Наукові роботи молодих вчених. Кафедра внутрішніх та професійних хвороб
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Browsing Наукові роботи молодих вчених. Кафедра внутрішніх та професійних хвороб by Author "Melenevych, Anastasiia"
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Item Dental aspects of cardiometabolic health(2023-03) Assaad, Salma; Melenevych, AnastasiiaCardiometabolic (CM) disorders are directly associated with adverse outcomes such as ischemic heart disease and stroke, which occupy the first two places in the structure of mortality worldwide according to World Health Organization data from December 2020. Recently, a lot of scientific data is emerging regarding the relationship between oral health and CM health. Mutual aggravation is observed – CM disorders, mainly hyperglycemia, insulin resistance, cardiovascular diseases with inadequate control of blood lipids and blood pressure contribute to poor oral health, and oral diseases, in its turn, such as periodontitis aggravate CM pathology by maintaining systemic inflammation.Item Diagnostic and prognostic role of markers of immune inflammation in chronic obstructive pulmonary disease in combination with hypertension(2016) Melenevych, AnastasiiaCurrently 210 million people have chronic obstructive pulmonary disease and it is predicted to become the third leading cause of death worldwide by 2030. In 2008, worldwide, approximately 40% of adults aged 25 and above had been diagnosed with hypertension. We have analyzed the most significant factors associated with increased cardiovascular risk in patients with COPD.Item 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 Practically significant innovations in GOLD 2011 guidelines for diagnosis, management and prevention of chronic obstructive pulmonary disease(2012) Melenevych, Anastasiia; Kalmykov, Oleksiy; Chernyakov, P.; Yasin, Abdul KarimOne of actual practical and scientific problems in general medicine and especially pulmonology is development of chronic obstructive pulmonary disease (COPD). Aim of the investigation was to reveal practically significant innovations in Global Initiative for chronic Obstructive Lung Disease (GOLD) 2011 guidelines for diagnosis, management and prevention of COPD. Material and methods: Comparation of two versions of GOLD guidelines published on official website www.goldcopd.org dated December, 2010 and February, 2012 (last one launched during a symposium hosted by the Asian Pacific Society of Respirology in November 2011) was performed. Only practically significant introductions are represented in this report. Results. The definition of COPD was reworded: 1) “common” - really, during last few years the incidence of COPD increased greatly all over the world; 2) “persistent” (about airflow limitation), while in all previous versions (starting from 2001) more cautious formulation “not fully reversible” was used. Additionally an assured formulation “exacerbations and comorbidities contribute to the overal severity of individual patients” is stated, while previously exacerbations were not included in COPD definition at all, and only presumptive “extrapulmonary effects may contribute” was used instead. Individualization of medical approach to patients with COPD remains in the limelight of COPD definition. Vitally important changes were conducted in diagnosis and assessment of COPD. It is still based on the patient's symptoms, the severity of the spirometric abnormality, identification of comorbidities, while evaluation of future risk of exacerbations was dramatically changed. Significance of lung ventilation function is specially highlighted: “Whereas spirometry was previously used to support a diagnosis of COPD, spirometry is now required to make a confident diagnosis of COPD”. Modernization of COPD management was performed using new diagnosis and assessment approaches to COPD. Strategy considering both disease impact (determined mainly by symptom burden and activity limitation) and future risk of disease progression (especially of the exacerbations) is recommended. Conclusion. New GOLD 2011 guidelines reflect a big step forward made in modern conception of COPD diagnosis, management and prevention. Further perspective from our point of view is to publish comprehensive monographs on the matter under the aegis of GOLD because of perfect analysis methodology provided by this international institution and highest qualification of experts (national leaders from different countries allover the world). This would greatly help medical practitioners and researchers.Item Right ventricular remodeling as an unfavorable feature in patients with chronic obstructive pulmonary disease combined with hypertension(2021-11) Melenevych, Anastasiia; Eshie, VictorWe investigated 69 patients with hypertension (HT) stage II in combination with chronic obstructive pulmonary disease (COPD) (GOLD 2, group B) in remission (57 males and 12 females ; mean age 55,80±5,51 years) who underwent 6-min walk test (6MWT), pulse oximetry, spirometry, chest X-ray, electrocardiography and echocardiography. IL-18 and IL-10 in the serum were determined by ELISA using a test system «Bender MedSystems, GmbH» (Austria). Worsening breathlessness, decreased tolerance to physical activity, reduction in oxygen saturation (SpO2) after 6MWT was associated with RV structural and functional impairment. Significant (p<0,05) differences in right heart chambers, indicating an increase in their overload, was found depending on the presence or absence of desaturation, i.e. decrease SpO2 during 6MWT more than 4% from baseline or below 90%: right atrial size - 39,79±2,27 mm vs. 35,83±5,02 mm; RV diameter - 27,10±2,22 mm vs. 28,37±2,40 mm; RV wall thickness - 5,58±0,57 mm vs. 5,22±0,61 mm; pulmonary artery to aorta ratio - 0,75±0,07 vs. 0,71±0,08. RV pressure overload (RV wall thickness > 5 mm and RV diameter < 30 mm) was associated with an imbalance of inflammatory response with increasing proinflammatory IL-18 and decreasing antiinflammatory IL-10. RV remodeling in response to pressure overload is often accompanied by maladaptive RV structural and functional impairment. Thus, RV remodeling with signs of overload by pressure was associated with increasing breathlessness, decreasing tolerance to physical activity, desaturation during 6MWT and imbalance of inflammatory response in patients with COPD combined with hypertension.