Наукові роботи молодих вчених. Кафедра внутрішніх та професійних хвороб

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    Lung hyperinflation - a prognostically significant marker in geriatric patients
    (2024-04) Ananya Dwivedi
    Lung hyperinflation is a common finding in patients with chronic obstructive pulmonary disease (COPD) observed via plain radiograph. Among people older than 65 years, the risk of developing COPD increases five times compared to 40 year olds (Easter M. et al., 2020). In addition, hyperinflation may be found in patients with the Tiffeneau index > 0,7. In most cases, this radiological finding is not given due attention, therefore further diagnosis and treatment is either delayed or insufficiently carried out.
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    A modern view on hyperkalemia’s management
    (2023-10) Melenevych, Anastasiia; Dwivedi, Ananya
    The 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.
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    Dental aspects of cardiometabolic health
    (2023-03) Assaad, Salma; Melenevych, Anastasiia
    Cardiometabolic (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.
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    Right ventricular remodeling as an unfavorable feature in patients with chronic obstructive pulmonary disease combined with hypertension
    (2021-11) Melenevych, Anastasiia; Eshie, Victor
    We 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.
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    Прогнозування майбутніх несприятливих подій у хворих на хронічне обструктивне захворювання легень на підставі аналізу сучасних оціночних тестів
    (2016) Мєленевич, А.Я.
    Хронічне обструктивне захворювання легень (ХОЗЛ) є гетерогенним захворюванням із системними проявами, які впливають на особливості перебігу та можливі наслідки. Поширеність ХОЗЛ серед населення в усіх вікових групах близько 1%, а серед осіб у віці > 40 років різко зростає до > 10 % (Chapman K.R., Маппіпо D.M., Soriano J.В. et al., 2006). За останніми даними Всесвітньої організації охорони здоров'я, ХОЗЛ призводить до загибелі > 2,9 мільйона осіб на рік. Серед провісників подальшого перебігу ХОЗЛ окрім об'єму форсованого видиху за 1 секунду (ОФВі), розглядають гіперреактивність дихальних шляхів, гіпоксемію, гіперкапнію, гіперінфляцію легень, легеневу гіпертензію, гіпотрофію, зниження толерантності до фізичних навантажень, зниження якості життя, анемію, коморбідну патологію та інші.
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    Роль маркерів імунного запалення при хронічному обструктивному захворюванні легень у поєднанні з гіпертонічною хворобою
    (2016) Меленевич, Анастасія Ярославівна
    Хронічне обструктивне захворювання легень (ХОЗЛ) являє собою серйозну проблему завдяки широкої розповсюдженості, прогресуючого перебігу, зменшення тривалості життя хворих. У середньому від 8 до 22% дорослих у віці 40 років і старше страждають ХОЗЛ (Фещенко Ю.І., 2012). Всесвітня організація охорони здоров’я (ВООЗ) відмічає неухильне зростання поширеності ХОЗЛ. Доля професійного ХОЗЛ – 19% (Шпагіна Л.А., 2013). Крім того, ХОЗЛ виходить на лідируючі позиції серед причин смерті. Експерти ВООЗ прогнозують, що до 2020 року дана патологія займатиме 5-е місце по захворюваності і 3-є місце в світі в структурі загальної смертності. За даними ВООЗ у 2012 році від ХОЗЛ померли більше 3 мільйонів чоловік, що склало майже 6% всіх випадків смерті. Згідно ВООЗ смертність від ХОЗЛ в структурі професійної захворюваності складає 40%. Одним із найбільш частих коморбідних станів є поєднання ХОЗЛ та гіпертонічної хвороби (ГХ), поширеність його коливається у значно широких межах від 6,8 до 70,2 %, в середньому 34,3 %. (Мостовий Ю.М., 2010). При ХОЗЛ запалення підтримується багато років, нерідко і десятиліттями, посилюючись в період загострення хвороби, що призводить до пригнічення адаптаційних реакцій організму, тривалої активації імунної системи. Нині з’являється все більше даних про роль імунного запалення у розвитку та прогресуванні ГХ. У хворих на ГХ прозапальні цитокіни можуть призводити до активації симпатоадреналової нервової системи та стимуляції продукції ангіотензину II.
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    Diagnostic and prognostic role of markers of immune inflammation in chronic obstructive pulmonary disease in combination with hypertension
    (2016) Melenevych, Anastasiia
    Currently 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.
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    Role of VEGF in development of chronic obstructive pulmonary disease in combination with hypertension
    (ХНМУ, 2015-05) Istomina, Olga
    Nowadays lot of attention is paid to issue of comorbid disease. On the basis of progressive humanity development, it is mentioned a decline of ecological situation, reduction of human motor activity, increasing of bad habits, poor nutrition and organism senilism. All these factors are lead to formation of several disease in humans at the same time. The prevalence of comorbid pathology averages 76,6%, 82% - for women, 72% - for men. One of the most common comorbid conditions is a chronic obstructive pulmonary disease (COPD) in combination with hypertension. According to the data WHO (newsletter #310, 2014) COPD and hypertension are included to the list of ten leading death causes in the world. Hypertension is found in COPD patients with varying frequency (from 6,8% to 76,3%) with average 34,3%. On this stage endothelial dysfunction can be considered as one of the most important independents risk factors for diabetes, atherosclerosis, COPD, hypertension, sepsis and growth of malignant neoplasms. One of the main endothelium functions is vascular growth regulations. One of the angiogenesis markers is vascular endothelial growth factor (VEGF). Among the angiogenic factors family, VEGF is considered to be a major one while neovascularization. Proteins which belong to the VEGF family group are glycoproteins that stimulate the formations of new blood and lymph vessels and also increase vascular permeability. One of the main factors for comobid pathology development is hypoxia and cells structure transformation under the mechanical factors influence that initiates VEGF production. By evaluation of GOLD 2014 revision COPD is characterized by a bronchial tubes affect (obstructive bronchiolitis) so as parenchymal distruction (emphysema). There are an extremely alveolar septa thinning and significantly reducing of their vascularization while progressive capillary endothelium loss and alveolar epithelium that leads to the substitution of lung tissue by the fibrous. Hypoxia promotes HIF-1a stabilization (hypoxia inducible factor-1a) which rapidly degraded at a sufficient oxygen concentration. HIF-1a and HIF-1βb is combined under hypoxia condition. Received complex is binded to a specific sensitive to the hypoxia region of the VEGF genes and increase its expression. Isolated mechanical stretching in a cell culture can contribute to VEGF realizing. Physical activity leading to the increasing of blood flow increasing shear stress and endothelial cells transformation followed by not only by increased VEGF level but also by increasing VEGFRs amount. A growth of shear stress and activation of the renin-angiotensin-aldosterone system while hypertension is also associated with increased VEGF content by mechanical influence on the vascular endothelial cells and angiotensin 2 interaction with angiotensin first type receptors which leads to the expression HIF-1a growth and increasing of VEGF synthesis. Thus VEGF and its receptors can be involved in many processes while COPD and hypertension, such as: airway walls remodeling, endothelial cell apoptosis and vascular remodeling.
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    Smoking as modifiable factor in development of cronic obstruktive pulmonary disease in combination with arterial hypertension
    (ХНМУ, 2015-01-20) Истомина, Ольга Владимировна; Istomina, Olga
    Chronic obstructive lung pulmonary disease and cardiovascular diaseases have remained the top major causes of mortalitykillers during the past decade. In the top of the 10 leading causes of death in the world COPD is in on the third place, it's 3,.1 million people, and arterial hypertension is on the on the tenth – 1,.1 million. Combination of theseis two pathologiesy aggravates the course of each other,, and represents serious medical and social problems, which leads to health-related quality of life reducing ed quality of life and, eventually, may lead to disability. At the present time, for these diseases can be determine the main modifiable factor that can be determined for these diseases, increasing the risk of them, is such as smoking. Tobacco use is a major cause of many of the world’s top killer mortal diseases illnesses – including cardiovascular diseasepathology, chronic obstructive lung pulmonary disease and lung cancer. In totalgeneral, tobacco use is responsible for the death in of about 1 of ineach 10 adults worldwide. Smokers arise the specific nature of inflammation,s includinges, along with the presence of neutrophils and macrophages, increaseds contents ofin CD8 cytotoxic T-cell and Ncnatural killers1 lymphocytes, presented only in smokers, leading to structural changes in the bronchi. In the later stages, primarily considering growing hypoxia, there are structural changes not only in pulmonary, but also in systemic circulation, but also in the systemic circulation. All this results in the And in the result formed formation of endothelial dysfunctionendothelial dysfunction. It is known, that endothelium regulates the vascular tone. So eEndothelial dysfunction is - an imbalance between substances produced in the endothelium and produced in the endothelium, which are responsible for contraction and expansion dilation of blood vessels. Which This in turn can be one of the causes of arterial hypertension. Nicotine constricts blood vessels, thereby, increasing arterial blood pressure. Also iIt's also stimulates the adrenal cortex to secrete adrenaline, which increases the heart rate and causes hypertension. According to the World Health Organization, today 1.3 billion people on our planet is dependent on tobacco. every Every year in Ukraine die from smoking-related causes about 100 000 people die from smoking-related causes, while in Kharkov Kharkiv because of smoking in a year die 3363 people die in a year due to smoking, accounting forabout 9 persons eople daily. So, it could be said, we can say, that smoking is one of the main reasons of COPD in combination with arterial hypertension. And this is a modifiable factor! And iIf everybody man decidess for himself, that he must to stop smoking, this it would ill be not only decreases the risk of development of these pathologies, but also significantly improve the quality of life.