Наукові праці. Кафедра пропедевтики внутрішньої медицини № 1, основ біоетики та біобезпеки
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Item Antihypertensive treatment effects on systemic inflammation, oxidative stress and proinflammatory cytokines(2020-12) Ashcheulova, Tetyana; Gerasimchuk, Nina; Kovalyova, Olga; Kompaniiets, Kira; Honchar, OleksiiHypertension in its origin is a heterogeneous and multisystemic disease. Evaluatation of the oxidative stress activity based on the level of 8-iso-PgF2α, of proinflammatory cytokines based on tumor necrosis factor-α and its type I soluble receptor and C-reactive protein is relevant for further understanding of pathogenesis of hypertension and improvement of the early diagnostics of heart failure.186 hypertensive patients have been observed during the 2-months course of treatment, aged 30 to 65 years. The serum levels of 8-iso-PgF2α (n = 34), tumor necrosis factor-α and its type I soluble receptor were determined by ELISA before and after course of treatment. C-reactive protein level was determined by biochemical method. The control group included 16 practically healthy individuals, aged 27 to 55 years. Hypertensive patients enrolled into study had been randomized into 3 arms that received different protocols of combined anti-hypertensive therapy. I clinical group – а combination of a bisoprolol and indapamid, II – а combination of a lacidipine and candesartan, III – а combination of а fosinopril sodium and hydrochlorothiazide. On the background of combined antihypertensive therapy, we observed favorable dynamics of 8-iso-PgF2α, tumor necrosis factor-α and its type I soluble receptor and C-reactive protein. Taking into account the insignificance of the correlations revealed, a one-factor dispersion analysis was applied which allows to determine with certainty the influence of the grade and duration of hypertension on the dynamics of the studied indices levels. It has been found that the grade of hypertension is related to the increase in TNF-α and 8-iso-PgF2α serum levels, but not on to TNF-α type I soluble receptor, and the duration of hypertension is related to the increase in activity of the C-reactive protein, TNF-α and its type I soluble receptor, with no relation to the level of 8-iso-PgF2α. Thus, oxidative stress possibly promotes the activation of potentially damaging immune mechanisms mediated by pro-inflammatory cytokines, nonspecific inflammation and drives the further progression of the target organs lesions.Item Нові реалії вищої медичної освіти в дистанційному форматі(ТНМУ, 2020-11) Кочубєй, Оксана Анатоліївна; Ащеулова, Тетяна Вадимівна; Ситіна, Ірина Василівна; Kochubiei, Oksana; Ashcheulova, Tetyana; Sytina, IrynaПандемія Covid-19 у 2020 році загострила ряд етичних, гуманітарних та технологічних проблем. Але за допомогою сучасних передових цифрових технологій було можливо перебудувати сферу освіти та наладити дистанційне навчання. Дистанційне навчання суспільство придумало через гостру потребу в ньому. А історія з світовим карантином чи не найцікавіший цьому доказ. Бо всім відомо, що освіта, науковий прогрес, доступність інформації та глобалізація тісно пов’язані між собою і напряму впливають один на одногоItem Supramolecular complex sacubitril / valsartan - the first representative of a new class of drugs for the treatment of chronic heart failure(2019-12) Ащеулова, Тетяна Вадимівна; Ащеулова, Татьяна Вадимовна; Ashcheulova, Tetyana; Компанієць, Кіра Миколаївна; Герасимчук, Ніна Миколаївна; Kompaniiets, K.; Gerasimchuk, N.Item Subclinical cardiac damage in cardiopulmonary polymorbidity. Part 2(KhNMU, 2019-10) Kochubiei, Oksana; Ambrosova, Tetyana; Ashcheulova, Tetyana; Honchar, Oleksii; Sytina, Iryna; Ащеулова, Тетяна; Амбросова, Тетяна; Кочубєй, Оксана; Гончарь, Олексій; Ситіна, ІринаHypertension and chronic obstructive pulmonary disease are frequent comorbid conditions in the internal medicine and are subject to meaningful cooperation among physicians, cardiologists, and pulmonologists. A combination of chronic obstructive pulmonary disease and hypertension presents certain diagnostic and therapeutic challenges. These conditions share common risk factors, similar clinical presentations and some common parts of pathogenesis. A problem of association between chronic obstructive pulmonary disease and hypertension may be currently discusses both as a simple combination of various clinical entities, and as chronic obstructive pulmonary disease resulting in development of factors contributing to hypertension. One way or another, either a simple combination, or a mutually aggravating syndrome, but we state there is a cardiorespiratory continuum where chronic obstructive pulmonary disease acts as a valid component of hypertension development, and vice versa. Thus, it seems to be relevant to study peculiarities of the structural and functional status of the cardiovascular system and microcirculation, systemic remodeling mechanisms, endothelial dysfunction and inflammation in presence of chronic obstructive pulmonary disease-associated hypertension. Problems of additional cardiovascular risk marker development, treatment efficiency assessment remain topical. The use of electrocardiography and echocardiography with dopplerometry has been an important diagnostic principle of subclinical cardiovascular damage in presence of hypertension and chronic obstructive pulmonary disease comorbidity. Non-invasive imaging methods play a central part in diagnosis of subclinical target organ damage. Wide implementation thereof is based on high diagnostic accuracy, common availability, safety and relatively low price.Item Early repolarization syndrome in modern interpretation(2019-08) Ashcheulova, Tetyana; Gerasimchuk, Nina; Sytina, IrynaRelevance of the study of early repolarization syndrome is associated with a high degree of its occurrence among the general population, namely among young people and people doing sports. Objective is to generalize the data of experimental and clinical studies which have found that the early repolarization syndrome is an idiopathic electrocardiographic phenomenon, which is considered by various specialists ambiguously; to assess the state of the cardiovascular system in the subjects, both adults and children with early repolarization syndrome, and to propose a diagnostic algorithm for detecting this phenomenon on the ECG when admitting to physical exercise and sports. The history of the development of early repolarization syndrome has been shown since 1936 to present time, which was first described by R. Shipley and W. Halleran. Clinical interest in ERS appeared as a result of a clinically established relationship with lethal arrhythmias in healthy people without structural changes in the heart. According to existing recommendations, the opinions of leading experts, including members of Heart Rhythm Society (HRS), the European Heart Rhythm Association (EHRA), the Asia-Pacific Society for Heart Rhythm (2015), it should be distinguish between the pattern and the syndrome of early ventricular repolarization. The Shanghai scale for the diagnosis of early repolarization syndrome, as well as the etiology, electrophysiology of early repolarization syndrome, its modern classification and electrocardiographic signs are presented. The features of early repolarization syndrome in athletes and in children, as well as the features of its treatment and prevention are shown. Conclusions. Thus, the early repolarization syndrome is an important cardiac problem. Future clinical and experimental studies should focus on finding out the exact causes and mechanisms for the development of the early repolarization syndrome and, ultimately, on developing strategies to prevent premature death from cardiac causes in individuals with this electrocardiogram disorder.Item Викладання дисципліни «Сестринська практика» на кафедрі пропедевтики внутрішньої медицини №1, основ біоетики та біобезпеки ХНМУ(ТНМУ, 2019-05) Ashcheulova, Tetyana; Ащеулова, Тетяна; Kochubiei, Oksana; Кочубєй, Оксана; Sytina, Iryna; Ситіна, ІринаВступ. Вивчення одного з розділів дисципліни «Сестринська практика» - «Професійні дії медичної сестри по забезпеченню діагностичного та лікувального процесу у відділеннях терапевтичного стаціонару» проводиться з використанням медичних навчальньних тренажерів. Основна частина. Тренажер внутрішньовенних ін'єкцій призначений для навчання техніці інфузійно-трансфузійної терапії, внутрішньовенних ін'єкцій і забору крові. Тренажер являє собою модель укріпленої на підставці руки людини. Ділянка, що призначена для ін’єкцій покрита «шкірою» із силікону, через яку візуалізуються та добре пальпуються 2 латексі вени. Реалістичності додає «штучна кров», якою заповнюється система вен, що надає можливості контролю правильного виконання внутрішньовенних маніпуляцій. Для опанування навичок внутрішньом’язових ін’єкцій використовується пластикова модель сідниць, на якій візуалізуються анатомічні орієнтири. У зоні верхнього зовнішнього квандранту вмонтований змінний м’який вкладиш, що за своїми фізичними властивостями схожий на м’язову тканину людини, що надає реалістичності під час введення голки, і зусилля які докладаються під час проведення ін’єкції на тренажері, будуть подібними до ін’єкцій людині. Для підшкірного введення лікарських засобів. студентам пропонується тренажер-подушечка, який може бути закріплений на плечі, стегні або в області передньої стінки живота. Товщина шару пінополіуретану, дозволяє вводити голку шприца на глибину до 2 см. Висновки. Використання тренажерів при проведенні занять з дисципліни «Сестринська практика» створює умови для наочності і доступності навчання із відпрацювання практичних навичок, надає можливість здійснювати об’єктивний контроль за їх виконанням, що у комплексі сприяє кращому засвоєнню навчального матеріалу.Item Subclinical cardiac damage in cardiopulmonary polymorbidity. Part 1(KhNMU, 2019-08-03) Ashcheulova, Tetyana; Ambrosova, Tetyana; Kochubiei, Oksana; Honchar, Oleksii; Sytina, Iryna; Ащеулова, Тетяна; Амбросова, Тетяна; Кочубєй, Оксана; Гончарь, Олексій; Ситіна, ІринаHypertension and chronic obstructive pulmonary disease are one of the frequent comorbid conditions in internal medicine and are subject to meaningful cooperation among physicians, cardiologists, and pulmonologists. A combination of chronic obstructive pulmonary disease and hypertension presents certain diagnostic and therapeutic challenges. These conditions share common risk factors, similar clinical presentations and some common parts of pathogenesis. The problem of association between chronic obstructive pulmonary disease and hypertension may be currently discusses both as a simple combination of various clinical entities, and as chronic obstructive pulmonary disease resulting in development of factors contributing to hypertension. One way or another, either a simple combination, or a mutually aggravating syndrome, but we state there is a cardiorespiratory continuum where chronic obstructive pulmonary disease acts as a valid component of hypertension development, and vice versa. Thus, it seems to be relevant to study peculiarities of the structural and functional status of the cardiovascular system and microcirculation, systemic remodeling mechanisms, endothelial dysfunction and inflammation in presence of chronic obstructive pulmonary disease -associated hypertension. Problems of additional cardiovascular risk marker development, treatment efficiency assessment remain topical. Use of electrocardiography and echocardiography with dopplerometry has been an important diagnostic principle of subclinical cardiovascular damage in presence of hypertension and chronic obstructive pulmonary disease comorbidity. Non-invasive imaging methods play a central part in diagnostics of subclinical target organ damage. Wide implementation thereof is based on high diagnostic accuracy, common availability, safety and relatively low price.Item Diastolic Dysfunction: from Discovery to the Last Updates(Zaporozhye medical journal., 2019-08) Ashcheulova, Tetyana; Demydenko, Ganna; Gerasimchuk, Nina; Rezunenko, Yuri; Kochubiei, Oksana; Ambrosova, TetyanaOver a long period, chronic heart failure was primarily associated with impaired contractility of the myocardium of the left ventricular, which is a manifestation of systolic dysfunction. Based on modern ideas about the pathophysiology of CHF syndrome, systolic dysfunction is considered as one of the etiological factors along with changes in wall tension and the structure of diastolic filling, i.e. everything that is included in the concept of "LV remodeling". The objective is to present a review of the key parameters of chronic heart failure and left ventricular diastolic dysfunction according to the last updates. Material and methods. The role and significance of diastolic dysfunction as the cause of chronic heart failure syndrome, have only been started to be determined over the past three decades, which can be explained by the difficulty of early diagnostics of diastolic dysfunction. The article describes the historical evolution of estimating heart failure and left ventricular diastolic dysfunction. It is important to note the high prevalence of diastolic dysfunction. The signs of myocardial diastolic dysfunction are detected in people with almost any heart disease. The universal review of the most important parameters which determine this disorder has been presented. It has been shown that nowadays Doppler echocardiography is the noninvasive “golden standard” for estimation of diastolic dysfunction. We have presented methods of treatment for diastolic dysfunction, based on updated recommendations of the American College of Cardiology / American Heart Association in treating patients with heart failure in 2017. Conclusions. The experimental studies show that the survival rate of patients with heart failure with a preserved ejection fraction depends not so much on its indices, but on the severity of diastolic dysfunction. Diastolic dysfunction in patients with heart failure is a more prognostic mortality rate than the ejection fraction, which needs further research for better treatment.Item Polymorphism of the renin-angiotensin system genes and endothelial no-synthase gene in obese patients with arterial hypertension(2018-12) Ashcheulova, Tetyana; Gerasimchuk, Nina; Demydenko, Ganna; Kulikova, MariiaThe review is dedicated to relationships between the blood pressure and body mass. Endothelial dysfunction and imbalance of neurohumoral systems, namely, the pathological increase in the activity of the renin-angiotensin system, in combination with obesity are the main mechanisms of the of the hypertonic disease pathogenesis. Here we discuss the research on polymorphism of the renin angiotensinic system genes and the endothelial synthase nitric oxide gene. The difficulty lies in the correct assessment of associations of alleles which have clinical signifi- cance. It is essential to determine precisely the associations of gene polymorphisms in the hypertonic disease with obesity. This provides an opportunity to identify new personified approaches to the treatment of patients with this complex pathology.Item Left ventricular diastolic function in patients with hypertensive kidney disease and obesity(2018) Гончарь, Алексей Владимирович; Гончарь, Олексій Володимирович; Honchar, Oleksii; Ащеулова, Татьяна Вадимовна; Ащеулова, Тетяна Вадимівна; Ashcheulova, Tetyana; Kovalyova, Olga; Ковальова, Ольга Миколаївна; Ковалева, Ольга Николаевна; Амбросова, Татьяна Николаевна; Амбросова, Тетяна Миколаївна; Ambrosova, Tetyana; Matyash, Nataliia; Матяш, Наталья Михайловна; Матяш, Наталія Михайлівна