Features of peripheral circulation in young people of different somatotype with normal and high blood pressure

Introduction: Hypertension is the most common disease of the circulatory system. The most relevant area in the assessment of individual human health is the constitutional approach. Many studies have shown that most indicators of the blood circulation are related to anthropometric parameters of the body, which is why studying the features of peripheral hemodynamics in representatives of different somatotypes with normal and high blood pressure is especially relevant. The purpose of the study was to determine the features of peripheral circulation in young people, aged 18 to 22 years, of different somatotype with normal and high blood pressure. Materials and methods: two groups of subjects selected: a control group (CG) — those in which the value of BP consistent optimum level by the WHO classification (125 people), the second group — those in which systolic blood pressure higher than 130 mmHg and (or) diastolic — 85 mmHg (135 people). Somatotyping performed using techniques by Carter and Heath. To study the condition of peripheral hemodynamics used rheovasography of the lower extremities. Results and discussion: statistical analysis of the results by the Kruskal-Wallis method in the individuals of both groups showed a significant difference in the majority of rheovasography indices among subjects of different somatotypes. The method of multiple comparisons showed significant differences in the values of peripheral circulation among representatives of different somatotypes with normal and high blood pressure. Conclusions: peripheral hemodynamics in subjects with normal blood pressure and predominance of the endomorphic component was characterized by significantly higher vascular tone of mainly medium and small diameter compared to ectomorphs. The peripheral circulation of individuals with high blood pressure and predominance of the endomorphic component, compared to ectomorphs and to lesser extent mesomorphs, was characterized by a significantly higher increase in the tone of the small arteries and a decrease in the tone of the large arteries

ПРОЕКТНО-ОРІЄНТОВАНЕ УПРАВЛІННЯ ПРОЦЕСАМИ РОЗВИТКУ ДУАЛЬНИХ СИСТЕМ

Approaches to ensure an adequate level of life safety in the border areas of neighboring countries in terms of intensification of interstate relations are proposed. The importance of the establishment and execution of cross-border operative-rescue units for emergency response is shown. Performance features of dual system «transboundary operative-rescue units - emergency situation» involving methods and tools of project-oriented management are identified. The influence of external and internal factors in order to improve the level efficiency of international units is analyzed. The main directions of improving the relationship between the elements of the dual system are systematized. Modeling approaches showing the influence of project-oriented management methodology on the dual system of «transboundary operative-rescue units - emergency situation» are developed. On the basis of applied geometry the model example of the interaction of two principles of the dual system «transboundary operative-rescue units - emergency situation», taking into account the impact of means and methods of project-oriented management is proposed. The analysis of equilibrium point movement of dual system with different coefficient data of changes in the environment of transboundary operative-rescue units and intensity of emergencies is made.Запропоновано підходи до забезпечення належного рівня безпеки життєдіяльності на прикордонних територіях суміжних держав в умовах інтенсифікації рівня розвитку міждержавних зв’язків. Показана важливість створення та функціонування транскордонних оперативно-рятувальних підрозділів для ліквідації надзвичайних ситуацій. Розглянуті особливості функціонування дуальної системи «транскордонні оперативно-рятувальні підрозділи – надзвичайні ситуації» із залученням методів та засобів проектно-орієнтованого управління. Проаналізовано вплив зовнішніх та внутрішніх чинників на підвищення результативності діяльності міждержавних формувань. Систематизовано основні напрямки удосконалення взаємозв’язків між елементами досліджуваної дуальної системи. Розроблено підходи до моделювання і аналізу впливу проектно-орієнтованої методології управління на діяльність дуальної системи «транскордонні оперативно-рятувальні підрозділи - надзвичайні ситуації». На засадах використання положень прикладної геометрії запропоновано приклад модельної реалізації процесу взаємодії двох начал дуальної системи «транскордонні оперативно-рятувальні підрозділи - надзвичайні ситуації» із урахуванням впливу засобів і методів проектно-орієнтованого управління. Проведений аналізпереміщення у фазовому просторі точки рівноваги дуальної системи при різних коефіцієнтах зміни в середовищі рівня ресурсної забезпеченості транскордонних оперативно-рятувальних підрозділів та інтенсивності надзвичайних ситуацій

Time to Virological Failure of 3 Classes of Antiretrovirals after Initiation of Highly Active Antiretroviral Therapy: Results from the EuroSIDA Study Group

Objective. The purpose of the present study was to determine the prevalence and incidence of virological triple drug-class failure (TCF) and to summarize the clinical outcome for patients who started receiving highly active antiretroviral therapy (HAART). Methods. The present study is an observational longitudinal study of 3496 treatment-experienced (TE) and treatment-naive (TN) patients monitored from the time they started receiving HAART (baseline) until TCF occurred (as determined on the basis of viral loads), until AIDS was newly diagnosed, or until death. Results. Four hundred forty-five patients (12.7%) had TCF; 370 (16.6%) of 2230 patients were TE, and 75 (5.9%) of 1266 patients were TN. At 6 years after starting HAART, 21.4% of TE and 11.2% of TN patients had TCF (P < .0001). The prevalence of TCF at or after 2002 was 15.5% in TE patients and 4.8% in TN patients. TN patients had a 32% annual increase in the incidence of TCF (95% confidence interval [CI], 14%-54%; P < .0001); at 5 years after starting HAART, the rate was comparable for TE and TN patients (3.3 and 3.4 cases/100 person-years of follow-up [PYFU], respectively). The incidence of new cases of AIDS or death was 2.7 cases/100 PYFU in patients who did not experience TCF and 5.0 cases/100 PYFU in patients who did experience TCF, an estimated 36% increase with each category of TCF (95% CI, 19%-56%; P < .0001). Conclusion. The prevalence of TCF was low after patients started receiving HAART, particularly among TN patients. Despite the influx of patients who had started receiving HAART more recently, the prevalence of TCF increased over calendar time. Patients with TCF had a higher incidence of newly diagnosed AIDS or death. Treatment of patients with TCF deserves further investigatio

РЕЗУЛЬТАТИ ГАЛУЗЕВОГО МОНІТОРИНГУ ДІЯЛЬНОСТІ ВИЩИХ НАВЧАЛЬНИХ ЗАКЛАДІВ ТА ЗАКЛАДІВ ПІСЛЯДИПЛОМНОЇ ОСВІТИ МОЗ УКРАЇНИ ЗА ОСНОВНИМИ ПОКАЗНИКАМИ ДІЯЛЬНОСТІ ЗА 2015 КАЛЕНДАРНИЙ РІК

In sectoral monitoring of universities and post-graduate schools Ministry of Health of Ukraine activity at  2015 year  was done according the following key indicators: educational and methodical work, scientific activity, personnel, international, state and sectoral recognition of work, tutorship and students’ activity, clinical practice, logistics and supply.The analysis of the sectoral monitoring indicates the presence of a minor range value of the sum which reflects the existence of common approaches students health care training carried out by MoH of Ukraine.У 2015 р. був проведений галузевий моніторинг діяльності вищих навчальних закладів та закладів післядипломної освіти МОЗ України за такими основними показниками діяльності, як: навчально-методична робота, наукова діяльність, кадрова політика, міжнародне, державне та галузеве визнання роботи, виховна робота, лікувальна робота, матеріально-технічне забезпечення.Аналіз показників галузевого моніторингу показує наявність незначного діапазону величини сумарного показника, що відображає існування єдиних підходів до організації навчально-методичної роботи щодо підготовки фахівців для галузі охорони здоров’я, що здійснюється МОЗ України

Effect Estimates in Randomized Trials and Observational Studies:Comparing Apples With Apples

Effect estimates from randomized trials and observational studies might not be directly comparable because of differences in study design, other than randomization, and in data analysis. We propose a 3-step procedure to facilitate meaningful comparisons of effect estimates from randomized trials and observational studies: 1) harmonization of the study protocols (eligibility criteria, treatment strategies, outcome, start and end of follow-up, causal contrast) so that the studies target the same causal effect, 2) harmonization of the data analysis to estimate the causal effect, and 3) sensitivity analyses to investigate the impact of discrepancies that could not be accounted for in the harmonization process. To illustrate our approach, we compared estimates of the effect of immediate with deferred initiation of antiretroviral therapy in individuals positive for the human immunodeficiency virus from the Strategic Timing of Antiretroviral Therapy (START) randomized trial and the observational HIV-CAUSAL Collaboration

Hypersensitivity reactions, hepatotoxicity, and other discontinuations in persons receiving integrase strand transfer inhibitors: results from the EuroSIDA study

Background: Hypersensitivity reaction (HSR) and hepatotoxicity are rare, but potentially serious side-effects of antiretroviral use. / Objective: To investigate discontinuations due to HSR, hepatotoxicity or other reasons among users of dolutegravir (DTG) vs. raltegravir (RAL) or elvitegravir (EVG) in the EuroSIDA cohort. / Methods: We compared individuals ≥18 years and starting combination antiretroviral therapy (ART, ≥3 drugs) with DTG vs. RAL or EVG, with or without abacavir (ABC), between January 16, 2014 and January 23, 2019. Discontinuations due to serious adverse events (SAEs) were independently reviewed. / Results: Altogether 4366 individuals started 5116 ART regimens including DTG, RAL, or EVG, contributing 9180 person-years of follow-up (PYFU), with median follow-up 1.6 (interquartile range 0.7-2.8) years per treatment episode. Of these, 3074 (60.1%) used DTG (1738 with ABC, 1336 without) and 2042 (39.9%) RAL or EVG (286 with ABC, 1756 without). 1261 (24.6%) INSTI episodes were discontinued, 649 of the DTG-containing regimens (discontinuation rate 115, 95% CI 106-124/1000 PYFU) and 612 RAL or EVG-containing regimens (173, CI 160-188/1000 PYFU). After independent review, there were five HSR discontinuations, two for DTG (one with and one without ABC, discontinuation rate 0.35, CI 0.04-1.28/1000 PYFU), and three for RAL or EVG without ABC (0.85, CI 0.18-2.48/1000 PYFU). There was one hepatotoxicity discontinuation on DTG with ABC (discontinuation rate 0.18, CI 0.00-0.99/1000 PYFU). / Conclusion: During 5 years of observations in the EuroSIDA cohort independently reviewed discontinuations due to HSR or hepatotoxicity were very rare, indicating a low rate of SAEs

HIV-1 Infection in Cyprus, the Eastern Mediterranean European Frontier: A Densely Sampled Transmission Dynamics Analysis from 1986 to 2012

Since HIV-1 treatment is increasingly considered an effective preventionstrategy, it is important to study local HIV-1 epidemics to formulate tailored preventionpolicies. The prevalence of HIV-1 in Cyprus was historically low until 2005. To investigatethe shift in epidemiological trends, we studied the transmission dynamics of HIV-1 in Cyprususing a densely sampled Cypriot HIV-1 transmission cohort that included 85 percent ofHIV-1-infected individuals linked to clinical care between 1986 and 2012 based on detailedclinical, epidemiological, behavioral and HIV-1 genetic information. Subtyping andtransmission cluster reconstruction were performed using maximum likelihood and Bayesianmethods, and the transmission chain network was linked to the clinical, epidemiological andbehavioral data. The results reveal that for the main HIV-1 subtype A1 and B sub-epidemics,young and drug-naïve HIV-1-infected individuals in Cyprus are driving the dynamics of thelocal HIV-1 epidemic. The results of this study provide a better understanding of thedynamics of the HIV-1 infection in Cyprus, which may impact the development of preventionstrategies. Furthermore, this methodology for analyzing densely sampled transmissiondynamics is applicable to other geographic regions to implement effective HIV-1 preventionstrategies in local settings

HIV-1 Infection in Cyprus, the Eastern Mediterranean European Frontier: A Densely Sampled Transmission Dynamics Analysis from 1986 to 2012

Since HIV-1 treatment is increasingly considered an effective preventionstrategy, it is important to study local HIV-1 epidemics to formulate tailored preventionpolicies. The prevalence of HIV-1 in Cyprus was historically low until 2005. To investigatethe shift in epidemiological trends, we studied the transmission dynamics of HIV-1 in Cyprususing a densely sampled Cypriot HIV-1 transmission cohort that included 85 percent ofHIV-1-infected individuals linked to clinical care between 1986 and 2012 based on detailedclinical, epidemiological, behavioral and HIV-1 genetic information. Subtyping andtransmission cluster reconstruction were performed using maximum likelihood and Bayesianmethods, and the transmission chain network was linked to the clinical, epidemiological andbehavioral data. The results reveal that for the main HIV-1 subtype A1 and B sub-epidemics,young and drug-naïve HIV-1-infected individuals in Cyprus are driving the dynamics of thelocal HIV-1 epidemic. The results of this study provide a better understanding of thedynamics of the HIV-1 infection in Cyprus, which may impact the development of preventionstrategies. Furthermore, this methodology for analyzing densely sampled transmissiondynamics is applicable to other geographic regions to implement effective HIV-1 preventionstrategies in local settings

ІННОВАЦІЙНА СПРЯМОВАНІСТЬ РОЗВИТКУ МЕДИЧНОЇ НАУКИ

The current legislative and regulatory framework for the priority areas of national science and its innovative orientation are presented. Mechanisms of peer review anticipated to develop research projects and approving them for execution are analysed. The data on the results of basic and applied research and their implementation in practice in 2015, presenting the results of scientific research in scientific medical forums that took place in 2015, the training of scientific personnel are presented. The attention on the need to improve the quality of scientific publications with the requirements of scientometric databases are accented. The data on the participation of scientists of the health system of Ukraine in international research projects are presented. The requirements for the further development of domestic medical science and improve its effectiveness and efficiency innovation into practice of health care of Ukraine.Проаналізована сучасна законодавчо-нормативна база щодо пріоритетних напрямів розвитку вітчизняної науки та її інноваційної спрямованості. Проаналізовано механізми експертної оцінки передбачуваних до розробки науково-дослідних проектів та затвердження їх до виконання. Наведені дані про результати  виконання  фундаментальних  та  прикладних наукових досліджень і впровадження їх у практику в 2015 р., про представлення результатів наукових розробок на наукових медичних форумах, які відбулися у 2015 р., про  підготовку  наукових кадрів. Акцентовано увагу на необхідності підвищення якості наукових публікацій з урахуванням вимог наукометричних баз даних. Наведені дані про участь науковців системи охорони  здоров’я України у міжнародних наукових проектах. Визначені вимоги для забезпечення подальшого розвитку вітчизняної медичної науки і підвищення її результативності та ефективності впровадження нововведень у практику охорони  здоров’я України