Lipid metabolism in non-alcoholic fatty liver disease in patients with different body weights in mid-mountain conditions

Aim. To study the peculiarities of lipid metabolism disorders in non-alcoholic fatty liver disease in lean and obese patients in medium altitude conditions. Materials and methods. The study was carried out within the framework of the project Etiopathogenetic features and rates of development of non-alcoholic fatty liver disease (NAFLD) in the conditions of Kyrgyzstan (№ of state registration MHN/TZ-2020-3). An open comparative study of patients with two forms of NAFLD: fatty liver and non-alcoholic steatohepatitis (n=236) living in low mountains (Bishkek, altitude above sea level 750800 m; n=111) and middle mountains (At-Bashy district , Naryn region, height above sea level 20462300 m; n=125) Kyrgyzstan. The average age of the patients was 55.70.95 years. Given that genetic factors may play a role in the development of NAFLD, we analyzed a population represented only by ethnic Kyrgyz. Patients in each group were divided into lean (BMI23) and obese (BMI23) groups. To determine physical activity, a physical activity questionnaire was used, which was compiled on the basis of the materials of the International Physical Activity Prevalence Study www.ipaq.ki.se. Physical examination included measurement of anthropometric parameters (height, body weight, waist circumference), calculation of body mass index (BMI), skeletal muscle mass index (SMM), percentage of body fat. According to the grades of the WHO, the degree of obesity was assessed by BMI for Asians. Blood samples were taken for research in the morning on an empty stomach after at least 12 hours of fasting. The following indicators were determined: glucose, lipid spectrum (total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides), alanine aminotransferase (ALT), aspartate aminotransferase (AST) levels. The BARD scale was used as a predictor for assessing the development of liver fibrosis in patients with NAFLD. The scoring system included three variables: BMI, AST/ALT, and the presence of DM 2. The diagnosis of NAFLD made on the basis of history, laboratory tests, ultrasound examination of the liver, and exclusion of other liver diseases. The results were analyzed using the SPSS 16.0 statistical software package for Windows. A p-value0.05 was considered statistically significant at the 95% confidence level. Results. It was found that the inhabitants of the middle mountains with NAFLD are represented by a lower BMI relative to the inhabitants of the low mountains. In women, the levels of SMM and the percentage of fat are significantly and statistically significantly correlated (r=-0.971; p0.001), while in men these two indicators are not related. Men showed a trend towards higher percentages of fat, regardless of body weight and region of residence. For women, this indicator was within acceptable limits and did not exceed 31%. There was found a statistically significant difference in total cholesterol levels between low and middle mountain people in the group of obese patients (p0.001) suffering from NAFLD. Statistically significant low ALT indices were revealed in the group of obese patients living in mid-mountain conditions. Conclusion. Taken together, our results suggest that chronic mid-mountain hypoxia may slow down the course of overweight-induced NAFLD

Role of T-786c Endothelial Gene Polymorphism of No - Synthase in the Development of Acute Contrast-induced Nephropathy in Patients with Coronary Heart Disease

Contrast-induced nephropathy (CIN) is the third considerable cause of acute kidney injury (AKI) and makes up almost 10% of all acute kidney failure (AKF) cases.Objective. To study the role of polymorphism of eNOS-gene in the development of acute contrast-induced nephropathy (CIN) in case of coronary heart disease.Materials and methods. The prospective study was conducted in the National Cardiology and Therapy Center named after academician Mirsaid Mirahimov from 2015 to 2018. A total of 184 patients with coronary heart disease (CHD) aged 33-70 years (average age 55.2 ± 8.5 years) were examined to determine possible associative relationships between eNOS gene polymorphism (T786C) and the development of acute CIN. Of these, the group without CIN was 152, and with the CIN there were 32 patients who underwent coronary angiographic examination (CAG). Radiopaque contrast agents Ultravist (Iopromide) and Omnipack (Iohexol) were used. CIN was defined as an increase in serum creatinine (Scr) concentration by more than 25% from the initial level or by more than 0.5 mg/dL (44.2 μmol/L) and a decrease in glomerular filtration rate (GFR) after administration of an iodinated contrast agent within 48-72 hours in the absence of other reasons. A molecular genetic study was conducted to determine the T-786C polymorphism of the eNOS gene.Results. The genotype frequency of the TT gene in the group with CIN was 87.5%, and in the group without CIN 69.7%, the reliability was p <0.05. But the connection of acute CIN with the genotypes of TS and SS was not observed in both of the groups.Conclusions. TT genotype T-786C polymorphism of the eNOS gene is a risk factor for the development of acute contrast-induced in patients with coronary heart disease

Testy produktywności otworów horyzontalnych

Horizontal drilling technology has significantly influenced the industry's approach to the development and recovery of hydrocarbons. Advances in drilling technology have led to improved well productivity, increased drainage areas, especially in low permeability reservoirs. These day companies adopted an approach that has assigned a high priority to monitoring horizontal wells in order to maximize benefits. The testing and logging programs are aimed to assess the flow profile of the horizontal wells, optimize well production rates and plan future production and workover strategies. For this reason development of new methods and technologies has become crucial. This paper covers peculiarities of production logging test techniques used in horizontal wells. This includes technological as well as technical innovations based on deeper understanding of the phenomena through detailed research of this area.W pracy przedstawiono specyfikę technik rejestrowania produktywności otworów horyzontalnych. Omówiono technologiczne oraz techniczne innowacje oparte na głębszym zrozumieniu zjawisk, dzięki przeprowadzeniu szczegółowych badań tego obszaru

PLACE OF VOLUMETRIC LOAD IN ASSESSMENT OF DIASTOLIC RESERVE OF THE LEFT VENTRICLE AND IN PREDICTION OF HEART FAILURE DEVELOPMENT FOR MYOCARDIAL INFARCTION PATIENTS

Aim. To study the role of volumetric load in assessment of diastolic reserve of the left ventricle (LV) and to reveal informative predictors of transmitral diastolic flow for heart failure development in myocardial infarction patients without systolic LV dysfunction.Material and methods. Totally, 40 males studied with primary Q-wave myocardial infarction without clinical signs of heart failure with the baseline LV ejection fraction 50-55%. Statistical analysis was performed via Excel 5.0. Standard methods of variational statistics were applied: mean values, standard deviation. Significance of differences was assessed with t-criteria by Student.Results. In patients with myocardial infarction at volume load there were 2 types of transmitral diastolic flow. 1 group — patients, who had ipsidirectional changes of transmitral diastolic flow, as the healthy: significantly increased Е and А (p<0,05), not changed Е/А, shortened IVRT of LV and Tdec (p<0,002). 2 group — patients, who at the load did not develop increase of Е (p>0,05), had significantly increased А by 12% (p<0,002) and hence decreased Е/А (p<0,05), and significantly prolonged IVRT of LV and Tdec (p<0,05); changes did not return to baseline by 5 minutes of recovery period.Conclusion. 1) load test of VDLT is safe and informative method for DR of LV estimation and for revealing of high risk congestive HF in MI. 2) in patients with decreased DR of LV in VL there is decrease of E, significant increase of A, decrease of E/A and prolongation of IVRT and Tdec, during postinfarction period in 27,3% cases congestive HF does develop. 3) in patients with MI and remaining DR of LV during postinfarction period the congestive HF does not develop

Left ventricular remodeling in patients with right ventricular myocardial infarction

Aim. To study left ventricular (LV) remodeling, interventricular and intraventricular asynchrony in isolated inferior LV myocardial infarction (MI) or combined inferior LV MI with right ventricular (RV) MI.Material and methods. 57 patients with inferior LV MI with or without RV MI (n=57) were included in a 6-month prospective study. The patients were divided into 2 groups: Group 1 - patients with inferior LV MI (n=30); Group 2 - patients with inferior LV MI in combination with RV MI (n=27). Electrocardiography and echocardiography were performed in all patients at admission, on days 3, 30 and 180 after MI.Results. Significant signs of diastolic dysfunction (RV end-diastolic area 29.21±2.0 cm2) were found in group 2 on the third day after MI. A significant increase in the LV volume indices and diastolic sphericity index (from 0.54±0.02 to 0.59±0.03 units) and an increase in interventricular asynchrony (from 37.4±4.2 to 44.6±4.2 ms) were found in group 2 in 30 days after MI. Increasing tendency towards intraventricular and interventricular asynchrony, despite the absence of pathological LV remodeling, occurred in group 2 in 6 months after MI.Conclusion. Patients with RV MI have more pronounced maladaptive LV remodeling, intraventricular and interventricular asynchrony and greater LV diastolic dysfunction

Left ventricular remodeling in patients with right ventricular myocardial infarction

Aim. To study left ventricular (LV) remodeling, interventricular and intraventricular asynchrony in isolated inferior LV myocardial infarction (MI) or combined inferior LV MI with right ventricular (RV) MI.Material and methods. 57 patients with inferior LV MI with or without RV MI (n=57) were included in a 6-month prospective study. The patients were divided into 2 groups: Group 1 - patients with inferior LV MI (n=30); Group 2 - patients with inferior LV MI in combination with RV MI (n=27). Electrocardiography and echocardiography were performed in all patients at admission, on days 3, 30 and 180 after MI.Results. Significant signs of diastolic dysfunction (RV end-diastolic area 29.21±2.0 cm2) were found in group 2 on the third day after MI. A significant increase in the LV volume indices and diastolic sphericity index (from 0.54±0.02 to 0.59±0.03 units) and an increase in interventricular asynchrony (from 37.4±4.2 to 44.6±4.2 ms) were found in group 2 in 30 days after MI. Increasing tendency towards intraventricular and interventricular asynchrony, despite the absence of pathological LV remodeling, occurred in group 2 in 6 months after MI.Conclusion. Patients with RV MI have more pronounced maladaptive LV remodeling, intraventricular and interventricular asynchrony and greater LV diastolic dysfunction.</p

Enalapril effects on renal function and ACE gene polymorphism in hypertensive nephropathy

Aim. To investigate the effects of enalapril on 24-hour proteinuria, renal function, intra-renal hemodynamics and survival, in regard to ACE gene polymorphism I/D, among patients with essential arterial hypertension (EAH). Material and methods. In total, 83 EAH patients were examined (mean age 41,48±1,25 years) as the main group (MG). The control group (CG) included 30 healthy people and was comparable to MG by gender and sex distribution. All participants underwent general clinical examination, assessment of 24-hour proteinuria and glomerular filtration rate (GFR), electrocardiography, echocardiography, renal ultrasound and renal vessel triplex scanning. ACE gene polymorphism was assessed by polymerase chain reaction method. Results. In EAH patients, D allele of ACE gene was associated, despite ACE inhibitor therapy during 4 years of the follow-up, with development of hypertensive nephropathy (HN), with an increase in 24-hour proteinuria from 276,67±112,13 to 836,50±294,50 mg/d, especially in individuals with DD genotype. The same group of patients developed renal failure: in 8 years, GFR decreased to 36,78±7,59 ml/min, while in patients with I allele, renal function was intact. Ten-year survival of EAH patients with DD genotype (all individuals developed renal failure) was significantly lower than in individuals with I allele. In EAH patients with II genotype, enalapril therapy resulted in vasodilatation and decreased resistivity and pulsatility indices, while no similar changes were observed in patients with DD genotype. Conclusion. Despite ACE inhibitor therapy, EAH patients with DD genotype were characterised by increased 24-hour proteinuria, reduced GFR, increased resistivity and pulsatility indices, and worse 10-year survival, compared to patients with I allele

Features of the diagnosis of veins of the lower extremities with floating thrombosis in ultrasonic angioscanning

Objective. Study of the features of the diagnosis of veins of the lower extremities with floating thrombosis in ultrasound angioscanning. This issue is not sufficiently studied in the scientific literature, which demonstrates its relevance. Material and methods. All patients of the main group (385) underwent UCAS upon admission, after surgery and in the dynamics of observation. Results. In all 385 patients, we detected blood clots of various localization and size. When analyzing the localization of thrombosis of the lower extremities, all of our patients were divided into 3 groups depending on the segment of the lesion. Left-sided localization of the pathological process was observed in 195 (50.7%) patients, and right-sided — in 165 (42.8%) patients. 24.2%), occlusive - in 38 (9.8%) patients. Conclusions. The following features are inherent in floating thrombosis in ultrasonic angioscanning: 1) the location of the floating thrombus above the upper third of the leg; 2) the presence of growing blood clots spreading in both the proximal and distal directions; 3) a weak connection between a blood clot and a vascular wall and the presence of blood flow in a thrombosed vein. The results of the study made a practical and theoretical contribution to phlebological science.Цель. Исследование особенностей диагностики вен нижних конечностей при флотирующем тромбозе в ультразвуковом ангиосканировании. Данный вопрос недостаточно изученный в научной литературе, что демонстрирует его актуальность. Материал и методы. Всем больным основной группы (385) проведено УЗАС при поступлении, после операции и в динамике наблюдения. Результаты. У всех 385 больных нами были обнаружены тромбы различной локализации и размера. При анализе локализации тромбоза нижних конечностей все наши больные были разделены на 3 группы в зависимости от сегмента поражения. Левосторонняя локализация патологического процесса наблюдалась у 195 (50,7%) больных, а правосторонняя - у 165 (42,8%).По характеру проксимальной части тромба флотирующий тромб встречался у 254 (66,0%) больных, пристеночный – у 93 (24,2%), окклюзивный – у 38 (9,8%) больных. Выводы. Флотирующему тромбозу в ультразвуковом ангиосканировании присущи следующие особенности: 1) расположение флотирующего тромба выше верхней трети голени; 2) наличие растущих тромбов, распространяющихся как в проксимальном, так и дистальном направлении; 3) слабая связь тромба с сосудистой стенкой и наличие кровотока в тромбированной вене. Результаты исследования внесли практико-теоретический вклад во флебологическую науку