COMPARATIVE EFFICACY OF BLOCKADE OF THE RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM WITH COMBINATIONS OF ALISKIREN AND AMLODIPINE, RAMIPRIL AND AMLODIPINE IN PATIENTS WITH ESSENTIAL HYPERTENSION

Hypertension is one of the most common disease of the cardiovascular system. Important components of a rational antihypertensive therapy are drugs that block the RAAS. The aim of the study was to conduct a comparative evaluation of the effectiveness of blockade of the renin-angiotensin-aldosterone system with drug combinations – aliskiren and amlodipine and combination of ramipril and amlodipine in patients with hypertension and increased body weight. 50 patients with hypertension of stage II, II degree, high and very high risk were involved in the study. Patients were randomized into two groups depending on the received treatment. The first group (25 patients) consisted of patients treated with combined therapy including ramipril and amlodipine, the second group (25 patients) consisted of patients receiving a combination of aliskiren and amlodipine. The control group (25 people) included apparently healthy people. By the 12th week of the study the daily average systolic blood pressure in the first group was 146 (145; 150) mm Hg and 131 (130; 137) mm Hg in the second group, respectively, the daily average diastolic blood pressure was equal to 94 (91; 96) mm Hg in the first group and 81 (80; 82) mm Hg in the second group . By the 12th week of treatment plasma renin levels in the first group was equal to 73 (50; 78) and 15 (14; 27) in the second group, respectively, the level of angiotensin-I in the first group was 6 (4; 7) and 1,4 (1,1; 1,9) in the second group, aldosterone levels in the first group was equal to 134 (132; 145) and 130 (123; 132) in the second group, respectively. It is found that combination of aliskiren and amlodipine have the advantage over the combination of ramipril and amlodipine in achieving of purposeful level of systolic and diastolic blood pressure in patients with hypertension and overweight. The purposeful level of blood pressure reached to 56,6% of patients in group I and 80% of patients in group II to 12th week of the study. Receiving both combinations equally reduces plasma aldosterone levels at the same time receiving a combination of aliskiren and amlodipine accompanied by a decrease in plasma rennin level of 69% and angiotensin-I of 67%, while the combination of ramipril and amlodipine increases of these hormones on 68% and 65% respectively. Thus, using combination of ramipril and amlodipine more effective in patients with low rennin hypertension , patients with normal and high rennin hypertension necessary combination of aliskiren and amlodipine

Conceptualization of the experience of the individual in the educational space in the light of scientific rationality as a problem of professional identity in global and sociocultural dynamics

As a problem, professional identity associated with the educational space is investigated from the position of belonging to professional groups. The contradictory state of education in the modern world actualizes the problem of identity in the educational space from the perspective of classical modern European rationality with its focus on the scientific forms of cognition, knowledge. The current situation in the world educational space is developed in the ambiguity of the idea of the world, which is expressed in the crisis of universalism and cognitive integrity: the place of rational knowledge in culture is replaced by mythic ideas. The way of thinking exists independently of the individual. The transfer of thinking is a learning task. However, at the present stage, with a sharp increase in the amount of information reported, the emphasis is on formalizing of the educational process, rather than constructivizing. The teacher’s responsibility as a carrier of scientific rationality, which primarily defines the universal meaning of human activity in the transmission of social experience and knowledge, is growing. The level of education of a person is a measure of implementation of the possibility of his/her formation, taking into account the dichotomous nature of the individual's socialization and professional identity based on it. Such a holistic perception of the world will allow gaining a deep understanding of the essence of things, fitting science into the cultural context of modernity

FEATURES OF HEMODYNAMICS OF LIVER AND HEART IN PATIENTS WITH VIRAL CIRRHOSIS

To study the peculiarities of hemodynamics of liver and heart Doppler echocardiography, duplex ultrasonography vascular screening in patients with viral cirrhosis were held. It was found that patients with viral cirrhosis have remodeling of viscerogenic hemodynamic, left ventricle myocardium with formation of various variants of its geometry. Disorder of heart ventricles relaxation, presence of moderate pulmonary hypertension are accompanied by more expressed portal hemodynamic disorders. Indices of viscerogenic hemodynamic correlate with geometric characteristics of heart ventricles and pulmonary artery, functional state of left ventricle and hemoglobin saturation with oxygen

PULMONARY HYPERTENSION IN PATIENTS WITH VIRAL CIRRHOSIS

To study the peculiarities of the formation of pulmonary hypertension in patients with viral cirrhosis we carried out tissue Doppler echocardiography, Doppler echocardiography, duplex vascular scanning, research of respiratory function in patients with viral cirrhosis. It was found that pulmonary hypertension in patients with viral cirrhosis was a frequent complication (38 %) and is often moderate. An acceleration of blood flow and dilation of the portal and splenic veins, disturbed longitudinal systolic function of the right ventricle and its relaxation as well as decrease of the respiratory function by the restrictive type are registered in patients with pulmonary hypertension

EARLYDIAGNOSIS OFINTRARENAL BLOOD FLOW DISORDERSIN PATIENTS WITH ESSENTIAL ARTERIAL HYPERTENSION

Summary. Among the causes of end-stage renal failure essential arterial (EAH) hypertension has a leading place. One of thepathogenic mechanisms of hypertensive nephropathy is a violation of intrarenal blood flow. The purpose of this study was to conduct an early diagnosis of intrarenal blood flow disorders using Doppler examination and comparison of these data with the standard criteria of nephropathy in EAH. Materials and methods. 80patients with stage II EAH were examined. Results. In patients with grade II and III EAH noted depletion of intrarenal blood flow, characterized by low Vmax and Vmin, while there was an increase IR characterizing renal vascular resistance. Hyper phase in hypertensive nephropathy was characterized by a relative increase in hemodynamic indices at the level of the trunk of the renal artery and segmental artery with a reduction in the small arteries to the level in healthy people. Hypofiltration phase was characterized by a significant reduction of velocity indexes that accompanied by a decreasing of vascular resistance (theirpseudonormalization). In assessing renal hemodynamics in patients with EAH and microalbuminuria showed a decreasening of Vmin and increasening of IR. A inverse correlation between the level of night BP decreasing and IR segmental artery (r = - 0,61, p<0,05). Conclusions: 1. In patients with essential hypertension grade IIand IIImarked depletion of intrarenal blood flow characterized by a decrease in peak systolic and minimum diastolic velocity. At the same time there is increasing resistance indices characterizing renal vascular resistance. 2. Early stage of fypertensive nephropathy criteria before the development of microalbuminuria, hyperfiltration can be the increase in the indices at the level of resistance of main and segmental arteries according to Doppler examination of renal vessels. 3. In patients with essential hypertension and microalbuminuria there is a decrease in diastolic velocity and resistive index increase, indicating an increase in intrarenal vascular resistance and may also be a diagnostic criterion of nephropathy. 4. The inverse correlation between the level of nighttime decrease in blood pressure and segmental artery resistance index indicate the negative impact of the lack of night reduction in blood pressure to renal function in hypertension

Magnetic Phase Separation and Magnetic Moment Alignment in Ordered Alloys FE 65

The structure and the magnetic state of ordered Fe65Al35-xMx (Mx = Ga, B; x = 0; 5 at.%) alloys are investigated using X-ray diffraction, Mössbauer spectroscopy, and magnetic measurements. The behavior of the magnetic characteristics and Mössbauer spectra of the binary alloy Fe65Al35 and the ternary alloy with gallium addition Fe65Al30Ga5 is explained in terms of the phase separation into two magnetic phases: a ferromagnetic one and a spin density wave. It is shown that the addition of boron to the initial binary alloy Fe65Al35 results in the ferromagnetic behavior of the ternary alloy

Influence of Tocolytic Therapy with Hexoprenaline on Heart Rate Variability, Lipid Spectrum and Glycemic Level in Obese Pregnant Women

Background. Obesity is associated with the risk of spontaneous preterm birth. Hexoprenaline is the effective and most widely used tocolytic agent, possessing however a significant number of side effects. The effect of hexoprenaline tocolysis on heart rate variability, lipid spectrum and glycaemia level in obese pregnant women remain unexplored.Aim of the research. To study the effect of tocolytic therapy with hexoprenaline on heart rate variability, lipid spectrum and glycemic level in obese pregnant women.Materials and methods. The study included two groups of pregnant women with threatened preterm labor who received tocolysis with hexoprenaline. One group consisted of 68 obese patients, the other – 72 non-obese pregnant women (control group). Patients underwent Holter monitoring. Fasting serum glucose and lipids spectrum were measured before starting tocolytic therapy and after 24 hours of tocolysis.Results. In obese pregnant women with hexoprenaline infusion, the heart rate, the 24-hours number of supraventricular extrasystoles and ventricular extrasystoles during the day are significantly higher. Frequency domain parameters, very low frequency during the day, low frequency at night and 24-hours high frequency were significantly decreased than in control group. After a day of tocolysis in obese pregnant women, the level of total cholesterol, low density lipoproteins, triglycerides, and glucose significantly increases when compared with the results before therapy. For patients in the control group treated with hexoprenaline, only the concentration of high-density lipoproteins is increased.Conclusion. Obesity in pregnant women receiving hexoprenaline tocolysis is associated with low heart rate variability and an increase in the number of cardiac arrhythmias, as well as lipid disorders and an increase in glucose level

Innovation supporting course eco-caltural orientation for students of pedagogic profiles of university

The article deals with the problem of formation of ecological culture at students of pedagogical training areas at the university. Reveals the conceptual approaches and didactic principles of supporting eco-cultural orientation coursesВ статье рассматриваются проблемы формирования экологической культуры у студентов педагогических направлений подготовки в вузе. Раскрываются концептуальные подходы и дидактические принципы построения поддерживающих курсов экокультурной направленност

Features of management of the women's team in the organizations of sphere of services

Целью настоящей стать является описание особенностей управления женским коллективом в организациях сферы услуг.The purpose of this be is to describe the features of the management of female staff in the organizations of sphere of services

Stromal and Tumor Glioma-Derived Cells with Similar Characteristics have Differences in α-Smooth Muscle Actin Expression and Localization

Gliomas are solid brain tumors composed of tumor cells and recruited heterogenic stromal components. The study of the interactions between the perivascular niche and its surrounding cells is of great value in unraveling mechanisms of drug resistance in malignant gliomas. In this study, we isolated the stromal diploid cell population from oligodendroglioma and a mixed population of tumor aneuploid and stromal diploid cells from astrocytoma specimens. The stromal cells expressed neural stem/progenitor and mesenchymal markers showing the same discordant phenotype that is typical for glioma cells. Moreover, some of the stromal cells expressed CD133. For the first time, we demonstrated that this type of stromal cells had the typical myofibroblastic phenotype as the α-SMA+ cells formed α-SMA fibers and exhibited the specific function to deposit extracellular matrix (ECM) proteins at least in vitro. Immunofluorescent analysis showed diffuse or focal α-SMA staining in the cytoplasm of the astrocytoma-derived, A172, T98G, and U251MG glioma cells. We could suggest that α-SMA may be one of the main molecules, bearing protective functions. Possible mechanisms and consequences of α-SMA disruptions in gliomas are discussed