Influence of dapagliflozin on cardiovascular remodeling in hypertensive patients with accompanying type 2 diabetes

Aim. To compare the results of 12-week treatment of patients with stage II hypertension (HTN) with accompanying diabetes mellitus (DM) type 2 between the combination of metformin + dapagliflozin and metformin monotherapy by studying changes in the elastic properties of the common carotid arteries (CCA), echocardiographic indicators, 24-hour ambulatory blood pressure monitoring (ABPM) and laboratory parameters of lipid and carbohydrate metabolism. Materials and methods. 24 patients with stage II HTN with type 2 DM were involved in the study, the average age was 60.4 years, 50 % – men. Patients in the first group were randomized to receive metformin, and the second group – to receive a combination of metformin and dapagliflozin. At inclusion and after 3 months of treatment, basic anthropometric data, laboratory indicators of lipid and carbohydrate metabolism, ABPM, echocardiography, and indicators of CCA local stiffness were studied. Statistical analysis was performed, the probability of differences is at the level of p < 0.05. Results. In both observation groups, there was a comparable decrease in SCORE 2-Diabetes range, glucose and glycated hemoglobin, total cholesterol, LDL cholesterol, average daily systolic blood pressure (SBP), daily SBP load, day and night pulse BP, as well as an increase in speed systolic movement of the lateral fibrous ring of the mitral valve (S lat). Only in the metformin + dapagliflozin group a decrease in the adipose tissue level, the average daily diastolic blood pressure (DBP), the burden of DBP, the size of the left atrium and right ventricle, an increase in the movement speeds of the medial (e’med), lateral (e’lat) ring of the mitral and of the tricuspid (e’tk) valve in the period of early diastolic filling of the ventricles, velocities of systolic movement of the medial fibrous ring of the mitral (S med) and tricuspid (S tk) valves, a decrease in the ratio E/e’, and an improvement in the elastic properties of general carotid arteries were observed. Conclusions. In persons with HTN stage II with DM type 2 the addition of dapagliflozin to the treatment regimen was associated with better control of blood pressure, improvement of diastolic function and longitudinal contractility of the left ventricle, elastic properties of CCA

Dependency between local carotid arterial stiffness and the presence of atherosclerotic plaque in the carotid basin in hypertensive patients with type 2 diabetes mellitus

Aim. To assess the impact of atherosclerotic plaque (ASP) on the local arterial stiffness of the common carotid arteries (CCA) in patients with stage II hypertension (HTN) in combination with type 2 diabetes mellitus (T2DM). Materials and methods. The study included 37 patients with stage II HTN and T2DM (mean age 60.4 ± 10.7; 66.7 % male). Patients were divided into two groups: 20 individuals with ASP and <50 % stenosis in the carotid basin, 17 without ASP. The study involved a clinical examination, body weight and percentage of adipose tissue (AT) measurements, analysis of lipid and carbohydrate metabolism laboratory parameters, echocardiography, CCA ultrasound examination with the determination of local stiffness and intima-media complex thickness (IMT). Statistical analysis was performed, significant differences were considered at p < 0.05. Results. The whole-body AT percentage 6.35 mmol/l (p = 0.036) and independent of age and sex. A greater left CCA diameter of more than 8.59 mm (p 6.35 mmol/l (p = 0.031) and it is also unaffected by age and sex. Conclusions. In individuals with stage II HTN and T2DM, the presence of CA atherosclerosis with stenosis up to 50 % is associated with a significantly increased CCA and ascending aorta diameter, a decreased percentage of AT, and an increased compliance coefficient of plaque-free wall segments

Types of the left ventricle geometry and changes in functional parameters of the heart in patients with atrial fibrillation

Aim. To study the features of the left ventricle remodeling and changes in its functional signs in patients with atrial fibrillation (AF). Materials and methods. In total, 2423 patients aged from 18 to 94 years (mean age – 57.9 ± 16.4 years), 51 % men, with pathologies of the cardiovascular and respiratory systems and patients without diagnosed diseases of cardiovascular system were enrolled in the study. Echocardiography was performed on an Esaote MyLab Seven device (Italy) according to generally accepted rules. The indicators of systolic and diastolic, valvular functions, the distribution of patients according to four classic types of the left ventricular geometry were studied. Statistical analysis was performed using the Statistica 13.0 software package for Windows. Statistically significant differences were calculated using the Mann–Whitney U test, Pearson’s χ2 test, Kruskal–Wallis test. A level of p < 0.05 was taken to indicate statistical significance. Results. The prevalence of AF in the group of normal geometry was 6.5 %, concentric remodeling – 11.8 %, eccentric hypertrophy – 17.4 %, concentric hypertrophy – 21.7 %. Left ventricular hypertrophy was diagnosed in 56.2 % of patients with AF (32.0 % – eccentric hypertrophy, 27.8 % – concentric hypertrophy), while in the patient group without AF, left ventricular hypertrophy was detected in only 33.9 % of the examined (20.4 % – eccentric hypertrophy, 13.5 % – concentric hypertrophy). In groups of concentric and eccentric hypertrophy, the patients were older, there was a higher prevalence of mitral, aortic, tricuspid valve regurgitation, and lower indicators of systolic function (EF, TEI, S’), diastolic function (e’med) than those in groups with normal geometry and concentric remodeling. In 29.3 % of patients with AF, the geometry of the left ventricle remained normal. Conclusions. The prevalence of AF increased according to the geometric patterns of the left ventricular remodeling with the highest rates in the groups of eccentric and concentric hypertrophy, which were also associated with worse indicators of systolic, diastolic, and valve functions

Modelling Li+ Ion Battery Electrode Properties

We formulated two detailed models for an electrolytic cell with particulate electrodes based on a lithium atom concentration dependent Butler-Volmer condition at the interface between electrode particles and the electrolyte. The first was based on a dilute-ion assumption for the electrolyte, while the second assumed that Li ions are present in excess. For the first, we used the method of multiple scales to homogenize this model over the microstructure, formed by the small lithium particles in the electrodes. For the second, we gave rigorous bounds for the effective electrochemical conductivity for a linearized case. We expect similar results and bounds for the "full nonlinear problem" because variational results are generally not adversely affected by a sinh term. Finally we used the asymptotic methods, based on parameters estimated from the literature, to attain a greatly simplified one-dimensional version of the original homogenized model. This simplified model accounts for the fact that diffusion of lithium atoms within individual electrode particles is relatively much faster than that of lithium ions across the whole cell so that lithium ion diffusion is what limits the performance of the battery. However, since most of the potential drop occurs across the Debye layers surrounding each electrode particle, lithium ion diffusion only significantly affects cell performance if there is more or less complete depletion of lithium ions in some region of the electrolyte which causes a break in the current flowing across the cell. This causes catastrophic failure. Providing such failure does not occur the potential drop across the cell is determined by the concentration of lithium atoms in the electrode particles. Within each electrode lithium atom concentration is, to leading order, a function of time only and not of position within the electrode. The depletion of electrode lithium atom concentration is directly proportional to the current being drawn off the cell. This leads one to expect that the potential of the cell gradually drops as current is drawn of it. We would like to emphasize that all the homogenization methods employed in this work give a systematic approach for investigating the effect that changes in the microstructure have on the behaviour of the battery. However, due to lack of time, we have not used this method to investigate particular particle geometries

A CLINICAL CASE OF CROHN’S DISEASE

The article demonstrates a clinical case of Crohn’s disease. The clinical manifestation of the disease, a diagnostic approach based on laboratory and instrumental methods with discussion of obtained results, and the up-to-date methods of investigation based on the literature data are shown. The significance of lifestyle modification, optimal drug treatment and regular check-ups for improvement of prognosis is emphasized

A toy model of the five-dimensional universe with the cosmological constant

A value of the cosmological constant in a toy model of the five-dimensional universe is calculated in such a manner that it remains in agreement with both astronomical observations and the quantum field theory concerning the zero-point fluctuations of the vacuum. The (negative) cosmological constant is equal to the inverse of the Planck length squared, which means that in the toy model the vanishing of the observed value of the cosmological constant is a consequence of the existence of an energy cutoff exactly at the level of the Planck scale. In turn, a model for both a virtual and a real particle-antiparticle pair is proposed which describes properly some energetic properties of both the vacuum fluctuations and created particles, as well as it allows one to calculate the discrete "bare" values of an elementary-particle mass, electric charge and intrinsic angular momentum (spin) at the energy cutoff. The relationships between the discussed model and some phenomena such as the Zitterbewegung and the Unruh-Davies effect are briefly analyzed, too. The proposed model also allows one to derive the Lorentz transformation and the Maxwell equations while considering the properties of the vacuum filled with the sea of virtual particles and their antiparticles. Finally, the existence of a finite value of the vacuum-energy density resulting from the toy model leads us to the formulation of dimensionless Einstein field equations which can be derived from the Lagrangian with a dimensionless (naively renormalized) coupling constant.Comment: 52 pages, 1 figure; a post-final, rewritten version with a number of new remarks and conclusion

Дослідження готовності працівників міліції до дій в екстремальних умовах

Дослідження готовності працівників міліції до дій в екстремальних умовах / І. В. Власенко, А. П. Богун, А. В. Березняк // Вісник Харківського національного університету внутрішніх справ. – 2007. – Вип. 36. – С. 420-430.Проаналізовано дослідження готовності працівників міліції до дій в екстремальних умовах. Надано практичні рекомендації щодо вирішення зазначених питань. Проанализированы исследования готовности сотрудников милиции к действиям в экстремальных условиях. Даны практические рекомендации по решению указанных вопросов. The analysis of the police officers' readiness to act in extreme conditions is analyzed. Practical recommendations are given to address these issues