels of the studied indicators was found among people with excessive and reduced body weight (p<0.05), which indicates a more severe course of the inflammatory process. According to the dynamics of EIS the indicators in patients with CP it is possible to claim a higher efficiency of therapy with additional prescription to the generally accepted treatment of ginkgo biloba and a course of bioregulatory therapy.","PeriodicalId":364588,"journal":{"name":"Family medicine. European practices","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126222319","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":"Microbiome and Leaky Gut Syndrome as Extra-articular Factors for Rheumatoid Arthritis","authors":"V. Chernyavskiy, Mariia Postemska, D. Reshotko","doi":"10.30841/2786-720x.4.2022.274650","DOIUrl":"https://doi.org/10.30841/2786-720x.4.2022.274650","url":null,"abstract":"Rheumatoid arthritis (RA) is an autoimmune disease characterized by chronic inflammation of the joints and causes damage to cartilage and joints. Not only genetic factors but also environmental factors are involved in the development and progression of this disease. In particular, diet has a significant impact on the development and course of the disease. Therefore, the question of the impact of changes in the intestinal microbiome in patients with RA is relevant and debatable. Scientific evidence in recent decades suggests that dysbacteriosis affects the chronic inflammatory response in RA and can be modified.\u0000The next issue in the development and progression of RA is the integrity of the intestinal barrier. According to the latest scientific findings, changes in the intestinal barrier are one of the key factors in the pathogenesis of RA. The study of intestinal barrier damage has found the protein I FABP, which is a promising marker of change in intestinal permeability in patients with RA.\u0000Today, a large amount of data has been collected and new approaches to modification of the above aspects of RA pathogenesis are being investigated. In combination with standard therapy, they can potentially reduce the intensity of symptoms and ensure long-term remission. Changes in diet, addition of probiotics, products of bacterial metabolism (for example, butyrate), have a positive effect on disease activity. The addition of larazotide, a drug that affects the integrity of dense joints, can be used in the treatment of patients with RA.\u0000This article shows the prospects of modification of the microbiome and intestinal permeability in the treatment of patients with RA. Due to the limited amount of data, this area needs further research.","PeriodicalId":364588,"journal":{"name":"Family medicine. European practices","volume":"100 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132260641","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":"Cellular and Humoral Disorders of the Immune System at Osteoarthritis with Comorbidity of Exocrine Pancreatic Insufficiency","authors":"I. Halabitska, Liliia Babinets","doi":"10.30841/2786-720x.4.2022.274646","DOIUrl":"https://doi.org/10.30841/2786-720x.4.2022.274646","url":null,"abstract":"The objective: to study the change in immunological parameters in patients with primary osteoarthritis (OA) under conditions of comorbidity with the digestive tract (DT) diseases, accompanied by exocrine pancreatic insufficiency (EPI).\u0000Materials and methods. The study included 304 patients with primary OA in comorbidity with DT diseases, accompanied by EPI out of exacerbation. The comparison group included 30 almost healthy persons. The patients with primary OA were comparable by age, gender and course of primary OA and were divided into 5 groups by type of comorbid pathology of DT organs, accompanied by EPI: the I group (n=62) – patients with primary OA without comorbid pathology, the 2d group (n=59) – patients with primary OA in comorbidity with chronic pancreatitis (CP), the 3d group (n = 60) – patients with primary OA in comorbidity with chronic noncalculous cholecystitis and functional diseases of gallbladder and biliary system, the 4th group (n=61) – patients with primary OA and chronic gastroduodenitis, the 5th group (n=61) – patients with primary OA and type 2 diabetes mellitus (T2DM).\u0000Results. The analysis of immunological parameters in patients with primary OA indicated on the statistically significant changes in the studied indicators in all groups compared to the control group (p<0.001), which specifies immunological disorders in the patients.\u0000A statistically significant increase in the level of T-lymphocytes in all studied groups was revealed compared to the control group (p<0.001), which indicates the activation of the T-cell link in immunity in patients with primary OA.\u0000The presence of negative effects of comorbid gastroenterological diseases in primary OA on the formation of immunodeficiency was determined.\u0000Conclusions. A statistically higher level of autoimmune disorders in patients with primary osteoarthritis (OA) has been established under conditions of comorbidity with gastroenterological diseases, accompanied by exocrine pancreatic insufficiency. It is proved that the deepening and progression of autoimmune disorders in primary OA is affected by the comorbidity of the digestive tract pathology.","PeriodicalId":364588,"journal":{"name":"Family medicine. European practices","volume":"57 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129842753","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":"Effectiveness of Intestinal Lavage for the Inflammatory, Pro- and Antioxidant Processes Correction in the Treatment of Chronic Pancreatitis Therapeutic Exacerbation","authors":"Bohdan Migenko, Liliia Babinets","doi":"10.30841/2786-720x.4.2022.274654","DOIUrl":"https://doi.org/10.30841/2786-720x.4.2022.274654","url":null,"abstract":"Chronic pancreatitis (CP) is an inflammatory disease of the pancreas with periods of exacerbation and remission. Frequent long-term exacerbations lead to the destruction of the soft tissue and a decrease in its functional properties. CP is manifested by an activation of inflammation, severe pain that reduces the quality of life, the development of exocrine and endocrine insufficiency and the development of polynutrient trophologic insufficiency (PTI), which requires adequate correction.\u0000The objective: to study the dynamics of inflammatory, pro- and antioxidant parameters under the influence of the use of the intestinal lavage method in patients with the therapeutic exacerbation of CP that occurred after acute pancreatitis (AP).\u0000Materials and methods. The study included 60 patients with CP after a history of AP. Patients were divided into two groups. I group included 38 patients who received a generally accepted complex of CP treatment. II group included 22 patients, whose treatment complex included a course of modified intestinal lavage in addition to the drug therapy. The effectiveness and duration of the procedures were determined by laboratory, anthropometric and instrumental parameters of CP and PTI in the patients with CP after AP history.\u0000The processes of pro- and antioxidant disorders were studied with the determination of the content of malonaldehyde, superoxide dismutase, catalase, and SH-groups.\u0000Results. The proposed method of intestinal lavage demonstrated that its use makes possible to increase the time of intestinal lavage due to the “pulsating” supply of liquid, provides a gentle effect of washing on the intestinal mucous membrane, and prevents additional traumatization of the intestine in case of the need to administer drugs.\u0000The use of a double circuit allows to administer drugs immediately after lavage without the probe removement, and in such way to prevent the mixing and possible side effects when using several drugs at the same time.\u0000Conclusions. The study demonstrated that the higher level of effectiveness of the proposed treatment complex with the inclusion of a course of intestinal lavage compared to the protocol complex for the management of patients with a therapeutic exacerbation of chronic pancreatitis (CP) after a history of acute pancreatitis (AP) was proved.\u0000The analysis of the level of C-reactive protein proved that this parameter can be a marker of the depth of intoxication and the severity of inflammation. The use of a course of intestinal lavage procedures in the generally accepted treatment of patients with CP after the history of AP led to a decrease in pain syndrome, improvement of anthropometric parameters, coprogram indicators and normalization of pro- and antioxidant changes.","PeriodicalId":364588,"journal":{"name":"Family medicine. European practices","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130336558","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":"Scoring of Professional Longevity of Patients with Arterial Hypertension of Military Personnel – the Participants of Modern Armed Conflicts","authors":"A. Voronko, O. Selіuk, A. Buzhenko, M. Selіuk, M. Kozachok, Ivan Buzhenko, Oleksii Voronko, Liliia Dmytruk, Zhanna Buzhenko","doi":"10.30841/2786-720x.4.2022.274623","DOIUrl":"https://doi.org/10.30841/2786-720x.4.2022.274623","url":null,"abstract":"The prediction of ability for military service by the health of patients who are experienced (with war experience) military persons with arterial hypertension (AH) with existing comorbid pathology is an urgent issue of today and a component of national security.\u0000The objective: to analyze the of factors that influence on the prognosis of health service for the military service of patientsmilitary personnel with AH – the participants of anti-terrorist operation / operation of the united forces (ATO / OUF), taking into account the available comorbid pathology.\u0000Materials and methods. Medical card of 213 military personnel – ATO/OUF participants with AH and comorbid pathology were analyzed. The first group included medical cards of 126 patients with AH stage I, the second group – medical cards of 87 patients with AH stage II.\u0000Clinical and laboratory, instrumental methods of research and consultation of narrow specialists and cumulative CIRS disease scale, which provides a separate total assessment of the condition of each of the organ systems on the range of Likert scale were used.\u0000Results. During the study, the professional longevity was forecasted using program Statistica SSP 10.0 and the forecasting of professional longevity using IBM SPSS 23.0.\u0000The most important prognostic factors that affect the change in the category of suitability for military service for the health of patients with AH of military personnel – ATO/OUF participants with comorbid pathology were determined, namely: age, sum of points on the cumulative CIRS scale and stage of AH (87.0 –91.8 % of the correct classifications of generated artificial neural networks, the area index under the ROC-curve AUC 0.971–0,992).\u0000Conclusions. Based on the statistics obtained data in the construction and analysis of artificial neural networks, the “algorithm for predicting a category of suitability for military service for the health of patients with arterial hypertension of military personnel – ATO/OUF participants with comorbid pathology” was developed.","PeriodicalId":364588,"journal":{"name":"Family medicine. European practices","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115618273","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":"Analysis of Reasons for Referral and Coverage of Breast Cancer Screening of Women Who are Internally Displaced Persons: Data and Perspectives","authors":"Nataliia Ponzel, P. Kolesnyk, Daniela Petovka, Yurii Bretsko, O. Kolesnyk, Vladyslav Lazaryk","doi":"10.30841/2786-720x.4.2022.274643","DOIUrl":"https://doi.org/10.30841/2786-720x.4.2022.274643","url":null,"abstract":"Millions of Ukrainian citizens were forced to leave their homes after the Russian invasion in Ukraine. Today the activation of social, humanitarian and medical problems is determined in Ukraine. A lot of internally displaced persons (IDPs) moved to the western regions, in particular, in Transcarpathia.\u0000Thousands of patients lost their family doctors and lost the permanent medical care. The main reasons for the doctor’s consultations are the treatment and primary care of the existing diseases. Screening and the early detection of cancer is not a priority and are ignored by the patients often.\u0000However, breast cancer (BC) remains the most common disease among female population in the country. In women 18–24 years old BC is in the third place in the disease structure (10.8%), in persons 30–74 years old its rate is 27.6–20.6 %.\u0000The objective: to perform the statistical analysis of the reasons for the referral to the doctor of the IDPs and to evaluate the frequency of the referrals for BC screening.\u0000Materials and methods. 2500 visits of IDPs to the doctors were registered in the clinic “InterFamily” (Uzhhorod). The reasons for the visits, diagnosis, medical management were coded with cods from the table “ICPC-2” in Excel program on the basis of which the research was conducted.\u0000Results. 657 women who are IDPs visited the doctor, 29.8% of them were 18–39 years old, 65% – 40–74 years old, 5.2% – over 75 years old. The patients were from all the regions of Ukraine that were affected by war direct invasion. The largest number of patients were from Donetsk, Luhansk regions, as well from Kharkiv, Zaporizhzhia and Kyiv regions. The most often reasons for the doctor’s visits were recorded respiratory diseases (23.8%), cardiovascular diseases (22.0%), diseases of the musculoskeletal system (9.5%), skin pathology, digestive organs and endocrine diseases (6.7%, 6.9% and 6.1%, respectively).\u0000Only 4.5% of all women 40–74 years old who were IDPs visited the volunteer clinic for BC screening, 0.5% of women 40–74 years old who were consulted for medical care not connected with female reproductive organs, or who visited clinic for prevention care, were referral for BC screening by a family doctor.\u0000Conclusions. BC screening had only 4.5% of women that indicate the low level of doctor’s concern and, probably, insufficient knowledge of women for diagnosis of this disease. A research project to study the motivation for BC screening of patients who are IDPs and the family doctors is proposed.","PeriodicalId":364588,"journal":{"name":"Family medicine. European practices","volume":"516 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133167494","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":"Mental Health and Sleep Disorders in Obese Patients, Their Relationship with Clinical and Pathogenetic Changes in the Organism and Impact on Quality of Life","authors":"T. Bagro, V. Tkachenko","doi":"10.30841/2786-720x.4.2022.274617","DOIUrl":"https://doi.org/10.30841/2786-720x.4.2022.274617","url":null,"abstract":"In the world the problem of obesity is an important aspect in the non-infectious diseases progression. It is known, that 95% of the pathogenic factor for the obesity development depends on the changes caused by neurochemical, hormonal and metabolic mechanisms that occur by depression, anxiety, eating disorders, circadian rhythms and sleepiness.\u0000The objective: to determine the psychosocial features and their relationship with clinical and pathogenetic changes in obese patients of working age.\u0000Materials and methods. 75 patients with obesity of the 1st and 2d degrees (39.03±0.93 years old) and 75 practically healthy persons of the corresponding age (36.84±0.96 years old) were examined. Waist circumference (WC), hip circumference (HC), body surface area (BSA), waist/hip ratio (WHR), conicity index (ConI), a body shape index (ABSI), abdominal volume index (AVI), blood pressure, blood levels of glucose, insulin, index HOMA, cholesterol, lipidogram indicators, serotonin, and leptin were determined in the patients.\u0000The psychological status was assessed by Hospital Anxiety and Depression Scale (HADS), Hamilton Anxiety Scale (HAM-A), the Dutch Eating Behavior Questionnaire (DEBQ), Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), the patient’s quality of life – by 36-Item Short Form Survey (SF-36). The statistical analysis was conducted by IBM SPSS Statistics, Statistica 12, descriptive statistics Excel 2010.\u0000Results. The patients of the studied group, unlike the control group, had significantly higher indices of WC, HC, BMI, WHR, ConI, ABSI, AVI, HOMA index, blood pressure, glucose, insulin, total cholesterol, lipidogram, leptin and the lower level of serotonin. This was accompanied with clinically expressed anxiety of depression which led to eating disorders (a tendency “to eat emotions”, to overeat when food is available, a habit to eat without restrictions), sleep disorders (excessive day time sleepiness, low quality of sleep) and reduced quality of life.\u0000The results of correlation analysis indicate a strong or moderate positive correlation between obesity indices, glucose level, lipidogram, atherogenicity index, HOMA index, scores of depression and anxiety scales, as well as strong negative correlation with ABSI index, high density lipoproteins, serotonin. In addition, a positive correlation was found between leptin level and scores of depression and anxiety scales, scores of eating behavior, sleepiness, and a negative correlation was determined between these indices and serotonin level.\u0000Conclusions. The patients of the studied group (100.0 %) had abdominal obesity. Among the anthropometric indices ABSI and AVI ones were the most significant and informative for determination of abdominal obesity in gender aspect, this can be an alternative for MRI diagnosis of visceral obesity at the level of primary medical care.\u0000A close relationship between abdominal obesity with psycho-emotional disorders, disorders of sleep and eat behavior, m","PeriodicalId":364588,"journal":{"name":"Family medicine. European practices","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133578264","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":"Interdependence Between Body Weight, Depth of Inflammation and Functional Capacity of the Pancreas in Patients with Primary Osteoarthritis and Type 2 Diabetes","authors":"Liliia Babinets, I. Halabitska","doi":"10.30841/2786-720x.3.2022.273914","DOIUrl":"https://doi.org/10.30841/2786-720x.3.2022.273914","url":null,"abstract":"Osteoarthritis (OA) is the most common joint disease and the leading cause of disability. OA not only affects the quality of life and shortens the functionally active period, but also increases mortality due to the progression of comorbidities, such as obesity, insulin resistance, type 2 diabetes (T2DM), cardiovascular disease.\u0000The objective: to identify pathogenetic links between OA and T2DM in order to improve the approach to diagnostic and treatment.\u0000Materials and methods.Patients with primary OA and T2DM without exacerbation were divided into three groups according to body mass index (BMI): Group I – 33 patients, Group II – 35 patients, Group III – 34 patients. The mean age of the patients was 61.57±7.97 years (from 29 to 68 years). All patients with comorbidity of T2DM and OA were comparable according to clinical, gender criteria, severity of comorbid pathologies and received treatment. The control group included 30 healthy people.\u0000Results. A statistically significant increase in the level of ESR was found in all studied groups compared to the control group (р<0.05). During the analysis of the CRP level in the studied groups, a statistically significant increase in the level of this indicator was found with increasing BMI (р<0.05). A statistically significant progression of T2DM with increasing BMI was recorded for all indicators (р<0.05). A statistically significant increase in total WOMAC index and VAS index with increasing BMI (р<0.05) was established, which indicates the progression of primary OA in comorbidity with T2DM with increasing BMI.\u0000The obtained data demonstrated the clinical significance of body weight increase, the accumulation of adipose tissue, and the deepening of the functional insufficiency of the pancreas for the progression of joint and pain syndromes in OA on the background of T2DM.\u0000Conclusions. The results of the study showed a statistically significant increase in the manifestations of low-intensity inflammation and the progression of incretory and excretory insufficiency of the pancreas with an increase in the body mass index in patients with primary osteoarthritis (OA) and type 2 diabetes mellitus (T2DM). The interdependence of the inflammatory syndrome with the accumulation of adipose tissue and the deepening of obesity in patients with comorbidity of OA and T2DM has been proven. It is necessary to continue further studies of osteoarthritic changes in the joints in T2DM patients, to develop diagnostic schemes and drug therapy for the combined course of these diseases.","PeriodicalId":364588,"journal":{"name":"Family medicine. European practices","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117113672","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}