Кафедра пропедевтики внутрішньої медицини № 1, основ біоетики та біобезпеки

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    24 hour blood pressure monitoring (ambulatory blood pressure monitoring)
    (2013-11-21) Aina, Funke Grace; Ashcheulova, Tetyana; Gerasimchuk, Nina
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    8-isoprostane as the main marker of oxidative stress
    (2018-11) Herasymchuk, Nina
    Цель работы – обобщение данных экспериментальных и клинических исследований, которыми установлено, что в основе ведущих метаболических процессов человека лежат окислительно-восстановительные реакции. Среди них особую роль играют свободнорадикальные реакции, ведущие к образованию перекисных соединений. Таким образом, актуально определение параметров оксидативного стресса, его интенсивности, необходимой для адекватной оценки компенсаторных возможностей организма, прогноза течения заболевания и эффективности лечения. Материалы и методы. Представлено определение понятия оксидативный стресс, перечислены важнейшие оксиданты и механизмы их повреждающего действия. Обсуждена роль оксидативного стресса в патогенезе ряда сердечно-сосуди- стых, легочных и неврологических заболеваний, а также показана активация окислительных процессов при дозревании яйцеклетки в фолликулярной жидкости. Изопростаны – недавно обнаруженная группа изомеров простагландинов. Показан метаболизм арахидоновой кислоты как наиболее широко распространенного и важного предшественника эйкозаноидов
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    8-изопростан как главный биологический маркер оксидативного стресса у больных бронхолегочной патологии
    (2014-11-25) Герасимчук, Ульяна Сергеевна; Корнилова, Наталья Юрьевна; Герасимчук, Нина Николаевна
    Экспериментальными и клиническими исследованиями установлено, что в основе ведущих метаболических процессов человека лежат окислительно-восстановительные реакции. Среди них особую роль играют свободнорадикальные реакции, ведущие к образованию перекисных соединений. 8-изопростан - это продукт метаболизма в реакциях перекисного окисления арахидоновой кислоты, изомерный простагландину F2 и его количество прямо пропорционально уровню образованных свободных радикалов.
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    A new era of innovations in cardiology
    (2013-11-21) Jorayev, Ahmet; Ashcheulova, Tetyana
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    Abdominal obesity and adipokines activity in patients with arterial hypertension
    (2013-06) Ashcheulova, Tetyana; Ambrosova, Tetyana; Kovalyova, Olga; Saed, Abbas Mudzhahid
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    Abdominal ultrasonography
    (KhNMU, 2014-04) Rastogi, Suyash; Kochubiei, Oksana
    Abdominal ultrasonography (also called abdominal ultrasound imaging or abdominal sonography) is a form of medical ultrasonography(medical application of ultrasound technology) to visualise abdominal anatomical structures. It uses transmission and reflection of ultrasound waves to visualise internal organs through the abdominal wall (with the help of gel which helps transmission of the sound waves). For this reason, the procedure is also called a transabdominal ultrasound, in contrast with endoscopic ultrasound, the latter combining ultrasound with endoscopy through visualize internal structures from within hollow organs. Abdominal ultrasound examinations are performed by gastroenterologists or certain other specialists in internal medicine, radiologists or sonographerstrained for this procedure. Ultrasound testing helps in the diagnosis of a wide range of diseases and conditions, including stomach problems, gallbladder or pancreas problems, and abdominal pain. During an ultrasound test, high-frequency sound waves, inaudible to the human ear, are transmitted through body tissues using an instrument called a transducer, which transmits the information to a computer that displays the information on a monitor. Ultrasound is used to create images of soft tissue structures, such as the gallbladder, liver, kidneys, pancreas, bladder, and other organs and parts of the body. Ultrasound can also measure the flow of blood in the arteries to detect blockages. Ultrasound testing is safe and easy to perform. Abdominal ultrasound can be used to diagnose abnormalities in various internal organs, such as the kidneys, liver, gallbladder, pancreas, spleen andabdominal aorta. If Doppler imaging is added, the blood flow inside blood vessels can be evaluated as well (for example, to look for renal artery stenosis). Through the abdominal wall, organs inside the pelvis can be seen, such as the as urinary bladder or the ovaries and uterus in women. Because water is an excellent conductor for ultrasound waves, visualizing these structures often requires a well-filled urinary bladder (this means the patients has to drink plenty of water before the examination). Abdominal ultrasound is commonly used in the setting of abdominal pain or an acute abdomen (sudden and/or severe abdominal pain syndrome in which surgical intervention might be necessary), in which it can diagnose appendicitis or cholecystitis. In patients with deranged liver function tests, ultrasound may show increased liver size (hepatomegaly), increased reflectiveness (which might, for example, indicate cholestasis), gallbladder or bile duct diseases, or a tumor in the liver. The same is true for patients with an abnormal kidney functionor pancreatic enzymes (pancreatic amylase and pancreatic lipase), in which ultrasound can be used for additional anatomical information. Ultrasound can also be used if there is suspicion of enlargement of one or more organs, such as used in screening for abdominal aortic aneurysm, investigation for splenomegaly or urinary retention. Ultrasound imaging is useful for detecting stones, for example kidney stones or gallstones, because they create a clearly visible ultrasound shadow behind the stone. Ultrasonography can be used to guide procedures such as treatment for kidney stones with Extracorporeal shock wave lithotripsy, needle biopsies orparacentesis (needle drainage of free fluid inside the abdominal cavity). Ultrasound may be used to detect the following digestive problems: • Cysts or abnormal growths in the liver, spleen, or pancreas • Abnormal enlargement of the spleen • Cancer of the liver or fatty liver • Gallstones or sludge in the gallbladder Generally, no special preparation is needed for an ultrasound. Depending on the type of test, you may need to drink fluid before the ultrasound or you may be asked to fast for several hours before the procedure. During the Ultrasound: you will lie on a padded examination table; a specially trained technologist will perform the test; A small amount of water-soluble gel is applied to the skin over the area to be examined. The gel does not harm your skin and will be wiped off after the test; a wand-like device called a transducer is gently applied against the skin, you may be asked to hold your breath briefly several times; the ultrasound test takes several minutes to complete, a radiologist will interpret the test results. Studies have shown that ultrasound is not hazardous. There are no harmful side effects and there is virtually no discomfort during the test. In addition, ultrasound does not use radiation, as X-ray tests do.
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    Activation of immunoinflammation in patients with comorbid condition
    (European Society of Hypertension, 2013-06) Kochubiei, Oksana
    The aim of the research: to study the levels of inflammatory cytokin interleukin-6 in conjunction with the parameters of lipid metabolism, in patients with hypertension depend on prediabetes presence. Methods. 94 hypertensive patients were examined. Common clinical investigations were provided. Interleukin-6 plasma level detected using ELISA (BSM). Data is represented as Me (Q25-Q75). Kruskal-Wallis and median test were used, р <0,05. Results. Patients were divided into two groups depend on the presence prediabetes. The 1 group consisted of hypertensive patients without prediabetes. The 2 group included hypertensive patients with prediabetes. Hypertensive patients were characterized by increased interleukin-6 activity (18,81 (13,14-26,69) pg/ml). In hypertensive patients with prediabetes decrease interleukin-6 activity (13,94 (11,00-16,94) pg/ml) were found. The hypertension is accompanied by dyslipidemia, characterized by increased levels of total cholesterol 5,67 (4,96- 7,11) mmol/L, triglyceride 2,75 (2,56-3,01) mmol/L, low-density lipoprotein-cholesterol 0,98 (0,83-1,35) mmol/L and decreased levels of highdensity lipoprotein-cholesterol 3,51 (2,77-4,54) mmol/L, it was most expressed in patients with hypertension of the 1 group. Conclusions. According to the obtained results, interleukin-6 plasma level is increased in patients with hypertension, suggesting that the haemodynamic stress caused by elevated blood pressure is sufficient incentive to the growth secretion of these cytokines. The hypertension is accompanied by dyslipidemia, characterized by increased levels of total cholesterol, triglyceride, low-density lipoprotein-cholesterol and decreased levels of highdensity lipoprotein-cholesterol,it was most expressed in patients with hypertension of the 1 group. Significant positive relationships between interleukin-6 and parameters of lipid metabolism in patients with hypertension and prediabetes were detected.
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    Activity of the main no synthesis enzymes of the combined therapy of fosinopril and hydrochlorothiazide at overweight hypertensive patients
    (2014-11-27) Gerasimchuk, Nina; Safargalina-Kornilova, Nadia; Potabenko, Svetlana
    The aim of the study was to investigate the activity of the main NO synthesis enzymes (endothelial-NO (e-NOS) and inducible-NO (i-NOS) synthases) at overweight patients with arterial hypertension therapy on the dynamics combined fosinopril and hydrochlorthiazide.
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    Additional pericardial leads to detect myocardial infarction
    (KhNMU, 2015-03) Kochubiei, Oksana; Кочубєй, Оксана Анатоліївна; Кочубей, Оксана Анатольевна; Soyombo Oluwabunmi, Emmanuel
    A lead of an electrocardiograph that has one electrode placed in any of six standard positions on the chest and another electrodeplaced on a limb. A record obtained from such a lead. Also is called chest lead. Those in which the exploring electrode is on the chest overlying the heart or its vicinity. For the diagnosis of posterior-basal and myocardial infarction using abduction V 7 - V 9; V 7 - the active electrode is located 5 intercostal space on the posterior axillary area; V 8 - active electrode is located in the same intercostal space at the shoulder line; V 9 - the active electrode is located in the same intercostals space on the paravertebral line. Epigastric abduction. Epigastria exhaust applicable in those cases when it is necessary to clarify the features characteristic of the anterior wall myocardial infarction, and anterior-septal area of posterior wall of the left ventricle. Leads denoted by the letter E. Active (red) electrode is applied to the epigastric region, indifferent (yellow) on the left hand, the ECG is removed at around 1 pericardial ECG mapping. The method consists of registering 35 precordial leads from various points of the chest 5 horizontal rows and 7 vertical. The method is used to assess the severity of myocardial infarction front or anterior-lateral wall of the left ventricle. This is determined by the sum of the amplitudes of the Q wave and R, square teeth R, and S, the total ST elevation and average values. The greater the total value of ST elevation and Q, the extensive myocardial infarction, the closest and adverse long-term prognosis of disease. With precordial mapaing can evaluate the effectiveness of treatment and rehabilitation measures. Additional designated by Slopak. It is used for the diagnosis of posterior-basal myocardial infarction. Yellow (indifferent) electrode is applied to the left arm, red (active) electrode is installed in II intercostal space at the left sternal border, then on middle claviclar line, anterior and middle axillary lines. When basal posterolateral myocardial infarction sometimes detected tooth V 1 - V 3. Additional electrodes may rarely be placed to generate other leads for specific diagnostic purposes. Right sided precordial leads may be used to better study pathology of the right ventricle. Posterior leads may be used to demonstrate the presence of a posterior myocardial infraction. A Lewis lead (requiring an electrode at the right sternal border in the second intercostal space) can be used to study pathological rhythms arising in the right atrium. An esophogeal lead may be used in certain advanced electrophysiology procedures; the esophageal lead uses an electrode placed inside the esophagus, which allows for high quality measurements of the electrical activity of the left atrium.
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    Adipokine apelin activity in patients with essential hypertension and central obesity
    (2014-06) Demydenko, Ganna; Kovalyova, Olga
    Obesity has been consistently associated with hypertension and increased cardiovascular risk. BMI as a measure of obesity is a good predictor of all-cause and cardiovascular mortality, cardiovascular mortality seems to be better predicted by abdominal or central obesity in addition to BMI. Aim of the study: to investigate apelin’s activity in patients with essential hypertension with obesity according to the type of obesity.
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    Adipokines dysfunction as a risk factor of type 2 diabetes mellitus in patients with hypertension
    (2014-06) Ashcheulova, Tetyana; Ащеулова, Тетяна Вадимівна; Ащеулова, Татьяна Вадимовна; Vizir, Marina; Ambrosova, Tetyana
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    Adipokines, glucometabolic disorders, abdominal obesity in hypertensive patients
    (2012) Ashcheulova, Tetyana; Ambrosova, Tetyana
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    Adiponectine and metabolic disorders in patients with arterial hypertension
    (2013-06) Ambrosova, Tetyana; Ashcheulova, Tetyana; Kovalyova, Olga; Smyrnova, Victoriia
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    Age peculiarities of circadian hearth rhythm in holter monitoring administration in patients with hypertension associated with obesity
    (2014-04) Ivanchenko, Svitlana; Honchar, Oleksii; Bezugla, Katerina
    Age features circadian rhythm heart during Holter monitoring patients with hypertension associated with obesty were described.
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    Aldosteronism and hypertension: Conn’s syndrome
    (KhNMU, 2015-05) Кочубєй, Оксана Анатоліївна; Кочубей, Оксана Анатольевна; Kochubiei, Oksana; Shirgba Sonter, Jacob
    Most hypertension is Essential Hypertension Proportion of Essential/Secondary depends on definition of “secondary” (eg if elevated BMI was a “secondary cause” 75% of patients would have it). Conn syndrome is an aldolsterone -producing adenoma. Conn's syndrome is named after Jerome W. Conn(1907–1994), the American endocrinologist who first described the condition at the University of Michigan in 1955. Aldosterone is a steroid hormone (mineralocorticoid family) produced by the outer section (zona glomerulosa) of the adrenal cortex in the adrenal glands It plays a central role in the regulation of blood pressure mainly by acting on the distal tubules and collecting of the nephrons, increasing reabsorption of ions and water in the kid, to cause the conservation of sodium, secretion of potassium, increase in water retention, and increase in blood pressure and blood volume. When dysregulated, aldosterone is pathogenic and contributes to the development and progression of cardiovascular and renal disease. Aldosterone has exactly the opposite function of atrial nutriuretic hormone secreted by the heart. Causes: Primary hyperaldosteronism has many causes, including adrenal hyperplasia and adrenal carcinoma. The syndrome is due to: 1. Solitary adrenal (conn) adenoma, 35% 2. Bilateral (micronodular) adrenal hyperplasia, 60% 3. Glucocorticoid remediable aldosteronism (dexamethansone-suppressible hyperaldosteronism) 1% 4. Rare forms, including disorders of the renin-angiotensin system 1% Complications list for Conn's syndrome: The list of complications that have been mentioned in various sources for Conn's syndrome includes:  Enlarged heart (Heart symptoms)  Loss of deep tendon reflexes  Heart disease - due to high blood pressure  Stroke- due to high blood pressure  Congestive heart failure - due to high blood pressure  Coronary artery disease - due to high blood pressure  Abnormal heart rhythm - due to low blood potassium levels  Death - due to low blood potassium levels Diagnosis measuring aldosterone alone is not considered adequate to diagnose primary hyperaldosteronism. The screening test of choice for diagnosis is the plasma aldosterone:plasma renin activity ratio. Renin activity, not simply plasma renin level, is assayed. Both aldosterone and renin are measured, and a ratio greater than 30 is indicative of primary hyperaldosteronism. Treatment - spironoloctone. Treatment of Conn's syndrome is usually successful. Many patients with a single adrenal adenoma will be able to stop drug treatment and will have normal blood pressures. Nevertheless, many specialist centres will follow a patient with Conn's syndrome for life. This is to monitor the rare possibility of growth of a second adenoma. Patients with bilateral hyperplasia should have life-long monitoring of effectiveness and side-effects of drug treatment. Again, quality of life is generally good, although some patients may not be able to tolerate spironolactone treatment.
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    Allergic urticaria in internal hospital
    (KhNMU, 2015-03) Кочубєй, Оксана Анатоліївна; Кочубей, Оксана Анатольевна; Kochubiei, Oksana; Ashcheulova, Tetyana; Ащеулова, Тетяна Вадимівна; Ащеулова, Татьяна Вадимовна; Weyulu, Selma
    Allergic Urticarial also known as Haves, affects about 20 percent of people at some time during their lives. It can be triggered by many substances or situations and usually starts as an itchy patch of skin that turns into swollen red welts. Its signs are an outbreak of swollen, pale red bumps, patches, or welts on the skin that appear suddenly either as a result of allergies, or for other reasons. Urticaria (Hives) usually causes itching, but may also burn or sting. They can appear anywhere on the body, including the face, lips, tongue, throat, or ears. Hives vary in size (from a pencil eraser to a dinner plate), and may join together to form larger areas known as plaques. They can last for hours, or up to several days before fading. Urticaria causes angioedema too, but the swelling occurs beneath the skin instead of on the surface. Angioedema is characterized by deep swelling around the eyes and lips and sometimes of the genitals, hands, and feet. It generally lasts longer than normal hives, but the swelling usually goes away in less than 24 hours. Acute urticaria is a common disorder that often prompts patients to seek treatment in the emergency department. In fact, acute urticaria is the most common cutaneous disease treated in the emergency department. Determining whether urticaria is part of an anaphylactic reaction is important. If an anaphylactic reaction occurs. Allergic urticarial can be admitted in Internal Hospital due to the severity of the attack . It may occur with the following symptoms and medical attention from the doctor is needed right away: dizziness; wheezing; difficulty breathing; tightness in the chest; swelling of the tongue, lips, or face. If associated angioedema is present, especially if laryngeal angioedema is suspected, prehospital administration of 0.3-0.5 mg of intramuscular epinephrine may be warranted. If associated bronchospasm is present, prehospital nebulized albuterol may be warranted. Other measures may be appropriate, such as continuous electrocardiography (ECG); blood pressure and pulse oximetry monitoring; administering IV crystalloids if the patient is hypotensive; and administering oxygen. If the patient has angioedema that is treated successfully in the ED, the patient should be sent home with an EpiPen prescription. The patient should be instructed to keep the EpiPen with him or her at all times and to use it if swelling of the lips, tongue, or face develops or if his or her voice becomes acutely hoarse. Care: Identify the etiology of the acute urticaria if possible. If an inciting agent can be identified, instruct the patient to avoid it. The major goal is to control the severity of acute urticaria lesions until the process resolves over 4-6 weeks. Inpatient therapy may be required if the urticaria is severe and does not respond to antihistamine therapy, or if the patient's condition progresses to laryngeal angioedema and/or anaphylactic shock. Special care may be needed by a patient with urticarial but most important is one to stay away from the agents that causing it, if identified and to make sure patient follow all medical advises.
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    Ambulatory ECG recording. Its reminiscence, merits and demerits
    (KhNMU, 2013-11-21) Isaac, Precious Adaora; Demydenko, Ganna
    Ambulatory ECG recording. Its reminiscence, merits and demerits