The Journal of V. N. Karazin Kharkiv National University. Series «Medicine»

6-11

Authors: Chernuskyi V. H., Popov M. M., Letiaho H. V., Hovalenkova O. L., Kashina-Yarmak V. L., Yevdokymova T. V., Gurova O. A.

The aim of the work was to evaluate the effect of immunomodulation therapy on factors of nonspecific immunity in children with bronchial asthma (BA) by including interferon (cycloferon) in a standard therapy. 120 children with BA aged from 5 to 14 were examined. The main group (n = 60) included children who, in addition to basic therapy, received an interferon inducer (cycloferon) according to the generally accepted scheme. In comparison group were children who received only basic therapy (n = 60), depending on the severity of the disease. In control group were 25 healthy children. The level of serum interferon, virus-induced interferon production (VII), mitogen-stimulated production of interferon (MSI), phagocytic activity of neutrophils, as well as spontaneous and induced activity were determined. The arithmetic mean (M) and the absolute value error (m) were statistically calculated. The reliability of the differences was determined by the t-test of the Student (p < 0,05). The analysis of the indices of interferon status and phagocytic activity, depending on the type of therapeutic tactics, showed that as a result of the inclusion of cycloferon in the baseline, there was a significant increase in the levels of VII (p < 0,05) and MSI (p < 0,05 ), spontaneous and induced neutrophil activity. It was noted that this positive effect was more noticeable in moderate and severe BA (p < 0,05). Activation of factors of nonspecific protection contributed to a decrease in the frequency of exacerbations of BA in children, as well as a longer-term clinical remission in this contingent of children.

16-22

Authors: Gorantla S. G. B. K., Petrenko O. V., Martynenko O. V.

Violation of functioning of the autonomic nervous system is an important factor in the formation and progression of arterial hypertension (AH). Abnormal nocturnal blood pressure (BP) reduction is regarded as an independent prognostic factor for cardiovascular complications in patients with AH. One of the possible factors that determine the violation of BP circadian rhythm can be imbalance of different parts of autonomic nervous system. The aim of our study was to study heart rate variability (HRV) in patients with AH, dependently of BP profile. 72 patients with AH were examined. Average age was 57 ± 11 years. All patients underwent ambulatory BP (ABPM) and ECG monitoring. To define the daily profile the nocturnal BP dip was quantified and for HRV evaluation the frequency analysis method was used. HRV changes in patients with AH present with reduced total power and with a violation in the ratio of the powers of very low, low and high frequencies, enhanced sympathycotension and influence of humoral factors. Violations of systolic BP (SBP) daily profile was mainly characterized by an increase in the power of low frequency waves, which indicates an intensification of sympathetic and decreased parasympathetic influences. Violations of diastolic BP (DBP) daily profile were mainly characterized by a relative increase in the power of very low frequency waves. The obtained results showed that in the management of patients with AH it is important not only to control the circadian SBP and DBP profiles, but the evaluation of HRV also.

27-33

Authors: Petyunina O. V.

Depression after AMI increases the frequency of re-hospitalization because of acute coronary syndrome, heart failure, MI, and is a risk factor for cardiac arrest and death. The objective of the study was to define the influence of anxiety-depressive disorders (ADD) on afterinfarction remodeling and the participation of sST2 fibrosis factor in this process. 100 STEMI patients were enrolled to the study, 81 (81 %) male and 29 (29 %) female, of average age of 58,94 ± 10,16 years. Examinations were performed twice: during 1–3 days after PCI with infarct-related artery stenting and included clinical-anamnesis data, blood analyses. The sST2 level was defined by immune-fermentative method with usage of «Presage ST2 Assay», Critical Diagnostics, USA. For ADD objectivization, HADS (Heart Anxiety and Depression Scale) and Teylor questionary were used. In 6 month 6-minute walk test and the volume fraction of interstitial collagen (VFIC) were done. Conclusion: ADD in patients with STEMI aggravates the course of postinfarction period and entails the progression of fibrotic-hypertrophic processes and corresponding remodeling of myocardium, decrease of physical tolerance.

40-44

Authors: Tymoshenko O. S., Yabluchansky M. I.

60 patients with difficult-to-control arterial hypertension (DTCAH) were examined (average age is 59.0 ± 9.4 years). The changes in blood pressure (BP) and parameters of heart rate variability (HRV) during biofeedback sessions (BFB) in loop of paced breathing (PB) in patients with DTCAH on the background of standard drug therapy were assessed. It has been established that the systematic sessions of BFB in loop of PB in patients with DTCAH allow to increase the total power of the HRV spectrum, VLF and HF, and also improve control of BP. BFB in loop of PB can be recommended as an adjunctive method to the standard drug therapy for patients with DTCAH.

49-54

Authors: Ben Abdallah M. R., Golubkina E. A., Silenko I. Y., Yabluchanskiy M. I.

A clinical case of elderly female patient diagnosed with Weber-Christian disease developed on the background of long standing chronic autoimmune thyroiditis with impaired function of the thyroid gland (hypothyroidism) and unstable hormonal status, after surgery (hysterectomy, oophorectomy).

59-62

Authors: Kaminsky S. V., Sinichenko E. S., Martymianova L. O., Rybchynskyi S. V.

On the example of a clinical case of atrial fibrillation (AF) in a young patient with a myocardial bridge (MB) were considered anatomical and physiological features, diagnostics, differential diagnosis of AF, and the setting of a clinical diagnosis. Recommendations for the modification of the lifestyle, as well as the tactics of medication, are described.

67-70

Authors: Kulik Y. E., Martymianova L. O., Rybchynskyi S. V., Kartvelishviliy H. Yu.

The issues of etiology of development of cardiac changes in renal dysfunction, diagnostics and establishment of clinical diagnosis are reviewed as illustrated by a clinical case. Recommendations on lifestyle modification and medicament treatment tactics are described.

76-80

Authors: Makharynska O. S., Doroshenko O. V., Rahul M.

Massive pulmonary thromboembolism is presented in this article on example of clinical case. Clinical investigation, prognosis evaluation tools, diagnosis and acute phase treatment along with prevention of recurrent episode of pulmonary embolism presented. Observed and described clinical case of pulmonary embolism in older patient, when patient was mistakenly diagnosed in emergency department as acute coronary syndrome patient.

86-90

Authors: Nsikak-Abasi M. D., Kornieieva K. I., Stehnyi D. I., Lebedinska M. M.

Anemia is common comorbidity in patients with heart failure. In Europe one in two patients with chronic heart failure has iron deficiency. Iron deficiency anemia is associated with a worse prognosis in the heart failure patient population and is an independent risk-factor for mortality, poor exercise capacity and low quality of life.

95-98

Authors: Streliana I. A., Brynza M. S., Volkov D. E., Lopin D. O.

Changes in heart rate variability (HRV) before and after catheter radiofrequency ablation (RFA) of pulmonary veins in paroxysmal atrial fibrillation (AF) are considered at an example of clinical case. Initially low HRV in patients after ablation halved, which can lead to increased frequency and extension of AF paroxysms. In the accompanied medication, which included bisoprolol, valsartan, atorvastatin and rivaroxaban, to increase HRV were proposed increasing the dose of bisoprolol or search for more effective beta blocker.

102-106

Authors: Zolotarova T. V., Abu Rabia S., Brynza M. S., Volkov D. E.

Catheter ablation of the pulmonary veins is the method of choice for the treatment of patients with symptomatic paroxysmal atrial fibrillation (AF). However, there are may be complications or recurrence of AF paroxysms and as we have described in our clinical case 2 after ablation really important to conclude that ablation does not eliminate drug therapy, but modifies it.

119-128

Authors: Falade A. S., Belal S. A. S., Liuta E. A., Litvin A. S.

The lecture presents modern data on acute lymphoblastic leukemia as the one of the most common malignant disease of children, youth and the elderly. The data on the major risk factors, causes, pathogenesis, clinical manifestations, as well as the main approaches to the diagnosis and treatment of this disease and possible predictions for patients in different clinical situations are described.