Women’s experience of divorce. Acta biomedica scientifica

The article is devoted to the problem of studying the experience of women going through the situation of divorce at different stages of the divorce and post-divorce period.Methods. The study was carried out at the intersection of idiographic and nomothetic approaches. At the first stage, the specifics of the experience of experiencing divorce in the online space are described, revealed through an interpretive-phenomenological analysis of the content of a closed Internet forum (n = 297). On the second – the specifics of emotional perception, cognitive assessment and coping with the situation of divorce, depending on the post-divorce experience (n = 50).Results. The experience of divorce by women is accompanied by ambivalent emotions, activates the understanding of the situation and coping with it. Online communication is an effective strategy focused on getting support, self-change, designing the future, allowing you to experience a sense of community in a life situation while maintaining psychological safety. The assessment of the divorce situation and coping strategies are specific: women who have gone through a divorce less than 3 years ago are more likely to seek social support; from 3 to 10 years – prefer the strategy of “flight-avoidance”; more than 10 years ago – “positive revaluation”. Conclusion. The experience of women experiencing the situation of divorce, including emotional, cognitive and conative components, is specific depending on the stage of the divorce and post-divorce period. An effective mechanism for shaping the experience of experiencing a divorce is network communication in a closed group of people who have similar problems

Токсикологическая характеристика Максаквина

.

PREGNANCY COURSE AND OUTCOME IN A WOMAN WITH STAGE III ESSENTIAL ARTERIAL HYPERTENSION

A clinical case of pregnancy in a woman with Stage III essential arterial hypertension is presented. The authors discuss the importance of hyperhomocysteinemia problem in pregnancy, and demonstrate the need to combine standard diagnostic methods with the assessment of hereditary thrombophilia markers in this clinical group. The therapeutic strategy is justified, and respective clinical recommendations are given

Prediction of the long-term risk of adverse cardiovascular events after an episode of acute coronary syndrome in patients with type 2 diabetes

Aim. To determine independent predictors of adverse cardiovascular events (ACE) and to develop a long-term (12 months) prognostic model after an episode of acute coronary syndrome (ACS) in patients with type 2 diabetes (T2D).Material and methods. The study included 120 T2D patients hospitalized due to ACS in the period from January 2016 to February 2017. All patients underwent standard diagnostic tests. Twelve months after ACS, the incidence of ACE in T2D patients was assessed: cardiovascular mortality, myocardial infarction, emergency surgical revascularization. Additionally, we analyzed composite endpoint (CEP), including all of the adverse outcomes listed. Patients were divided into 2 groups: group 1 (n=34) — patients with ACE; group 2 (n=86) — patients without ACE. Factors associated with the CEP were then included in the logistic regression to determine independent predictors of ACE. In order to predict the development of CEP in patients with ACS and T2D, a logit model was created. To process the model, a ROC analysis was performed.Results. Independent factors associated with ACE for 12 months in T2D patients after an ACS were established: MI of moderate severity (D.M. Aronov classification); hypertriglyceridemia; decreased heart rate variability (SDNN <0 ms); segments with significant coronary stenosis in the amount of ≥3; no surgical revascularization during acute MI. Based on independent factors, a logit model was developed for assessing 12-month risk of ACE in T2D patients after an ACS.Conclusion. The developed risk prediction model for T2D patients after ACS, based on accessible diagnostic tests, allows to determine the probability of ACE within 12 months

The importance of three-stage cardiac rehabilitation in patients with acute coronary syndrome and type 2 diabetes mellitus

Introduction. Acute coronary syndrome (ACS) patients with type 2 diabetes mellitus (T2DM) have worse prognosis than those without diabetes. Risk of adverse outcome in this cohort remains high despite the introduction of new methods of invasive treatment of ACS. The use of all-inclusive cardiac rehabilitation (CR) programs allows improving prognosis in patients with ACS and T2DM. Aim. The aim of the study was to evaluate impact of two- or three-stage CR on long-term prognosis in patients with ACS and T2DM. Methods. The study included 251 ACS patients hospitalized in the department of cardiology, of which 120 patients with T2DM. Management of ACS was carried out in accordance with the clinical recommendations of the European Society of Cardiology (2015, 2017). All patients underwent standard laboratory and instrumental examination. We analyzed prognostic parameters (myocardial revascularization, myocardial infarction and mortality) during 12 months of follow-up in diabetic and non-diabetic patients with ACS who underwent two or a three-stage CR. Additionally, the achievement of the combined endpoint, which include at least one of the ACE, was analyzed. Results. Long-term prognosis in ACS patients who underwent three-stage CR in diabetic and non-diabetic groups did not differ significantly. However, the frequency of repeated myocardial revascularization was higher in patients with T2DM in comparison with non-diabetic patients inside the two-stage CR subgroup. Conclusion. Three-stage CR should be recommended in diabetic patients with ACS to improve long-term prognosis