Кафедра внутрішніх та професійних хвороб
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Browsing Кафедра внутрішніх та професійних хвороб by Author "Melenevych, Anastasiia"
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Item Desaturation and IL-18/IL-10 ratio as prognostic predictors for adverse right ventricular remodeling(2021-09) Melenevych, Anastasiia; Melenevych, OlgaAdverse right ventricular (RV) remodeling leads to heart failure that represents an important determinant of outcome in patients with hypertension (HT) combined with chronic obstructive pulmonary disease (COPD). Chronic hypoxia and systemic inflammation contribute to tissue destruction and disruption normal repair and defense mechanisms, resulting in pulmonary vascular remodeling and pulmonary hypertension. We found that desaturation is associated with inflammatory activation and contributes to right heart chambers overload. The cut off level of IL-18/IL-10 ratio 26.64 is an independent prognostic predictor for RV pressure overload in patients with HT stage II in combination with moderate COPD.Item Diseases of internal organs in combat surgical trauma and injuries in catastrophes and accidents in peacetime. Diseases caused by exposure to thermal factors (heat and cold)(2022-12) Martovytskyi, Dmytro; Melenevych, Anastasiia; Molotyagin, DmytroThe evolution of firearms has a peculiar phasing, inevitably associated with the views and techniques of treating gunshot wounds. The invention of cartridges, multiply charged automatic weapons, pointed cartridges, bullets that easily unfold or flatten in the human body (which are prohibited by the III Declaration of the Hague Convention of 1899), leaving no chance for the enemy, led to the emergence of such a science as wound ballistics. Frostbite is considered a frequent companion of wars, sometimes it has the character of an epidemic and occupies a significant share in the structure of sanitary losses. Mostly the fingers of the upper and lower extremities, ears, nose, and sometimes the external genitalia are frozen. According to military and peacetime statistics, frostbite of the lower extremities predominates. Hyperthermia is a pathological condition of the body that occurs as a result of a violation of thermoregulation and / or the action of external heat.Item Gender differences in exercise capacity and left ventricular geometry among patients with comorbid pathology – hypertension with chronic obstructive pulmonary disease(2023-09) Melenevych, AnastasiiaHypertension (HT) and chronic obstructive pulmonary disease (COPD) are one of the most common comorbid pathologies associated with the risk of cardiovascular events. As long as the ejection fraction (EF) remains preserved, it is quite challenging to establish signs of heart failure. Dyspnea and exercise intolerance in COPD can mask reduced heart function, especially in hypertensive patients. Our aim was to assess gender differences in exercise capacity using 6-min walk test (6MWT) and left ventricular (LV) geometry among patients with HT and COPD. We found that dyspnea level before and after the 6MWT, drop in SpO2 during the 6MWT as well as the distance walked in the 6MWT showed no significant (p > 0,05) gender differences. LV systolic function was preserved in all patients (EF > 55 %). LV diastolic function echocardiographic parameters didn’t show significant differences between men and women. At the same time, we found that all women had unfavorable types of LV geometry (concentric and eccentric hypertrophy), concentric hypertrophy was predominated. All four types of LV geometry were found among men. Thus, despite the lack of differences in clinical and functional data by gender, the predominance of LV concentric hypertrophy in women was reliably established among the patients with HT and COPD.Item A modern view on hyperkalemia’s management(2023-10) Melenevych, Anastasiia; Dwivedi, AnanyaThe study demonstrated that sodium polystyrene sulfonate (SPS) and calcium polystyrene sulfonate (CPS) have dominated the management of hyperkalemia over 6 decades after being approved by the United States Food and Drug Administration (FDA) in 1958 because of their long term effi cacy but due to their affi liation with gastrointestinal side effects their usage has been insubstantial or limited. Earlier SPS was thought to work effectively for constipation along with sorbitol but later FDA found it to be causing colonic necrosis and increased mortality. CPS was useful in patients with high sodium load but there were cases with increased vascular calcifi cation. So, eventually in 2009, the FDA prohibited their long-term use for hyperkalemia. The shortcomings led to the development of “new generation” potassium binders including - patiromer and sodium-zirconium cyclosilicate (SZC / ZS-9). In clinical studies patiromer was found to be well tolerated and reduced hyperkalemia in patients with diabetes mellitus, chronic kidney disease, heart failure, hypertension to enhance cardiovascular and renal outcomes and also in patients on renin-angiotensin-aldosterone system inhibitors (RAASi) therapy. Cochrane reviews were conducted three times (2005, 2015, and 2020) for comparison of “old generation” potassium binders with the new generation” potassium binders however, from the point of view of safety, preference was given to the “new generation” potassium binders.Item Radiation damage. The concept of radiation injury, medical care at the stages of medical evacuation. Acute radiation sickness. Stage treatment of patients with acute radiation sickness. Atypical forms of radiation sickness : methodical instructions for the 5th year students to the practical class(2022-12) Shelest, Borys; Martovytskyi, Dmytro; Melenevych, Anastasiia; Molotyagin, DmytroKnowledge of the effects of ionizing radiation on humans, measures to protect against them, and treatment of victims is the best antidote to fear. It is important to imagine the point where radiation becomes really life threatening. The urgency of the problem is connected not only with the adverse effects of radioactive radiation on the body of professionals who are systematically exposed to additional radiation in the course of work, but also with the study of the consequences of radioactive contamination of the area. The area of radionuclide contamination is quite large as a result of the Chernobyl explosion. In addition, there are cases of safety violations when working with radioactive substances, which leads to pathological changes in the civilian population.Item Which patient characteristics are associated with exerciseinduced desaturation in COPD combined with hypertension?(2023-10) Melenevych, AnastasiiaWe analyzed associations between various patient characteristics and exercise-induced desaturation in chronic obstructive pulmonary disease (COPD) combined with hypertension. We found that the male sex, dyspnea, fatigue, the distance walked in the 6-min walk test, BODE index, quality of life (assessed using a Clinical COPD Questionnaire) are associated with exercise-induced desaturation in patients with COPD combined with hypertension stage II.