Arterial Hypertension with Comorbid Chronic Obstructive Pulmonary Disease: Relationship Between of Tolerance to Physical Exercise And Structural and Functional State of the Heart

The aim of the study was to establish the relationship between tolerance to exercise, oxygen saturation, and structural and functional cardiac status in patients with hypertension in combination with COPD. This study included 120 patients with primary arterial hypertension of stage I-II, grade 1, 2, and 3 in combination with COPD of grades 2 and 3 and clinical groups A, B, C, D, consisting group 1; group 2 – 30 patients with primary hypertension, and group 3 – 30 patients with COPD; group 4 – 30 practically healthy people representative by age and sex. Research methods included general clinical examination (collection of complaints, anamnestic data) and instrumental research methods: electrocardiography (ECG), echocardiography, measurement of ambulatory blood pressure (BP) profile (ABPM), spirometry, pulsoxymetry (SpO2), 6-minutes walking test (6MWT). On examination of 120 patients with stage I-II, grade 1 hypertension was established in 19 (15.8%), grade 2 was in 83 (69.2%) and grade 3 was in 18 (15%) patients, respectively. COPD in clinical group A was diagnosed in 10 (8.3%), B – in 51 (42.5%), C – in 18 (15%) and D - in 41 (34.2%) patients, respectively. The most common was AH stage 2 with COPD in clinical group B – 35 (29.2%) cases and D – 31 (25.8%) cases. The 24-hour average systolic BP (SBP) in patients of the main group was 165 [144;178] mmHg, and the diastolic BP (DBP) was 103 [94;111] mmHg. The daytime average SBP was 160 [140;180] mmHg, and the DBP was 105 [93;117] mmHg accordingly. The night-time average SBP was 165 [155;175] mmHg, DBP – 100 [95;105] mmHg, heart rate (HR) – 83 [76;88] minutes, respiration rate (RR) – 21 [19;24] minutes. Decreases in index of chronotropic reserve (ICR) and the index of inotropic reserve (IIR) and load index indicate an increase in myocardial oxygen demand during exercise. There was an inverse correlation of IIR with SBP at rest (r= –0.42; p˂0.05) and a direct correlation with age (r=0.28; p˂0.05), which is significantly different from the control group. A direct correlation was found between the double product (DP) before and after exercise (r=0.43; p˂0.05), which indicated an increase in consumption of oxygen by the myocardium. We found a direct correlation between left atrium (LA) and the ratio of expiratory volume per 1 sec (FEV1) to the forced lung capacity (FEV) – FEV1/FVC (r=0.32; p˂0.05), which indicates the effect of the severity of bronchial obstruction on the level of left ventricular (LV) overload in patients with hypertension combined with COPD. The inverse correlation between thickness of the posterior wall of the LV (RVWT) and FEV1/FVC (r= -0.32; p˂0.05) indicates the contribution of disorders of bronchial patency and intrathoracic pressure with the level of BP to the development of concentric remodeling and LV hypertrophy. The inverse correlation between SV and COPD Assessment Test (CAT) (r= -0.32; p˂0.05) indicates an additional effect of COPD clinical severity on central hemodynamics in patients with hypertension. This relationship between the ventilatory and hemodynamic parameters is confirmed by the inverse correlation of HR and FVC (r= –0.33; p˂0.05)), left ventricular internal dimension (LVEDD) of LV and CAT (r= –0.24; p˂0.05)), stroke volume (SV) and Modified British Medical Research Questionnaire (mMRC) (r= –0.42; p.00.05), CAT and pack years (r=0.33; p˂0.05), inverse correlation between CAT and mMRC and FEV1, FVC and FEV1/FVC (r= -0.40;p˂0.05 and r= -0.45; p˂0.05), respectively. Linear regression analysis showed that changes in SV LV, LVEDD and SpO2 were dependent predictors of patient’s worsening state according to CAT (p˂0.05). The direct correlation was established between the desaturation (ΔSpO2) and ΔDP (r=0.48) and the inverse of ΔSBP (r= -0.29), 6MWT (r= -0.45), ICR (r= -0.34) and IIR (r= -0.29), which indicates a pronounced effect of hypoxemia on hemo-dynamics in patients with hypertension in combination with COPD. Comprehensive determination of cardiorespiratory reserve by 6-minute walk test, pulse oximetry and ambulatory blood pressure monitoring in patients with hypertension in combination with COPD makes it possible to establish disadaptation of the body to physical activity due to hypoxemia, decrease in the index of chrono- and inotropic reserves, which is an indication for administering appro-priate therapy. In patients with hypertension combined with COPD, the degree of desaturation, stroke volume, end-diastolic parameters of the left ventricle, maximal size and volume of the left atrium, as well as remodeling of the left heart sections in the concentric direction can be considered as independent predictors of prognosis. The 6-minute walk test with desaturation can be used as an additional method of personalizing rehabilitation measures in patients with hypertension in combination with COPD

Електромагнітні хвилі у багатокомпонентних штучних композитних матеріалах

Дисертаційна робота представлена в рамках актуального напрямку сучасної радіофізики, який стосується синтезу штучних композитних матеріалів і теоретичного й експериментального дослідження їх електродинамічних властивостей. Матеріали, що досліджуються, містять оптично-активні включення та можуть функціонувати на однакових фізичних принципах у різних діапазонах частот від НВЧ до оптичного. Автором були розвинуті й узагальнені існуючі методи аналізу штучних середовищ зі складною просторовою композицією, що в поєднанні з підходами сучасної радіофізики та математичної фізики, дозволило виявити низку нових фізичних ефектів і закономірностей поширення та розсіяння електромагнітних хвиль на таких композитних структурах. Отримані в дисертаційній роботі результати являються важливими, як для прикладних досліджень спрямованих на створення високоефективних пристроїв фотоніки, мікроелектроніки, оптоелектроніки та плазмоніки, так і для поглиблення фундаментальних знань про особливості взаємодії електромагнітного випромінювання зі штучними композитними середовищами.Fesenko V. I. Electromagnetic waves in multicomponent artificial composite media. – Qualification scientific work is as a manuscript. Thesis for a Doctoral Degree in Physics and Mathematics, Specialtiy 01.04.03 – Radiophysics. – Institute of Radio Astronomy of the National Academy of Sciences of Ukraine; V. N. Karazin Kharkіv National University Ministry of Education and Science of Ukraine. – Kharkiv, 2020. The thesis is related to a new field of modern radiophysics, which concerns with the synthesis of artificial composite structures and theoretical and experimental study of their electromagnetic properties. The structures under study are composed of optically active components and can operate on the same physical principles in different frequency ranges from microwave to visible. The aim of the work is to develop and analyze, in the framework of a unified theory, several physical and mathematical models of the electromagnetic field interaction with artificial composite media. In the proposed models, the effects of anisotropy and spatial inhomogeneity on the characteristics of electromagnetic wave propagation in the studied artificial structures are accounted for. The author develops and generalizes the existing methods of analysis of artificial structures with complex spatial composition. These methods combined with other approaches of modern radiophysics and mathematical physics allow revealing a number of new physical conditions and effects of propagation and scattering of electromagnetic waves in such composite structures

Organization of research work of interns – dentists and the ways of its improvement

The growing pace of scientific, technical and-social development of society contributes to the purposeful search, selection, education and training of people with strong abilities in a particular field of knowledge. In this regard, there is a growing interest among the teaching staff of higher medical institutions to the problem of identifying and training interns with advanced skills and abilities of research work at the professional level

Application of systemic-effect antibacterial medications in the modern periodontology

Numerous srudies have established that pathological processes in the periodontium are accompanied by a series of changes that are induced by various microorganisms. This paper provides a review of the literatrtre on the application of systemic antibacterial medications in the practice of a periodontist. Medications that are created for suppressing and eliminating periodontal pathogens are used for the implementation of the preventive-therapeutic efect in the cotnplex treatment of periodontal diseases

Remodeling of heart in patients with stable ischemic heart disease combined with chronic obsructive pulmonary disease as a basis for development of heart failure

The aim of this study was to determine phenotypes of remodeling of heart and the status of systolic and diastolic function in patients with ischemic heart disease (IHD) combined with chronic obstructive pulmonary disease (COPD) with early symptoms and signs of heart failure (HF). We enrolled 108 males with stable IHD and spirometrically confirmed COPD which preceded the manifestations of IHD – the main group (group 1). As comparison groups 30 males with stable IHD (group 2) and 30 males with COPD (group 3) were examined. Control group included 30 males without IHD and respiratory diseases. All groups were comparable in age, groups 1 and 2 – in the duration of IHD, groups 1 and 3 – in the duration of COPD. The patients of the group 1 were divided into 3 subgroups: subgroup 1 – 45 patients with stable angina, subgroup 2 – 27 patients with postinfarction cardiosclerosis, subgroup 3 –36 patients with combination of stable IHD and arterial hypertension (AH) without history of myocardial infarction. The patients of group 1 had different phenotypes of heart remodeling, which depended on the clinical forms of IHD, the presence of concomitant AH, the severity of bronchial obstruction. The patients of subgroup 1 in 60.0% cases had concentric remodeling and concentric left ventricular hypertrophy (LVH), in 26.7% – normal LV geometry, in all these cases ejection fraction (EF) was preserved. Only in 13.3% of cases eccentric LVH with mildly reduced EF was found. 59.3% of patients in subgroup 2 had eccentric LVH, left atrium dilatation and 55.6% had reduced EF. All patients of subgroup 3 had concentric direction of LV remodeling. The phenotypes of HF with reduced and mildly reduced EF were accompanied by impaired LV diastolic function. In assessing the likelihood of HF with preserved EF the HFA-PEFF score showed better accuracy. Pulmonary hypertension had a mixed cause with predominance of postcapillar compone

The enhancement of optical processes near rough surface of metals

Last decades the enhancement of optical transitions near metal surface was observed under study the optical processes (luminescence, Raman scattering, IR absorption). The effect consists in an essential increase of the intensity of transition (for example, an effective cross-section increases by factor 10⁵…10¹¹ for Raman scattering and 10…10⁴ for IR absorption) or efficiency of the processes near metal surface (e.g. generation of second harmonic). We have analyzed a various experimental techniques that made it possible to achieve an enhancement in surface enhanced infrared absorption (SEIRA), surface enhanced Raman scattering (SERS), metal-enhanced fluorescence. Under the conditions of our experiment and according to literature data, there was observed enhancement factor which equal to 3…20 for vibrations of various molecular groups in SEIRA. Peculiarity of another optical amplifier, namely, colloidal gold nanoparticles, which were effectively used for enhancement of signal in IR absorption and Raman scattering, metal-enhanced fluorescence, has been studied also. Different roughness of gold surface leads to changes in an enhancement factor. The structural features of bovine serum albumine (BSA) – colloidal gold system and enhancement of guanine that obtained in SEIRA experiment are discussed. Atom force microscopy (AFM) technique was applied to test the roughness of the metal surface. We made an attempt to model the factor of enhancement of electrical field and its frequency dependence for different metal surfaces, and ascertained that silver, gold and copper are the best