Наукові праці. Кафедра внутрішньої медицини № 3 та ендокринології
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Item A clinical case of idiopathic pulmonary arterial hypertension in patient with comorbid ischemic heart disease: the key stages of diagnosis(2014) Журавльова, Лариса Володимирівна; Філоненко, Марина Вячеславівна; Лопіна, Наталія Андріївна; Zhuravlyova, Larysa; Filonenko, Maryna; Lopina, NataliiaDespite the progress achieved in the development of new directions in the diagnosis and treatment of idiopathic pulmonary arterial hypertension, it remains one of the most severe and prognostically unfavorable diseases. The article presents a clinical case and an algorithm for diagnosis of this rare disease, in respect to the decision-making in clinical practice. The present case underscores the need to consider a broad differential diagnosis for marked dyspnea in mature patients, especially when the intensity of dyspnea is out of proportion to the severity of underlying heart or lung diseases, or when symptoms fail to subside as expected in response to conventional therapy. Early diagnosis of idiopathic pulmonary arterial hypertension is vitally important for initiating modern therapy in order to improve the quality and duration of life in such patients.Item A connection betweeen arterial hypertansion, dyslipidemia and activity of interleukin-6 in type 2 diabetes mellitus(2019) Zhuravlyova, Larysa; Sokolnikova, Nelia; Filonenko, MarynaPurpose. To determine the relationship between blood pressure (BP), lipid metabolism and levels of IL-1β and IL-6 in patients with type 2 diabetes mellitus (T2DM).Item Acute chord rupture of the mitral valve posterior leaflet in heart failure progression in hypertensive patient with coronary heart disease and chronic obstructive lung disease(2015) Журавльова, Лариса Володимирівна; Лопіна, Наталія Андріївна; Волков, Дмитро Євгенович; Лопін, Дмитро Олександрович; Кузнецов, Ігор Володимирович; Zhuravlyova, Larysa; Lopina, Nataliia; Volkov, D.; Lopin, Dmytro; Kuznetsov, I.Acute chord rupture of the mitral valve posterior leaflet is rare but serious cause of severe mitral valve insufficiency, acute heart failure manifestation or chronic heart failure progression and leads to difficulties in the differential diagnosis of the reasons of heart failure. Acute chord rupture in degenerative mitral valve disease should be suspected in older patients with left ventricular dysfunction and co-morbidities as a cause of heart failure.Item Acute myocardial infarction and antecedent hypertension: the changes of selenium levels, antioxidant enzymes and their correlation with the level of cardiac biomarkers(2019) Zhuravlyova, Larysa; Filonenko, MarynaThe purpose of this study was to determine the relationship between the activity of antioxidant agents and the levels of cardiac biomarkers in patients with non-ST elevation myocardial infarction (NSTEMI) and antecedent hypertension (AH).Item Adipocytokinemia and exocrine pancreatic insufficiency in patients with combined course of type 2 diabetes mellitus and chronic pancreatitis(2019) Zhuravlyova, Larysa; Shekhovtsova, YuliiaTumor necrosis fa ctor α TNF α and apelin both are adipocytokines, which can be considered as unifying links in pancreatic metabolic disorders in patients with chronic pancreatitis and type 2 diabetes mellitus.Item An Imbalance of the hormones of fatty tissue in patients with type 2 diabetes mellitus depending on body mass index(2017) Zhuravlyova, Larysa; Ogneva, Olena; Lavrynenko, OlgaPurpose. The study was designed to assess the level of resistin and tumor necrosis factor-alpha (TNF-α) and its relationship with body mass index (BMI) in patients with type 2 diabetes mellitus (DM-2) with normal body weight and obesity.Item An imbalance of the hormones of fatty tissue in patients with type 2 DM depending on the body mass index(2018) Zhuravlyova, Larysa; Ogneva, Olena; Lavrynenko, OlgaPurpose. The study was designed to assess the level of resistin and tumor necrosis factor-alpha (TNF-α) and its relationship with body mass index (BMI) in patients with type 2 diabetes mellitus (DM-2) with normal body weight and obesity.Item Analysis of the epidemiological risk factors of the cause of autoimmune diseases(2018) Ivanteeva, Julija; Kurchanova, Julija; Sikalo, YuliiaBackground. Over the past decades, there has been a sharp increase in autoimmune pathology all over the world. In this regard, the study of the causes and risk factors for the onset of autoimmune diseases (AID) in the modern aspect is an important stage in the prevention of their occurrence. Aim. To identify the risk factors for the occurrence of the most common socially significant AID - rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and type 1 diabetes mellitus (DM 1).Item Apelin – additional marker of insulin resistance(2015) Журавльова, Лариса Володимирівна; Шеховцова, Юлія Олександрівна; Zhuravlyova, Larysa; Shekhovtsova, YuliiaSummary: The purpose of the present study was to determine the correlations between the state of carbohydrate metabolism and concentrations of apelin in blood of patients with type 2 diabetes mellitus with different phenotypes. Materials and methods. A total of 32 patients with type 2 diabetes mellitus with different phenotypes (13 men, mean age 56,77 ± 1,79 years) were examined. The control group included 20 healthy individuals. Results. The significant elevation of adipocytokine apelin level was found. The significant correlations between body mass index, apelin and the parameters of carbohydrate metabolism were defined. Conclusions. Increased levels of apelin and connection between this adipocytokine and anthropometric parameters as well as indices of carbohydrate metabolism suggests that elevated body weight contributes to activation and strengthening of impact mechanisms of adipose tissue hormones on metabolic statusItem Apelin – Possible diagnostic marker of chronic pancreatitis?(2015) Журавлева, Лариса Владимировна; Шеховцова, Юлия Александровна; Zhuravlyova, Larysa; Shekhovtsova, YuliiaBackground: Apelin is an adipocytokine, which produced by activated pancreatic stellate cells in the pancreas during chronic pancreatitis. Aim: The aim of this study was to evaluate the apelin serum concentration in patients with CP in order to determinate it is possible diagnostic value.Item Apelin-possible marker of progression of metabolic disoders in the pancreas in patients with combined course of chronic pancreatitis and type 2 diabetes mellitus(2016) Журавлева, Лариса Владимировна; Шеховцова, Юлия Александровна; Zhuravlyova, Larysa; Shekhovtsova, YuliiaApelin is an adipocytokine, which can be considered as unifying link between metabolic disorders in the body and the development of pathological changes in the pancreas in patients with combined course of chronic pancreatitis and type 2 diabetes mellitusItem Approach to diagnosis of liver fibrosis: serum markers(2015) Zhuravlyova, Anna; Ogneva, Olena; Zhuravlyova, LarysaHepatic fibrosis is the final common pathway for many different liver insults. Originally considered to be irreversible, hepatic fibrosis is now known to be a dynamic process with a significant potential for resolution. Timely diagnosis of liver fibrosis can prevent development of unwanted complications. The diagnosis and quantitation of fibrosis have traditionally relied on liver biopsy. However, there are a number of drawbacks that limit its use. This article reviews the current methods of assessment of hepatic fibrosis based on the serum markers.Item Arterial stiffness markers in patients with coronary artery disease and type 2 diabetes mellitus(2016) Журавлева, Лариса Владимировна; Лопина, Наталья Андреевна; Кузнецов, Игорь Владимирович; Zhuravlyova, Larysa; Lopina, Nataliia; Kuznetsov, I.To assess arterial stiffness markers in patients with coronary artery disease and concomitant type 2 diabetes mellitus.Item CAG поліморфізм гену андрогенового рецептору у жінок в постменопаузі, хворих на артеріальну гіпертензію та цукровий діабет(2017) Бутова, Тетяна СергіївнаМета дослідження. Дослідити зв'язок між CAG-повторами гену AR та рівнем дигідротестостерону (ДГТ) у сироватці крові у жінок у постменопаузі (ПМ), хворих на цукровий діабет (ЦД) 2 типу та артеріальну гіпертензію (АГ). Матеріали та методи дослідження. 106 жінок у ПМ були розподілені на групи: до 1-ої входило 30 хворих на ЦД 2 типу; до 2-ої – 34 хворих на АГ 2-3 ступеня; до 3-ої – 42 хворих на АГ 2-3 ступеня та ЦД 2 типу, до групи контролю – 31 жінка. Усім жінкам імуноферментним способом вимірювався рівень ДГТ в сироватці крові, виділено геномну ДНК з лейкоцитів крові, проведено ідентифікацію кількості САG-повторів у гені AR методом ПЦР. Результати та їх обговорення. CAG-повтори спостерігалися у 96 (70,07±3,91%) з 137 випадків. Мінімальне число CAG-повторів дорівнювало 14, максимальне – 28, розповсюдженість алелів гену AR була достовірно різною у залежності від груп пацієнток. З метою визначення впливу поліморфізму гену AR на ризик розвитку захворювання було проведено порівняльний аналіз довжини алелей між групами спостереження за допомогою показнику SBM. За критичне значення кількості CAG-повторів було взято 22 повтори. Між показниками рівня ДГТ і CAG-повторами серед всіх груп спостерігається прямий кореляційний зв’язок. Висновки. АГ, як супутня хвороба, негативно впливає на перебіг ЦД 2 типу у жінок у ПМ, що виражається у більшому підвищенні рівня ДГТ у венозній крові у групі хворих з коморбідною патологією, ніж у хворих на ЦД 2 типу. Виявлено зв'язок між рівнем ДГТ у плазмі крові та кількістю CAG-повторів у жінок у ПМ, більш сильний кореляційний зв'язок був між ДГТ і «довгими» алелями гену AR у групі з коморбідною патологією (АГ з ЦД 2 типу). Наявність збільшеної кількості CAG-повторів у гені AR можна розцінювати як предиктор розвитку та прогресії АГ у жінок з ЦД 2 типу у ПМ.Цель исследования. Исследовать связь между CAG-повторами гена AR и уровнем дигидротестостерона (ДГТ) в сыворотке крови у женщин в постменопаузе (ПМ), больных сахарным диабетом (СД) 2 типа и артериальной гипертензией (АГ). Материалы и методы исследования. 106 женщин в ПМ были разделены на группы: в первую входило 30 больных СД 2 типа; во вторую - 34 больных АГ 2-3 степени; в третью - 42 больных АГ 2-3 степени и СД 2 типа, в группу контроля - 31 женщина. Всем женщинам иммуноферментным способом измерялся уровень ДГТ в сыворотке крови, выделено геномную ДНК из лейкоцитов крови, проведена идентификация количества САG-повторов в гене AR методом ПЦР. Результаты и их обсуждение. CAG-повторы наблюдались в 96 (70,07 ± 3,91%) с 137 случаев. Минимальное число CAG-повторов равно 14, максимальное - 28, распространенность аллелей гена AR была достоверно разной в зависимости от групп пациенток. С целью определения влияния полиморфизма гена AR на риск развития заболевания был проведен сравнительный анализ длины аллелей между группами наблюдения с помощью показателя SBM. За критическое значение количества CAG-повторов было взято 22 повтора. Между показателями уровня ДГТ в сыворотке крови и CAG-повторами гена AR у наблюдаемых женщин всех групп наблюдается прямая корреляционная связь. Выводы. АГ, как сопутствующая болезнь, отрицательно влияет на течение СД 2 типа у женщин в ПМ, выражающяяся в большем повышении уровня ДГТ в венозной крови в группе больных с коморбидной патологией, чем у больных СД 2 типа. Выявлена связь между уровнем ДГТ в плазме крови и количеством CAG-повторов у женщин в ПМ, более сильная корреляционная связь была между ДГТ и «длинными» аллелями гена AR в группе с коморбидной патологией (АГ с СД 2 типа). Наличие увеличенного количества CAG-повторов в гене AR можно расценивать как предиктор развития и прогрессии АГ у женщин с СД 2 типа в ПМ.To investigate the relationship between repetitions CAG- repeats AR gene and levels of dihydrotestosterone (DHT) in the serum of postmenopausal women (PM), diabetes mellitus (DM) type 2 and hypertension (HT). Materials and methods. 106 women in PM were divided into groups: the first included 30 patients with type 2 diabetes; to the second - 34 patients with hypertension 2-3 grade; to the 3rd - 42 patients with hypertension of 2-3 degree and type 2 diabetes, to control group - 31 women. All women ELISA method DHT levels measured in serum isolated genomic DNA from white blood cells, were identified number of repetitions CAG- repeats AR gene PCR. Results and discussion. CAG-repeats were observed in 96 (70,07 ± 3,91%) of 137 cases. The minimum number of CAG-repeats equal to 14 maximum - 28 AR gene allele prevalence was significantly different depending on the groups of patients. To determine the influence of gene polymorphisms AR at risk of developing the disease was a comparative analysis of long alleles between groups monitoring via indicator SBM. For critical number of CAG-repeats were taken 22 repetitions. Among indicators of DHT in serum and CAG-repeats in the AR gene observed groups of women observed a direct correlation. Conclusions. AG as concomitant disease, adversely affect the course of type 2 diabetes in women PM, resulting in greater levels of DHT increase in venous blood in patients with comorbid disorders than in patients with type 2 diabetes. The relation between the level of DHT in the blood plasma and the number of CAG-repeats in women PM, a strong correlation was between DHT and "long" alleles AR gene in the group with comorbid disorders (hypertension with type 2 diabetes). The presence of increased number of CAG-repeats in AR gene can be regarded as a predictor of the development and progression of hypertension in women with type 2 diabetes in PM.Item Cardivascular risk in patients with arterial hypertension and type 2 diabetes mellitus(2012) Zhuravlyova, Larysa; Ilchenko, Iryna; Yankevych, OleksandrThe aim of this study was to estimate the relation of cardiovascular risk to daily profile of BP and degree of type 2 diabetes mellitus compensation in hypertensive patients.Item Caspase-dependent activation of cascade cytokines in young patients with autoimmune thyroiditis in combination with gastroesophageal reflux disease(2021) Pasiieshvili, Tamara; Pasiieshvili, Liudmyla; Zhelezniakova, Natalia; Kovalyova, OlgaThe development of an inflammatory reaction in any disease of internal organs obeys to the basic law of inflammation – the participation of the immune system in its implementation.The sequence of the inclusion of its various components, the volume of the cellular and humoral response depends on many factors: the action and the virulence of the pathogen, the state of the immune system both in general and its individual links, concomitant diseases and a number of others.An inflammatory reaction is a genetically determined function of the body, aimed at maintaining homeostasis, that is, neutralizing the pathogen without significant consequences for the body.Item Changes of lipid profile in patients with chronic pancreatitis and diabetus mellitus type 2(2019) Zhuravlyova, Larysa; Shekhovtsova, YuliiaIn modern science, metabolic infringements that occur primarily in patients with metabolic syndrome, which consist, first of all, of dyslipidemia and type 2 diabetes mellitus (DM2) play an important role in the development of chronic pancreatitis (CP). The aim of the present study was to investigate changes of lipid profile in patients with combined course of CP and DM2.Item Clinical case of acute chord rupture of the mitral valve posterior leaflet in older patient with comorbidites(2015) Журавльова, Лариса Володимирівна; Лопіна, Наталія Андріївна; Кузнецов, Ігор Володимирович; Lopin, Dmytro; Kramarenko, Irina; Sumanova, IrinaThe article describes the etiologic role of the various factors such as chronic rheumatic heart disease, bacterial endocarditis, aortic valve stenosis, hypertension, coronary heart disease, including acute myocardial infarction, degenerative disease of the valves, connective tissue diseases, chest trauma, systemic lupus erythematosus, congenital heart disease which leading to the mitral valve chords rupture, gives the current classification of the nosology and also features of manifestation and clinical course. Also described a clinical case of mitral valve posterior leaflet chord rupture of patient with hypertension, ischemic heart disease and chronic obstructive pulmonary disease, which reflects all the stages of diagnostic search and the difficulties encountered in making the diagnosis, analyzed the basic concepts of medical and surgical treatment, features the choice of treatment strategy depending on the degree of mitral valve insufficiency.Item Clinical Significance of natriuretic peptides(2022) Zhuravlyova, Larysa; Sokolnikova, Nelia; Rogachova, TetianaNatriuretic peptides are widely known for their protective effects against the development of metabolic syndrome and cardiovascular disease. The important role of determining the levels of natriuretic peptides in the diagnosis, assessment of severity, prognosis and effectiveness of treatment of heart failure has been proven in many studies and noted in clinical guidelines worldwide. Visceral obesity reduces the production and action of natriuretic peptides, increasing the risk of heart failure and 2 type diabetes mellitus. Metabolic syndrome is present in 60% of patients with chronic heart failure, most of its components contribute to the development and progression of chronic heart failure and include obesity, hypertension, dyslipidemia, insulin resistance, impaired glucose tolerance. The prevalence of metabolic syndrome in the general population is 34% and is constantly increasing due to unhealthy diet, sedentary lifestyle and chronic stress. The prevalence of chronic heart failure is increasing rapidly in all industrialized countries, affecting 2% of adults and 10% of the elderly. Therefore, the problem of early diagnosis and treatment of metabolic syndrome and chronic heart failure is relevant nowadays. The review focuses on the pathophysiological relationships between natriuretic peptides, heart failure and metabolic syndrome, and the approaches to the correction of natriuretic peptides’ metabolism.Item Clinical significance of visfatin and homocysteine in forecasting of osteoarthritis in women of pre-and postmenopausal age with type 2 diabetes mellitus(2022) Zhuravlyova, Larysa; Cherpita, ValentynaType 2 diabetes mellitus is a leading cause of death and has high prevalence. Patients with type 2 diabetes mellitus are often diagnosed with osteoarthritis, the vast majority of cases are found in pre- and postmenopausal women due to decreased estrogen levels, as well as their numerous hormonal and metabolic disorders. The study determined the prognostic significance of visfatin and homocysteine in the development of osteoarthritis in pre- and postmenopausal women with type 2 diabetes mellitus and built a prognostic model for the development of osteoarthritis. We studied 82 pre- and postmenopausal women: 20 women (1 group) with isolated type 2 diabetes mellitus and 62 women (group 2) with comorbid type 2 diabetes mellitus and osteoarthritis. The study found that reliable predictors of osteoarthritis in women with type 2 diabetes mellitus in pre- and postmenopausal women were waist circumference, levels of very-low-density lipoproteins, visfatin and homocysteine, which were included in a prognostic model with high levels of sensitivity and specificity: 96.8 % and 90.0 %, respectively. The value of the area under the curve was 0.992±0.006 [95.0 % CI 0.979–1.000], p<0.001. The obtained prognostic model opens new ways of timely diagnosis of early osteoarthritis in pre- and postmenopausal women with type 2 diabetes mellitus.