D-dimer as a potential predictor of thromboembolic and cardiovascular complications in patients with chronic kidney disease

The aim of the study was to evaluate the relationship between D-dimer levels and different biomarkers­ of renal diseases to identify the relationship between hypercoagulation and chronic kidney disease (CKD). To achieve this aim, we conducted a one-step prospective observational study involving 140 patients with CKD who were hospitali­zed in Ivano-Frankivsk Regional Clinical Hospital in Ukraine during 2018-2019. Of these patients, 100 patients (71.4%; 95% CI 53.4-76.7) had glomerulonephritis (GN) and 40 patients (28,6%; 95% CI 21.3-36.8) had diabetic nephropathy (DN). All patients underwent standard examination, which included general clinical, biochemical and instrumental research methods. D-dimer was quantitatively determined in blood serum by enzyme-linked immunosorbent assay (ELISA). The 140 patients were divided into two groups according to the level of D-dimers: normal level (<0.5 mg/l) and elevated level (≥0.5 mg/l). Elevated D-dimer levels were associated with an increased age of patients, decreased glomerular filtration rate, decreased blood albumin level, increased daily protein excretion and a tendency to develop thromboembolic complications during 1 year of monitoring. D-dimer is a biological marker that can detect hypercoagulation at an early preclinical stage in patients with CKD and identify patients with an increased cardiovascular risk, thereby promoting the earliest use of antiplatelet agents and anticoagulants and, consequently, it can reduce mortality­

Прогнозування міцності та розподілу бокового тиску при виробництві пресованих бетонних дорожніх каменів

У монографії висвітлено питання прогнозування міцності та розподілу бокового тиску при виробництві пресованих бетонних виробів з викорис-танням теорії нечіткої логіки та регресійного аналізу. Викладено результа-ти теоретичних та експериментальних досліджень величини прогнозованої міцності бетонних виробів. На базі апарату нечіткої логіки розроблено програмний модуль, який можна адаптувати до цільової функції шляхом навчання моделі. Матеріал монографії може бути корисним для студентів інженерно-будівельних спеціальностей, аспірантів, інженерних робітників.The monograph covers the issues of the strength prediction and lateral pressure’s distribution in the manufacture of pressed concrete products by using the theory of fuzzy logic and regression analysis. The results of theoretical and experimental research of predicted strength of concrete products value are shown. The software module is developed on the basis of fuzzy logic that can be adapted to the objective function by model learning. Material of the monograph can be useful to students of engineering and construction specialties, graduate students, engineering workers

Results of application of terpenoid-containing drugs in therapy of chronic parodontitis

The therapeutic effect of the drug Antiran containing terpenoid isobornyl acetate on the inflammation in the parodontium in 30 patients with chronic parodontitis of mild severity was investigated. It was used a 30% solution of the drug Antiran as the irrigating liquid with ultrasound scaling and closed curettagein the main group (15 patients), and 0.06% chlorhexidine solution in the comparison group (15 patients). Then, all patients were dialyzed by the solution of the drug Antiran in the parodontal tissues for 20 minutes daily. The dynamics of treatment was assessed by index and functional indicators. It was found that on the 7 th day of treatment, almost all the measurable indicators were differed statistically significantly in the study groups and indicated the best result of treatment in the main group.Исследовано терапевтическое действие препарата Антиран, содержащего терпеноид изоборнилацетат, на воспалительный процесс в пародонте у 30 пациентов с хроническим пародонтитом легкой степени тяжести. Основной группе (15 пациентов) в качестве орошающей жидкости при ультразвуковом скейлинге и закрытом кюретаже применяли 30% раствор препарата Антиран, а группе сравнения (15 пациентов) — 0,06% раствор хлоргексидина. Затем всем пациентам проводили диализ раствора препарата Антиран в ткани пародонта по 20 минут ежедневно. Динамику лечения оценивали по индексным и функциональным показателям. Установлено, что на 7-е сутки лечения почти все измеряемые показатели в исследуемых группах отличались статистически значимо и свидетельствовали о лучшем результате лечения в основной группе

Закономірності розподілення тиску по висоті в бетонній суміші, що ущільнюється

Теоретично обґрунтовані закономірності, які дозволяють точніше прогнозувати як характер залежності, так і абсолютні значення розподілення тисків по висоті бетонного суміші, що ущільнюється. Запропоновано експериментальну установку для виявлення закономірності розподілу надлишкового тиску в масиві бетонного суміші по висоті. Наведено математичне моделювання динаміки робочого процесу ущільнення бетонної суміші, що складається із системи диференційних рівнянь, з урахуванням низки припущень.Теоретически обоснованы закономерности, которые позволяют точнее прогнозировать как характер зависимости, так и абсолютные значения распределения давлений по высоте уплотняемого бетонного изделия. Предложена экспериментальная установка для выявления закономерности распределения избыточного давления в массиве бетонного изделия по высоте. Приведено математическое моделирование динамики рабочего процесса уплотнения бетонной смеси, которая состоит из системы дифференциальных уравнений, с учётом ряда допущений.Dependencies which enables to predict more precisely as well as character of dependency and absolute value of pressures distribution by the height of compressed concrete item has been theoretically grounded. Experimental device for regularity clarification of extra pressure distribution by the height of concrete item has been proposed. Mathematical modeling of operational process’s dynamic of compressed concrete mixture has been lead with differential equations by taking into account some assumptions

Effect of SGLT2 inhibitors on stroke and atrial fibrillation in diabetic kidney disease: Results from the CREDENCE trial and meta-analysis

BACKGROUND AND PURPOSE: Chronic kidney disease with reduced estimated glomerular filtration rate or elevated albuminuria increases risk for ischemic and hemorrhagic stroke. This study assessed the effects of sodium glucose cotransporter 2 inhibitors (SGLT2i) on stroke and atrial fibrillation/flutter (AF/AFL) from CREDENCE (Canagliflozin and Renal Events in Diabetes With Established Nephropathy Clinical Evaluation) and a meta-Analysis of large cardiovascular outcome trials (CVOTs) of SGLT2i in type 2 diabetes mellitus. METHODS: CREDENCE randomized 4401 participants with type 2 diabetes mellitus and chronic kidney disease to canagliflozin or placebo. Post hoc, we estimated effects on fatal or nonfatal stroke, stroke subtypes, and intermediate markers of stroke risk including AF/AFL. Stroke and AF/AFL data from 3 other completed large CVOTs and CREDENCE were pooled using random-effects meta-Analysis. RESULTS: In CREDENCE, 142 participants experienced a stroke during follow-up (10.9/1000 patient-years with canagliflozin, 14.2/1000 patient-years with placebo; hazard ratio [HR], 0.77 [95% CI, 0.55-1.08]). Effects by stroke subtypes were: ischemic (HR, 0.88 [95% CI, 0.61-1.28]; n=111), hemorrhagic (HR, 0.50 [95% CI, 0.19-1.32]; n=18), and undetermined (HR, 0.54 [95% CI, 0.20-1.46]; n=17). There was no clear effect on AF/AFL (HR, 0.76 [95% CI, 0.53-1.10]; n=115). The overall effects in the 4 CVOTs combined were: Total stroke (HRpooled, 0.96 [95% CI, 0.82-1.12]), ischemic stroke (HRpooled, 1.01 [95% CI, 0.89-1.14]), hemorrhagic stroke (HRpooled, 0.50 [95% CI, 0.30-0.83]), undetermined stroke (HRpooled, 0.86 [95% CI, 0.49-1.51]), and AF/AFL (HRpooled, 0.81 [95% CI, 0.71-0.93]). There was evidence that SGLT2i effects on total stroke varied by baseline estimated glomerular filtration rate (P=0.01), with protection in the lowest estimated glomerular filtration rate (45 mL/min/1.73 m2]) subgroup (HRpooled, 0.50 [95% CI, 0.31-0.79]). CONCLUSIONS: Although we found no clear effect of SGLT2i on total stroke in CREDENCE or across trials combined, there was some evidence of benefit in preventing hemorrhagic stroke and AF/AFL, as well as total stroke for those with lowest estimated glomerular filtration rate. Future research should focus on confirming these data and exploring potential mechanisms

Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to 300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m 2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

The competence education format as an innovation quality of an educational process

Рассматриваются основные задачи проектирования и реализации компетентностного обучения в высшей школе с точки зрения управления качеством образовательного процесса в рамках ФГОС ВПО.The main problems of planning and realization of the competence education at a higher school are considered from positions of the quality management of an educational process within the framework of the Federal state educational standards