Diagnostics of Level of Formation of Motivational, Activity and Behavioral Components of Ecological Culture of Personality of Future Teacher: Application of Method by G. E. Zalessky

This article deals with the problem of diagnostics of level of formation of motivational and behavioral components of ecological culture of the future teacher’s personality. The authors believe that the process of development of these components reflects the dynamics of formation of the investigated personality traits. The essence and the notion of ecological culture of personality is determined. Its basic structural and functional components are revealed. Special attention is paid to the development of the motivational component associated with the development in the students of axiological and conceptual structures (motives, needs, etc.), which in general determine the focus on ecology friendly activities. The analysis of the methods devoted to questions of formation of ecological culture and education of students is made. The study showed that most of them do not address the issue of identifying the nature of the personal dispositions of the subjects. To solve the problem of the study, the possibility of applying the value-normative method developed by professor G. E. Zalessky for the diagnosis of the value-motivational units of personality is proved. The authors present their development and results of testing of the diagnostic methods. It is noted that this development allows to assess the level of development of intrinsiv ecological motivation of students and the corresponding type of behaviour. It is proved that, given the nature of the interaction of three critical components of ecological culture of the individual - cognitive, motivational and behavioral - it is possible to obtain a preliminary typology of level of ecological culture of the subjects

Autoantibody levels in blood of <i>H. pylori</i>-infected patients with chronic gastritis

Helicobacter pylori (H. pylori) increases the risk of diseases associated with mucous membrane inflammation of gastrointestinal tract, in particular, gastritis, stomach ulcers, and duodenal ulcers. It may also induce a chronic immune response, causing damage to the mucous membrane and development of these diseases. In addition, the role of H. pylori in the initiation of a wide range of autoimmune diseases is discussed. The aim of this study was to assess the level of autoantibodies – markers of various autoimmune diseases in the blood of H. pylori-infected patients with chronic gastritis. We used samples of whole peripheral blood from 267 primary patients with chronic gastritis in the acute stage. The presence of H. pylori in gastric juice from patients was determined using real-time PCR. The level of autoantibodies to double-stranded and single-stranded DNA, autoantibodies to thyroglobulin, thyroid peroxidase, concentration of rheumatoid factor, IgG autoantibodies to the cyclic citrullinated peptide, IgM and IgG autoantibodies to beta(2)-glycoprotein were determined by the enzyme immunoassay. The average level of rheumatoid factor in blood serum was similar for H. pylori-infected and non-infected patients, and did not exceed the normal values. The level of antibodies to cyclic citrullinated peptide, one of the sensitive markers of rheumatoid arthritis, was increased in all patients, being, however, significantly lower in H. pylori-infected patients compared with non-infected persons. Autoantibodies to thyroglobulin, thyroid peroxidase are considered classic markers of autoimmune diseases of the thyroid gland. In blood of H. pylori-infected patients we have found an increased concentration of autoantibodies to thyroglobulin and thyroid peroxidase in comparison with non-infected ones, but the average level of these antibodies did not exceed the normal range. Any differences in the levels of systemic lupus erythematosus serological markers, i.e., autoantibodies to double-stranded and single-stranded DNA, were found between H. pylori-infected and non-infected patients. The levels of thrombosis risk marker in patients with systemic lupus erythematosus (IgG and IgM autoantibodies to beta(2)-glycoprotein) were also within the normal ranges. However, in H. pylori-infected patients, it even turned out to be statistically significantly lower than in non-infected ones. Thus, no data have been obtained on increased levels of the tested markers of autoimmune pathology in blood of H. pylori-infected patients with chronic gastritis at the acute stage. However, this does not allow us to make an unambiguous conclusion that the influence of H. pylori does not affect the development of immunological changes associated with autoimmune diseases

Experiense of treatment with a growth hormone receptor antagonist in patients with hereditary form of acromegaly: clinical cases

Acromegaly is a severe neuroendocrine disease caused by chronic excessive production of somatotropic hormone (STH), characterized by specific changes in appearance, metabolic disorders. In 95% of cases, the cause of pathology is STH-producing pituitary adenomas. The priority method of treatment for acromegaly is transnasal transsphenoidal adenomectomy. If it is impossible to carry out neurosurgical intervention, in order to prevent the progression of the disease and the development of complications, patients are recommended drug therapy with long-acting somatostatin analogues, and if their effectiveness is low, additional radiation therapy may be applied to the neoplasm area. The usage of a relatively new group of drugs, antagonists of STH receptors, namely Pegvisomant for the purpose of drug treatment of acromegaly demonstrates high efficacy even in cases of aggressive forms resistant to other types of treatment. In this article we present two clinical cases of hereditary acromegaly, when the initiation of Pegvisomant therapy led to the achievement of clinical and laboratory remission of acromegaly in patients with an aggressive form of the disease, accompanied by continued growth of residual neoplasm tissue and preservation of its secreting ability even after surgical interventions, radiatiotherapy and long-term drug treatment with somatostatin analogues. The results of the above clinical cases confirm the success of mono- or combined (in cases with continued growth of the neoplasm) therapy with a growth hormone receptor antagonist, Pegvisomant, especially in the case of aggressive acromegaly

Efficacy of long-term octreotide therapy of acromegaly as the first-line medical treatment

Acromegaly is a severe neuroendocrine disease characterized by hypersecretion of growth hormone (GH) caused in 95% of cases by pituitary adenoma, which leads to the development of pathology of various organs and systems. The severity of the condition is due not only to the direct effect of somatotropic hormone on the body and the effect of the adenoma on the surrounding structures, but also to the age of the patient and complications associated with the disease. Improvement in treatment methods allows for a personalized approach to patient management, taking into account various aspects of the clinical case. It is important for a specialist to take into account comorbidity in acromegaly, both in terms of pathological disorders and the impact on the patient’s psycho-emotional state. We present a clinical case of successful treatment with somatostatin analogues (ASS) in a patient who is afraid of surgery and has cardiovascular complications of acromegaly. Since the onset of acromegaly, confirmed by an elevated level of insulin-like growth factor-1 (IGF-1) and an endosellar pituitary macroadenoma measuring 11x9.5x8 mm, ASS therapy was initiated in the patient. The choice in favor of conservative treatment was due to a burdened cardiovascular history and the patient’s fear of surgery. Within three years from the start of drug therapy, there was a significant improvement in overall well-being, a tendency to reduce the size of the pituitary adenoma, and biochemical remission was achieved. The clinical case described by us confirms the possibility of successful primary treatment of ASS in a patient with acromegaly, taking into account all individual characteristics

Leflunomide hepatotoxicity potential mechanisms review

The article provides the leflunomide hepatotoxicity pathogenesis and clinical manifestations review, including the pathophysiological and morphological changes in the liver.В статье представлен обзор литературы о механизмах развития и проявлениях гепатотоксичности лефлуномида, включая патофизиологические и морфологические изменения в печени при использовании данного лекарственного препарата

Мультимодальная визуализация в диагностике апикальной гипертрофической кардиомиопатии: клинический случай

Apical hypertrophic cardiomyopathy is rare familial form of hypertrophic cardiomyopathy, with hypertrophy mainly affecting the apex of the left ventricle and characterized by a spade-like left ventricular cavity. Despite varying presentation, impaired capabilities of some standard instrumental methods and dissent on diagnostic criteria several diagnostic characteristics estimated by various noninvasive imaging modalities make it possible to establish a diagnosis with high accuracy. We hereby describe a case with electrocardiographic abnormalities and chest pain with suspected acute coronary syndrome. Acute coronary syndrome was excluded as well as performing invasive coronary angiography was avoided using advanced diagnostic tools including single photon emission computed tomography and apical hypertrophic cardiomyopathy was demonstrated by careful differential diagnosis.Апикальная гипертрофическая кардиомиопатия — редкая наследственная патология, ключевым признаком которой является асимметричная гипертрофия миокарда с вовлечением верхушки левого желудочка, что обусловливает характерную для данной патологии конфигурацию полости сердца в  виде пикового туза. Несмотря на  неспецифический характер предъявляемых жалоб, отсутствие унифицированных диагностических критериев, а также ограниченные возможности некоторых стандартных инструментальных методов исследования, определенные диагностические характеристики, выявляемые с помощью различных неинвазивных визуализирующих пособий, позволяют с высокой точностью установить диагноз. В настоящей работе мы приводим клинический случай апикальной гипертрофической кардиомиопатии у пациента с неспецифическими жалобами на боль в груди и изменениями на ЭКГ, не исключающими возможное развитие острого коронарного синдрома. Полученные нами результаты в сопровождении современных диагностических методов исследования, включая однофотонную эмиссионную компьютерную томографию, позволили не только своевременно установить правильный диагноз, но и исключить ишемическую болезнь сердца, тем самым избежать необоснованного проведения инвазивной коронароангиографии

Leflunomide and essential phospholipids effect on electrocardiographic parameters of laboratory rabbits

The article deals with influence analysis of leflunomide and its combination with essential phospholipids on electrocardiographic parameters of laboratory rabbits. It was shown that leflunomide 10 mg/kg exposition during 42 days moderate prolongate RR interval but does not influence on P wave and PQ, QT and corrected QT interval durationВ статье приведён анализ влияния лефлуномида и его комбинации с эссенциальными фосфолипидами на электрокардиографические параметры лабораторных кроликов. Показано, что введение лефлуномида в дозе 10 мг/кг в течение 42 дней умеренно удлиняет интервал RR, но не влияет на продолжительность зубца P и длину интервалов PQ, QT и корригированного QT

Design of hepatotoxicity and cardiotoxicity experimental evaluation of leflunomid in rabbits

The article deals the experiment methodology on rabbits in order to assess hepatotoxicity of leflunomide during the intake of essential phospholipids. A model of drug administration was chosen, a concept of manipulations for evaluation of hepatotoxicity was developed, which includes blood sampling, weighing, liver biopsy as well as cardiotoxicity – electrocardiography.В статье представлена методология проведения эксперимента на кроликах по оценке гепатотоксичности лефлуномида на фоне приёма эссенциальных фосфолипидов. Подобрана модель введения препарата, разработана концепция манипуляций для оценки гепатотоксичности: забор крови, взвешивание, биопсия печени, а также кардиотоксичности – снятие электрокардиограммы

Impact of renal impairment on atrial fibrillation: ESC-EHRA EORP-AF Long-Term General Registry

Background: Atrial fibrillation (AF) and renal impairment share a bidirectional relationship with important pathophysiological interactions. We evaluated the impact of renal impairment in a contemporary cohort of patients with AF. Methods: We utilised the ESC-EHRA EORP-AF Long-Term General Registry. Outcomes were analysed according to renal function by CKD-EPI equation. The primary endpoint was a composite of thromboembolism, major bleeding, acute coronary syndrome and all-cause death. Secondary endpoints were each of these separately including ischaemic stroke, haemorrhagic event, intracranial haemorrhage, cardiovascular death and hospital admission. Results: A total of 9306 patients were included. The distribution of patients with no, mild, moderate and severe renal impairment at baseline were 16.9%, 49.3%, 30% and 3.8%, respectively. AF patients with impaired renal function were older, more likely to be females, had worse cardiac imaging parameters and multiple comorbidities. Among patients with an indication for anticoagulation, prescription of these agents was reduced in those with severe renal impairment, p&nbsp;&lt;.001. Over 24&nbsp;months, impaired renal function was associated with significantly greater incidence of the primary composite outcome and all secondary outcomes. Multivariable Cox regression analysis demonstrated an inverse relationship between eGFR and the primary outcome (HR 1.07 [95% CI, 1.01–1.14] per 10&nbsp;ml/min/1.73&nbsp;m2 decrease), that was most notable in patients with eGFR &lt;30&nbsp;ml/min/1.73&nbsp;m2 (HR 2.21 [95% CI, 1.23–3.99] compared to eGFR ≥90&nbsp;ml/min/1.73&nbsp;m2). Conclusion: A significant proportion of patients with AF suffer from concomitant renal impairment which impacts their overall management. Furthermore, renal impairment is an independent predictor of major adverse events including thromboembolism, major bleeding, acute coronary syndrome and all-cause death in patients with AF

Clinical complexity and impact of the ABC (Atrial fibrillation Better Care) pathway in patients with atrial fibrillation: a report from the ESC-EHRA EURObservational Research Programme in AF General Long-Term Registry

Background: Clinical complexity is increasingly prevalent among patients with atrial fibrillation (AF). The ‘Atrial fibrillation Better Care’ (ABC) pathway approach has been proposed to streamline a more holistic and integrated approach to AF care; however, there are limited data on its usefulness among clinically complex patients. We aim to determine the impact of ABC pathway in a contemporary cohort of clinically complex AF patients. Methods: From the ESC-EHRA EORP-AF General Long-Term Registry, we analysed clinically complex AF patients, defined as the presence of frailty, multimorbidity and/or polypharmacy. A K-medoids cluster analysis was performed to identify different groups of clinical complexity. The impact of an ABC-adherent approach on major outcomes was analysed through Cox-regression analyses and delay of event (DoE) analyses. Results: Among 9966 AF patients included, 8289 (83.1%) were clinically complex. Adherence to the ABC pathway in the clinically complex group reduced the risk of all-cause death (adjusted HR [aHR]: 0.72, 95%CI 0.58–0.91), major adverse cardiovascular events (MACEs; aHR: 0.68, 95%CI 0.52–0.87) and composite outcome (aHR: 0.70, 95%CI: 0.58–0.85). Adherence to the ABC pathway was associated with a significant reduction in the risk of death (aHR: 0.74, 95%CI 0.56–0.98) and composite outcome (aHR: 0.76, 95%CI 0.60–0.96) also in the high-complexity cluster; similar trends were observed for MACEs. In DoE analyses, an ABC-adherent approach resulted in significant gains in event-free survival for all the outcomes investigated in clinically complex patients. Based on absolute risk reduction at 1 year of follow-up, the number needed to treat for ABC pathway adherence was 24 for all-cause death, 31 for MACEs and 20 for the composite outcome. Conclusions: An ABC-adherent approach reduces the risk of major outcomes in clinically complex AF patients. Ensuring adherence to the ABC pathway is essential to improve clinical outcomes among clinically complex AF patients