Analysis of factors associated with arterial stiffness in the general working-age population

Aim. To examine associations of cardio-ankle vascular index (CAVI) with classical, behavioral and social risk factors (RFs) of cardiovascular disease (CVD) in adult population.Material and methods. The study included 1365 people (women, 59%) from a representative sample aged 25-64 years (ESSE-RF), who underwent standard cardiology screening and volume sphygmography (VaSera-1500). All respondents signed an informed consent to participate in the study. The analysis included blocks of classical, social and behavioral risk factors for CVD. A linear model was used to identify associations. An error rate of <5% was considered significant.Results. Age, sex, systolic blood pressure (SBP), triglycerides were associated with higher CAVI values, and body mass index (BMI) was associated with lower values, respectively. After 45 years, a direct association with heart rate (HR) became increasingly important, while after 50 years — with diabetes and the intake of beta-blockers, while the association between diabetes and CAVI was observed only among individuals not taking angiotensin-converting enzyme (ACE) inhibitors. A direct association was found with high-sensitivity C-reactive protein (hsCRP) in men, and an inverse association with diuretics in women, respectively. A sedentary work in combination with a history of bronchitis or with positive family history for CVD showed a direct relationship, while a sufficient physical activity (PA) showed an inverse relationship with the studied indicator, but only among people with belowaverage income.Conclusion. According to the data obtained, in addition to age and sex, the following risk factors made a significant contribution to CAVI parameters in the examined population: BMI, SBP, triglycerides, diabetes, HR, intake of betablockers, diuretics, ACE inhibitors; hsCRP, PA. The unfavorable role of betablockers, high HR, diabetes, sedentary work, chronic lung pathology, hereditary burden, as well as the protective role of ACE inhibitors, diuretics and intense PA in relation to arterial stiffness in the working-age population has been shown. Additional studies are needed to determine the nature of a number of associations. The results obtained may contribute to the study of CAVI role in risk stratification and further development of methodological approaches to CVD prevention

Детерминанты контроля артериальной гипертонии в гипертензивной популяции, получающей медикаментозную терапию

Highlights. The leading factor of ineffective arterial hypertension (AH) control in the population taking medications was the number of metabolic risk factors (RF). In addition, in men, the odds of reaching the blood pressure targets were lower if there was a history of kidney disease and bronchitis, and higher, if statins and hypotensive drugs were taken together, respectively. In women, heart rate equal or higher than 75 beats/min and total carotid atherosclerotic plaque thickness were associated with lower and a visit to a physician in the past year - with higher odds of effective hypertension control, respectively.Aim. Analysis of factors associated with reaching blood pressure targets in hypertensive population taking medications.Methods. We examined men and women of 25-64 y.o., randomly drawn from general population, having hypertension and receiving medications. All participants underwent standardized cardiac screening, including a survey on a number of socio-demographic, psychosocial, behavioral variables, traditional and metabolic cardiovascular risk factors, life quality. We measured anthropometric and blood pressure variables, "intima-media" thickness, presence and total thickness of carotid atherosclerotic plaques. Analysis included data from 480 respondents. Parametric and nonparametric statistics were used. To analyze relationships, multivariable logistic regression was used. An error probability <5% was considered statistically significant.Results. After adjustment for age, wealth level, cardio-vascular deseases and the number of antihypertensive drugs, the following factors increased the chances of effective treatment for hypertension in men - statins, positive answer to the question “Do you feel pain or discomfort?” on the EQ5D scale. Lower odds for detecting target blood pressure levels were associated to the count of metabolic syndrome components according to IDF criteria except arterial hypertension (0-4), kidney disease, previous bronchitis, age. A direct association with the effectiveness of treatment for hypertension in women was shown by a visit to the doctor during the past year, and the opposite - the number of metabolic syndrome components, heart rate ≥75 per minute and the total thickness of carotid atherosclerotic plaques, respectively.Conclusion. Lack of hypertension control was associated to metabolic risk factors count, age, kidney disease, heart rate ≥75 per minute, previous bronchitis, lack of visit to a doctor over the past year, as well as total thickness of carotid atherosclerotic plaques. The situation can be improved by deliberately losing weight, taking statins by all people at very high and high risk, and seeing a doctor regularly. It is necessary to further study the factors that hinder achievement of blood pressure targets, as well as methods aimed at the prevention and effective correction of metabolic disorders.Основные положения. Ведущим фактором неэффективного контроля артериальной гипертонии (АГ) в медикаментозно лечащейся популяции было количество метаболических факторов риска (ФР). Кроме того, у мужчин шансы достижения целевого уровня артериального давления были ниже при наличии в анамнезе заболеваний почек и бронхита, и выше - при совместном приеме статинов и гипотензивных препаратов, соответственно. У женщин частота сердечных сокращений >75 уд/мин и суммарная толщина каротидных атеросклеротических бляшек ассоциировались с более низкими, а визит к врачу за прошедший год - с более высокими шансами эффективного контроля заболевания.Цель. Анализ факторов, ассоциированных с вероятностью эффективного медикаментозного контроля артериальной гипертонии (АГ) в гипертензивной популяции.Материалы и методы. Объект исследования - мужчины и женщины репрезентативной выборки неорганизованной популяции 25-64 лет, страдающие АГ и получающие медикаментозную терапию. Все участники исследования прошли стандартизованный кардиологический скрининг, включающий опрос по ряду социально-демографических, психосоциальных, поведенческих переменных, анамнез и семейный характер заболеваний, наличие традиционных и метаболических факторов риска сердечно-сосудистых заболеваний, оценку качества жизни, антропометрические измерения, измерение артериального давления (АД), толщины комплекса «интима - медиа», наличия и суммарной толщины каротидных атеросклеротических бляшек. В анализ вошли данные 480 респондентов. Использованы методы параметрический и непараметрической статистики. Для анализа взаимосвязей применяли многофакторную логистическую регрессию. Вероятность ошибки <5% считали статистически значимой.Результаты. Согласно оценкам, полученным с поправкой на возраст, уровень достатка, наличие сердечно-сосудистых заболеваний и количество принимаемых гипотензивных препаратов, у мужчин шансы эффективного лечения АГ повышали прием статинов и положительный ответ на вопрос о боли или дискомфорте по шкале EQ5D; понижали шансы выявления целевых уровней АД количество компонентов метаболического синдрома кроме АГ по критериям IDF (0-4), заболевания почек, перенесенный бронхит, возраст. Прямую ассоциацию с эффективностью лечения АГ у женщин показал визит к врачу за прошедший год, обратную - количество компонентов метаболического синдрома, частота сердечных сокращений ≥75 уд/мин и суммарная высота каротидных атеросклеротических бляшек.Заключение. Результаты данной работы подчеркивают важный вклад в неэффективность контроля АГ таких факторов, как количество метаболических факторов риска, возраст, заболевания почек, высокая частота сердечных сокращений, перенесенный бронхит, непосещение врача за прошедший год, а также выраженность каротидного атеросклероза. На ситуацию может положительно влиять намеренное снижение избыточного веса, прием статинов лицами очень высокого и высокого риска, а также регулярное посещение врача. Необходимо дальнейшее изучение факторов, затрудняющих достижение целевых уровней АД, а также методов, нацеленных на профилактику и эффективную коррекцию метаболических расстройств

The role of SH groups in the regulation of Gardos channels in glucose deficiency

Background. Disruption of the energy balance of erythrocytes under conditions of a decrease in the glycolysis level can cause a change in the ion permeability of their membrane.   The aim. To study Ca2+-dependent potassium permeability of the erythrocytes membrane in the presence of SH group modifiers under conditions of glucose deficiency.   Materials and methods. The study used precipitated erythrocytes obtained from the blood of 20 male Wistar rats. The change in the Ca2+-dependent potassium conductivity of the erythrocyte membrane was determined using the potentiometric method. The A23187-and redox-induced hyperpolarization responses of erythrocytes were evaluated.   Results. Glucose deficiency in the medium, as well as the use of the glycolysis inhibitor 2-deoxyglucose, led to an increase in the amplitude of A23187-stimulated membrane hyperpolarization by the opening of the Gardos channels. At the same time, the redox-dependent hyperpolarization of the erythrocyte membrane turned out to be insensitive to a decrease in the glucose content in the medium and to the glycolysis inhibition. The effects of SH group modifiers in the normal incubation medium and under glucose deficiency turned out to be multidirectional and depended on the method of stimulation of Gardos channels.   Conclusion. The results obtained indicate that metabolic disorders in erythrocytes under conditions of glucose deficiency lead to a change in the mechanisms of control of Gardos channels with the participation of SH groups of the proteins of these channels or their regulatory proteins

IMMUNOREGULATORY IMBALANCE AND FUNCTIONAL STATE OF THE HEART IN THE PATIENTS WITH DIABETES MELLITUS TYPE 2

Diabetes mellitus type 2 is one of the most important non-infectious diseases in the modern world, being an important risk factor of cardiovascular disorders. Changes in left ventricular myocardial diastolic function are observed in diabetic patients independently from other comorbidities. Etiology of the heart failure during diabetes mellitus type 2 is multifactorial, exhibiting cellular,  molecular and metabolic aspects. However, its pathophysiological mechanisms are not completely understood. The aim of this study was to evaluate numbers of inflammatory T lymphocytes, i.e., T helper type 1 (Th1) and T helper type 17 (Th17) cells, and FoxP3+T regulatory lymphocytes, depending on the functional state of the heart assessed by two-dimensional echocardiography in patients with arterial hypertension and diabetes mellitus type 2. A total of twenty-five patients with a combination of arterial hypertension and diabetes mellitus type 2, and 14 patients with arterial hypertension without carbohydrate disturbances were recruited to a cross-ectional case-control study. All the patients underwent echocardiography with transthoracic access at the M-mode, B-mode and Doppler mode of imaging. We evaluated numbers of Th1 and Th17 lymphocytes by intracellular production of IL-17 and IFNγ by CD4+ lymphocytes, respectively. The numbers of FoxP3+T regulatory lymphocytes were estimated by expression of CD25 and FoxP3 transcription factor. A flow cytometry approach was used in both cases. We revealed some correlations between the numbers of Th17 lymphocytes, FoxP3+T regulatory lymphocytes and functional parameters of myocardium in patients with diabetes mellitus type 2, which were absent in patientswithout carbohydrate impairments. The numbers of FoxP3+T egulatory lymphocytes, Treg/Th17 lymphocyte ratio, and mean fluorescence intensity of IL-17 for Th17 cells was lower in patients with diabetes mellitus and diastolic dysfunction compared to the patients with diabetes free of diastolic dysfunction. Association of diastolic dysfunction with diabetes mellitus type 2 was accompanied by increase of IFNγ+Th1 lymphocyte numbers and concentrations of IL-10, IFNγ and TNFα in serum as compared to the patients with diastolic dysfunction in the absence of carbohydrate metabolism disturbances. The diabetic patients with diastolic dysfunction were characterized by hyperinsulinemia, hyperglycemia, higher index of insulin resistance, increase of waist circumference and visceral adiposity index when compared to the patients with diastolic dysfunction without diabetes. Visceral obesity and decrease of insulin sensitivity may be regarded as pathogenetically significant factors for the development of immune regulatory imbalance and diastolic dysfunction in the patients with diabetes mellitus type 2

Ilaser Submucous Destruction in the Treatment of Hemorrhoids

Aim: to improve the results of treatment in patients with hemorrhoids of the 2nd and 3rd stages.Materials and methods. The prospective study included 60 patients with hemorrhoids of the 2nd and 3rd stages. All patients underwent destruction of internal hemorrhoids with a fiber laser with a diode pump with a wavelength of 1940 nm. The technique is based on the effect of laser energy on the cavernous tissue of the internal hemorrhoidal node and on the terminal branches of the upper rectal artery. The efficiency of the destruction of internal hemorrhoids and the frequency of relapses of the disease were evaluated. The effectiveness of the proposed method was evaluated using anoscopy, measurement of the size of internal hemorrhoidal nodes, transrectal ultrasound with dopplerography. The analysis of the intensity of the pain syndrome, the consumption of nonsteroidal anti-inflammatory drugs and the assessment of the quality of life on the SF-36 scale was carried out. Sphincterometry was performed in all patients to determine the possible effect of laser radiation on the rectal locking apparatus. To assess the possible causes of complications, a single-factor analysis of the amount of energy transferred to each hemorrhoidal node and the total amount of energy spent on the operation was conducted.Results. In all patients, by day 7 after surgery, the pain syndrome in 43 patients (75.4 %) corresponded to 0 points according to VAS. In 3 patients (5 %) intraoperative hemorrhage developed. In the early postoperative period, 5 patients (8.3 %) had 7 complications: 5 cases of thrombosis of the external hemorrhoidal node and 2 — of acute urinary retention. The conducted single-factor analysis showed the dependence of the development of complications on the energy transferred to each hemorrhoidal node and its total amount for the entire operation. In terms of up to 6 months, there were no signs of a return of the disease in any case (hemorrhoidal prolapse and blood discharge). The detected hemorrhoids before the operation, a month after the operation, were not visualized, which persisted after 6 months. The performed transrectal ultrasound examination with spectral-wave dopplerography for up to 6 months allowed to diagnose a persistent decrease in blood flow along the terminal branches of the upper rectal artery compared with preoperative values. When performed sphincterometry, there was no change in the parameters of the anal sphincter function compared to preoperative parameters.Conclusion. The proposed method applying a fiber laser with a diode pump with a wavelength of 1940 nm makes it possible to affect transdermally the internal hemorrhoidal node without damaging the mucosa of the anal canal. The absence of postoperative wounds in the anal canal leads to a decrease in pain syndrome, and by day 7 there are no clinical manifestations of hemorrhoids. The method of laser destruction of internal hemorrhoids can be used in outpatient conditions and can improve the quality of life of patients in the early postoperative period

Actual Problems of Chemical-Analytical Control in Ecotechnoparks for Processing Industrial Waste

В статье изложены задачи входного аналитического контроля в экотехнопарках по обработке, утилизации и обезвреживанию производственных отходов, приведена сравнительная характеристика современных методов определения в них содержания металлов и органических соединений, предложены новые подходы к исследованию химического состава жидких неорганических отходов I и II классов опасности на основе применения вольтамперометрии в смешанных водно-органических средах.The article describes the tasks of input analytical control in ecotechnoparks for processing, recycling and neutralization of industrial waste, provides a comparative description of modern methods for determining the content of metals and organic compounds in waste, and suggests new approaches to the study of the chemical composition of liquid inorganic waste of hazard classes I and II based on the use of voltammetry in mixed water-organic media

SUBCELLULAR LOCALIZATION OF FoxP3 TRANSCRIPTION FACTOR IN PATIENTS WITH ACUTE CORONARY SYNDROME: COMPARATIVE ANALYSIS AND PROSPECTIVE OBSERVATION

The key cellular and molecular factors being involved in the resolution of inflammation following acute myocardial infarction remain poorly understood. T-regulatory (Treg) lymphocytes are characterized by the extreme potential to regulate the strength and direction of immune responses during the myocardial injury. The functional activity of Treg-lymphocytes depends upon the transcription factor forkhead box protein P3 (FoxP3). It may be also expressed in conventional T-lymphocytes at the stage of their activation. Nuclear localization of FoxP3 is a prerequisite factor determining its ability to impact the suppressive functions of Treglymphocytes.The aim of the present study was comparative evaluation of FoxP3+T-lymphocytes frequency and counts, combined with estimation of FoxP3 subcellular localization, in patients with acute myocardial infarction and chronic coronary syndrome and examination of changes of these parameters in the short-term follow-up of patients with myocardial infarction. The study included 14 patients with chronic coronary syndrome (8 males; 6 females; 63.2±9.0 y.o.) and 5 patients with acute anterior ST-segment elevation myocardial infarction (4 males; 1 female; 61.4±11.2 y.o.) at days 1, 3 and 7 after the event. The frequency of FoxP3+ conventional and regulatory T-lymphocytes was evaluated in peripheral blood mononuclear cells together with estimation of the level of FoxP3 nuclear localization by imaging flow cytometry.Patients with infarction were characterized by the decreased counts of FoxP3+Treg-lymphocytes compared to patients with chronic coronary syndrome, and exhibited even further decrease in the counts of FoxP3+Tregcells at day 7 after infarction, while frequency of Treg and conventional T-lymphocytes did not differ significantly. The level of FoxP3 nuclear translocation was lower both in Treg and conventional T-lymphocytes in patients at day 1 post-infarction compared to patients with chronic coronary syndrome. Absolute counts of FoxP3+Tregs with nuclear FoxP3 localization remained significantly lower both at days 1 and 7 post-infarction compared to patients with chronic coronary syndrome.Thus, here we demonstrated that FoxP3 nuclear localization experiences decrease in the course of acute myocardial infarction and may serve as a more sensitive marker of changes in Treg-lymphocyte functioning than simple evaluation of their frequency

ФАКТОРЫ, АССОЦИИРОВАННЫЕ С ВЕРОЯТНОСТЬЮ ВЫЯВЛЕНИЯ АРТЕРИАЛЬНОЙ ГИПЕРТЕНЗИИ В ОБЩЕЙ ПОПУЛЯЦИИ ТРУДОСПОСОБНОГО ВОЗРАСТА

Aim. To determine the factors associated with the prevalence of arterial hypertension (AH) in the unorganized urban population of working age.Methods. Random sample drawn from adult urban population aged 25–64 years (n = 1600, 59%-women) was examined in the standardized cardiologic screening program. The following associative factors were analyzed: age, family status, level of education and income; excessive salt consumption (ESC), low physical activity, alcohol consumption; family history of AH; anxiety/depression (HADS); smoking, body mass index (BMI), heart rate (HR). Logistic regression was used to analyze the relationships. A p value of <5% was considered statistically signifcant.Results. After adjustment for age, the odds for AH were higher in men (OR = 1,57, p<0,001) with the maximum gender effect found in 35–44 years (OR = 3,66, p<0,001). In the singlefactor analysis, age, BMI, family history of AH, HR and ESC were the most signifcant risk factors for AH in men. Secondary education and clinical anxiety in addition with the above-mentioned ones increased odds for AH in women. In the multivariable model, age, BMI, family history of AH and HR were associated with high AH prevalence in men. In women, these factors included age, BMI, family history of AH, HR, ESC, middle education and clinical anxiety. Out of the other modifable risk factors, BMI contributed greatly to the variability in AH prevalence in the examined population.Conclusion. The obtained fndings provides novel data on the comparative signifcance of the studied risk factors. The efforts to prevent excessive weight gain and dietary salt consumption seem promising to reduce AH prevalence in the population. Further studies focusing on the role of genetic, behavioral, and environmental factors for AH development will ensure the establishment of more effective, accurate and personalized prevention approaches in the future.Цель. Определить факторы, ассоциированные с частотой выявления артериальной гипертензии (АГ) в неорганизованной городской популяции людей трудоспособного возраста.Материалы и методы. По программе стандартизованного кардиологического скрининга обследована случайная популяционная выборка взрослого городского населения в возрасте 25–64 лет (n = 1600, 59% – женщины). Анализировали следующие ассоциативные факторы: возраст, семейный статус, уровень образования и достатка; привычка досаливать пищу, низкая физическая активность, потребление алкоголя; наличие АГ у ближайших родственников; тревога и/или депрессия (HADS); курение, индекс массы тела (ИМТ), частота сердечных сокращений (ЧСС). Для анализа взаимосвязей использовали логистический регрессионный анализ. Вероятность ошибки < 5% считали статистически значимой.Результаты. После поправки по возрасту в обследованной популяции АГ чаще выявлялась у мужчин (отношение шансов – 1,57, p<0,001) с максимально выраженным гендерным эффектом в возрасте 35–44 лет (отношение шансов – 3,66, p<0,001). По данным однофакторного анализа, возраст, ИМТ, семейный характер АГ, ЧСС, привычка досаливать пищу были наиболее значимыми факторами риска (ФР) выявления АГ у мужчин. Эти же факторы, а также средний уровень образования и клиническая тревога повышали шансы выявления АГ у женщин. В многофакторной модели с более высокими шансами выявления АГ в мужской популяции были ассоциированы возраст, ИМТ, семейный характер АГ и ЧСС. В женской популяции набор факторов в данном аспекте включал возраст, ИМТ, семейный характер АГ, ЧСС, привычку досаливать пищу, средний уровень образования, клиническую тревогу. Из модифицируемых ФР ИМТ вносил наибольший вклад в вариацию распространенности АГ в обследованной популяции.Заключение. Полученные данные фокусируют внимание на сравнительной значимости ФР, ассоциированных с частотой выявления АГ в общей популяции трудоспособного возраста. На основании результатов исследования в качестве приоритетных направлений по снижению распространенности АГ среди населения следует отметить предупреждение избыточного веса и потребления соли, воздействие на которые обещает наиболее весомый превентивный эффект. Дальнейшие исследования, проясняющие роль генетических, поведенческих, экологических факторов в развитии АГ, помогут в создании более эффективных, высокоселективных и персонализированных подходов к предупреждению развития заболевания в будущем