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

13-17

Authors: S. А. S. Belal, A. L. Kulik, A. V. Martynenko, M. I. Yabluchanskiy

On 14 healthy volunteers (6 men and 8 women) aged from 21 to 27 years the effectiveness of biofeedback in the loop of paced breathing and heart rate variability (HRV) parameters in different race groups was examined. All volunteers were divided into 2 groups comparable in age and sex: 1 — representatives of the South Europeoid race, 2 — representatives of the Medium Europeoid race. Each volunteer underwent 7 bio¬feedback sessions in the studied loop. It was found that in the beginning in representatives of the South Europeoid race biofeedback quality index was lower than that in representatives of the Medium Europeoid race, but both of them was located in the suboptimal zone. Biofeedback in the loop of paced breathing and HRV parameters has the same positive effect on the representatives of both races, that allows to recommend it for correction of regulation balance in each of them.

23-31

Authors: M. P. Kopytsya, N. V. Tytarenko, N. V. Bila, O. L. Oparin

The aim of this study was to define the utility of the measurement N-terminal pro-brain natriuretic peptide (NTproBNP) and other clinical and biochemical markers to predict adverse events (death, stroke, unstable angina, re-infarction, or necessity of revascularization at 1 year in patients with acute coronary syndrome (ACS). Parameters with significant differences in patients with and without complications were taken for ana-ly¬sis: age, heart rate (HR) at admission, levels of hemoglobin and NTproBNP. Curves of sensitivity and spe¬ci-fi¬city were used based on the method of ROC analysis and cut-off values were chosen for each variable. Ball scoring was performed for each parameter regard to the cut-off value and a scale for calculating the summarized diagnostic coefficient (DC) by the method of Gubler was offered. A multimarker approach includ¬ed on NTproBNP, hemoglobin, HR at admission and age and the summation of balls based on offered sca¬le and calculating DC provides in¬formation in terms of ACS prognosis at 1 year, with a worse outcome for those with diagnostic coefficient has negative value (sensitivity 87,5 % and specificity 75,6 %).

38-41

Authors: T. М. Pasieshvili

In patients with asthma and obesity studied the performance of proinflammatory cytokines ТNF-α and IL-6 and lipid profile. It is shown that the active inflammatory process in the broncho-pulmonary system leads to a significant increase of the TNF-α and IL-6, which is due not only inflammation, but also the additional generation of adipose tissue. Lipid profile of these patients is characterized by the formation of the most atherogenic lipoproteins voices, which is considered as an adverse factor in the formation of metabolic disorders.

52-62

Authors: О. E. Tominа, O. Yu. Bichkova, G. M. Fomych, O. O. Ivleva, О. O. Ohriamkina, N. Yu. Usan

In out-patient conditions patients with hypertension were investigated (n = 141): of which the core group consisted of 41 patients with hypertension (H) comorbid with peptic ulcer (PU); the comparison group 1 con-sisted of 58 patients with isolated H and comparison group 2 consisted of 42 patients with isolated РU. The frequency of circadian rhythm (CR) of systolic blood pressure (SBP) and heart rate variability (HRV) were studied, including taking into account the different types of CR SBP. Three types of CR SBP (dipper, non-dipper, knight-peacker) with a prevalence of pathological (45 % of non-dipper, 15 % of knight-peacker) CR SBP are characterized. Low Total Power (TP HRV) (1203 ms2 ± 852) with the lowest values in the group with knight-peacker CR SBP (839 ± 462 ms2), and there is a significant removal of simpatovagalnogo balance (LF/HF) in the sympathic direction (3,3 ± 2,6) due to the non-dipper CR SBP (5,3 ± 2,6). Violation of or-thostatic reactions is observed from the side of TP HRV (increase on 44,8 %) in the dipper CR SBP, and the test with modulated breath (decrease on 47,2 %) from the side of the LF/HF in the non-dipper CR SBP.

69-73

Authors: M. І. Shevchuk, N. І. Yabluchansky

This article was to examine the relationship between of the QRS complex duration and clinical manifesta-tions of arterial hypertension (AH). Relationship between the QRS complex duration (QRSD) and clinical manifestation of disease was studied in 130 patients (53 males and 77 females) mean age 65 ± 10 years with AH 1–3 degrees, and I–III stages. Estimated age, sex, prescription of hypertension, blood pressure (BP), heart rate class, the severity of heart failure, left ventricular ejection fraction (LVEF), acute myocardial infarction in the anamnesis (AMI), stroke in the anamnesis. Registration of the QRS complex was carried out on a com-puter electrocardiograph «Cardiolab+». In study population the range of QRSD was on five groups: 60–99 ms, 100–119 ms, 120–139 ms, 140–159 ms, > 160 ms. Evaluation of results by methods of parametric sta¬tis¬tics. Of these patients, 54 % had QRS complexes > 120 ms, shortened QRS complexes were absent. Distri¬bu¬tion of QRSD was asymmetric with a shift toward smaller values. Relationship QRSD in patients with AH was with its remoteness, the level of blood pressure, heart rate class, the severity of heart failure, reducing the degree of LVEF. Established the important role of the QRSD in clinical manifestations of hypertension. The degree of change in the QRSD should be used as a marker of the effectiveness of antihypertensive therapy.

81-90

Authors: N. V. Lysenko, A. Y. Kartvelishvili

Presented clinical pharmacology of biological products under the ATC classification system. The classifi-cation, characteristics of pharmacodynamics of drugs. An algorithm for the use of biological agents in thera-peutic practice: rheumatology, gastroenterology, neurology. Examined in detail the absolute and relative con-traindications and side effects of biological agents, as well as control measures in their long-term use.

99-104

Authors: N. V. Chuchula, E. N. Chuchula

Local anesthesia for the patient’s general condition is the most important dental procedures. This article pre¬sents the classification and overview of integral components of modern local anesthetic drug. Represented the classification of local anesthetics, the absolute and relative contraindications and characteristics of use according to concomitant somatic pathology of the patient. Characteristics, the use in risk groups and contraindications of complex corpular components of modern local anaesthetic preparations are presented.

109-112

Authors: N. N. Popov, A. N. Savvo, O. V. Piontkovsky, N. I. Timokhina, E. A. Dyachenko

Children are often treated in non-core healthcare establishments and receive consultation of a pediatric immunologist too late when they already suffer from irreversible changes in various organs and body systems. For the main purpose to expand practical doctors’ knowledge about humoral immunity primary immunodefi¬ciencies (PID) description of two cases of hypogammaglobulinemia in children (boys) aged 10 years is provided though clinical manifestation of the disease began in the early childhood. It was shown that proper diagnostics of PID allows providing adequate substitutive therapy and preventing children disability.

121-126

Authors: K. I. Reminskaya, L. O. Martymianova

The clinical pharmacology of thyroid hormons in the classification system of ATS is described. Clinical classification, pharmacokinetics and peculiarities of drugs of this groupare submitted. Indications for use and features of use of thyroid hormons in a therapeutic clinic are considered.The article points out the urgency of use of these drugs curing hypothyroidism (any genesis), preventing the recidivation of nodular goiter. The primary contraindications, emphases of interaction with other drugs, side effects and symptoms of over-doseare given.

10-21

Authors: A. N. Yabluchanskiy

Hemorrhagic stroke in response to intracerebral hemorrhage is considered an aseptic form of inflammation. With this in mind the dynamics of leukocytes changes in blood and in the hemorrhagic stroke zone as main factors of inflammation are examined. Sprague-Dawley rats (N = 24) underwent surgical procedures and were divided into two groups — control group and a hemorrhagic stroke group — an injection of 2 µL of sterile saline and 2 µL of 0,2U of Collagenase-IV (S) respectively. White blood cells count analysis, combined histological and immunohistological examination with further densitometric and statistical analysis of blood and hemorrhagic stroke zone leukocytes were performed. A synchronized increase in blood and hemorrhagic stroke zone levels of both polymorphonuclear and mononuclear leukocytes was observed, highlighting the inflammatory nature of hemorrhagic stroke. A delay of 48 hours between peak levels of polymorphonuclear and mononuclear leuokocytosis both in blood and the hemorrhagic stroke zone was established. Therefore, understanding hemorrhagic stroke as one of the forms of aseptic inflammation suggests alternate perspectives in the development of new approaches to diagnosis and treatment including interventions into kinetics of blood and hemorrhagic stroke zone leukocytes.

29-33

Authors: N. M. Zheleznyakova

The article deals with aspects of quality of life of patients with isolated COPD and combined with chronic pancreatitis (CP). Quality of life was assessed with general medical (SF-36 questionnaire) and specialized respiratory (St. George’s Hospital Questionnaire — SGRQ) questionnaires quality of life. It was found that the accompanying CP has a negative effect on quality of life of patients with COPD.

39-45

Authors: O. O. Lutsak, L. P. Parashchenyuk, P. M. Babych, L. G. Voronkov

Total score of standardized CHF-specific QOL survey MLHFQ, as well as it changes during treatment allow to foresee in approximation chances for survival in the patients with CHF of III–IV NYHA functional over the following 6 and 12 months of treatment. Total MLHQL score exceeding 72 (HR = 2,64) is an infor-mative predictor of patients’ with manifested CHF non-survival over the following 6 months. Total MLHQL score exceeding 69 (HR=2,34) is an informative predictor of patients’ with manifested CHF non-survival over the following 12 months. Increase in the total score in > 2,5 is a predictor of patients’ with clinically mani¬fested CHF over the following 6 months (HR = 4,97) and 12 months (HR = 3,50).

50-56

Authors: A. V. Muzhichuk

On base of a comprehensive survey of 248 patients with different thyroid pathology, artificial neural network has been created. Its task was to predict the possibility of cancer risk in patients with thyroid benign pathology. Neural network training based on the data of surveys carried out 120 patients, testing according to 128. Trained artificial neural network is highly flexible with regard to the different variants of the background benign pathology and capable with high sensitivity (89,5 %) and specificity (80,3 %) forecast the existence of hidden currents or probability of occurrence in future thyroid cancer in patients with benign pathology.

65-71

Authors: N. P. Kopitsa, Ya. V. Gileva, N. V. Belaya

Vascular inflammation plays a key role in atherogenesis. In this regard, in cardiology for clinical evaluation of patients are widely being used biomarkers reflecting inflammation in the organism, as their increasing is associated with an increased risk of cardiovascular disease development. Determining of the level of one of these biomarkers — lipoprotein-associated phospholipase A2 (Lp-FLA2) along with the already widely used C-reactive protein promises to significantly improve the detection of high-risk patients especially in acute coronary syndrome, as well as to assess the adequacy of therapeutic strategy.

88-101

Authors: M. I. Shevchyk, L. A. Martimyanova, N. I. Iabluchanskyi

This review discusses the importance of the QRS complex duration in patients with hypertension. QRS complex of ECG reflects the functional state of the myocardium — isovolumetric contraction and systole de-fining the entire follow-up of the heart. The change in QRS complex duration of hypertension is an important marker for early detection of ECG myocardial hypertrophy, the risk of arrhythmias, ECG changes the picture when combined with concomitant diseases and conditions, the effectiveness of antihypertensive therapy.

105-111

Authors: V. A. Strikhar, A. N. Fomich, N. I. Yabluchansky

An example of the clinical case demonstrates a significance of the correct diagnosis and treatment of is-olated diastolic arterial hyper-and hypotension in patient with sympathetic distress and atherosclerosis. Research methods comprised lipid profile, heart rate variability, blood pressure monitoring and Holter ECG. The crucial role in the treatment of the patient belonged to biofeedback and medical therapy with atorvasta-tin and cinnarizine.