ОЦІНКА МОТИВАЦІЙНОГО НАВЧАННЯ ПАЦІЄНТІВ З ГІПЕРТОНІЧНОЮ ХВОРОБОЮ ТА АЛІМЕНТАРНИМ ОЖИРІННЯМ

This article provides an assessment of the effectiveness of the developed motivational training program in hypertensive patients with alimentary obesity. It was established that the conduct of motivational training for such patients increases their level of intensity and attitude to health, leading to lifestyle modifications (prolongation of rest and sleep duration, adherence to a balanced diet, refusal of smoking), regular monitoring of blood pressure, which improves their quality of life.У статті проведено оцінку ефективності розробленої нами програми мотиваційного навчання пацієнтів з гіпертонічною хворобою та аліментарним ожирінням. Встановлено, що проведення мотиваційного навчання для таких пацієнтів підвищує їх рівень інтенсивності ставлення до здоров’я, що приводить до модифікації способу життя (збільшення тривалості відпочинку і тривалості сну, дотримання раціонального харчування, відмова від тютюнокуріння), регулярного контролю артеріального тиску, що покращує їх якість життя

ОСНОВНІ СКЛАДОВІ ЗДОРОВ’Я

In the article analyzes the basic concepts and approaches to health positions. It is shown that qualitative and quantitative characteristics of both health and illness have a fairly wide range of interpretation. It was summed, that the health is a multifactorial concept, which become the main strategy of life to improve the vitality of the body.У статті розглянуто поняття та основні підходи до позиції здоров'я. Показано, що якісні і кількісні характеристики як здоров'я, так і хвороби мають досить широкий діапазон тлумачення. Підсумовано, що здоров’я є мультифакторним поняттям, яке виступає основною стратегією життя людини з метою підвищення життєстійкості організму

ОЖИРІННЯ ЯК СОЦІАЛЬНА ПРОБЛЕМА СУЧАСНОСТІ

The article analyzes the combined incidence course alimentary obesity.It was  established that alimentary obesity in the population of Ternopil region often combined with endocrine disorders, including diabetes mellitus type 2 (in 62.7% of patients) and cardiac pathology, namely hypertension (34.3% patients), while in gender aspect woman more often  had comorbidity pathology. The results indicate that alimentary obesity contributes to an unfavorable background for the main course of the disease.У статті проаналізовано захворюваність на поєднаний перебіг аліментарного ожиріння. Встановлено, що аліментарне ожиріння в населення Тернопільської області найчастіше поєднується з ендокринною патологією, зокрема, з цукровим діабетом 2 типу (у 62,7 % хворих) та кардіологічною патологією, а саме з гіпертонічною хворобою (34,3 % пацієнтів), при цьому в гендерному аспекті частіше на поєднані патології хворіють жінки. Отримані результати свідчать про те, що аліментарне ожиріння призводить до формування несприятливого тла для перебігу основної хвороби

Immunoglobulin, glucocorticoid, or combination therapy for multisystem inflammatory syndrome in children: a propensity-weighted cohort study

Background: Multisystem inflammatory syndrome in children (MIS-C), a hyperinflammatory condition associated with SARS-CoV-2 infection, has emerged as a serious illness in children worldwide. Immunoglobulin or glucocorticoids, or both, are currently recommended treatments. Methods: The Best Available Treatment Study evaluated immunomodulatory treatments for MIS-C in an international observational cohort. Analysis of the first 614 patients was previously reported. In this propensity-weighted cohort study, clinical and outcome data from children with suspected or proven MIS-C were collected onto a web-based Research Electronic Data Capture database. After excluding neonates and incomplete or duplicate records, inverse probability weighting was used to compare primary treatments with intravenous immunoglobulin, intravenous immunoglobulin plus glucocorticoids, or glucocorticoids alone, using intravenous immunoglobulin as the reference treatment. Primary outcomes were a composite of inotropic or ventilator support from the second day after treatment initiation, or death, and time to improvement on an ordinal clinical severity scale. Secondary outcomes included treatment escalation, clinical deterioration, fever, and coronary artery aneurysm occurrence and resolution. This study is registered with the ISRCTN registry, ISRCTN69546370. Findings: We enrolled 2101 children (aged 0 months to 19 years) with clinically diagnosed MIS-C from 39 countries between June 14, 2020, and April 25, 2022, and, following exclusions, 2009 patients were included for analysis (median age 8·0 years [IQR 4·2–11·4], 1191 [59·3%] male and 818 [40·7%] female, and 825 [41·1%] White). 680 (33·8%) patients received primary treatment with intravenous immunoglobulin, 698 (34·7%) with intravenous immunoglobulin plus glucocorticoids, 487 (24·2%) with glucocorticoids alone; 59 (2·9%) patients received other combinations, including biologicals, and 85 (4·2%) patients received no immunomodulators. There were no significant differences between treatments for primary outcomes for the 1586 patients with complete baseline and outcome data that were considered for primary analysis. Adjusted odds ratios for ventilation, inotropic support, or death were 1·09 (95% CI 0·75–1·58; corrected p value=1·00) for intravenous immunoglobulin plus glucocorticoids and 0·93 (0·58–1·47; corrected p value=1·00) for glucocorticoids alone, versus intravenous immunoglobulin alone. Adjusted average hazard ratios for time to improvement were 1·04 (95% CI 0·91–1·20; corrected p value=1·00) for intravenous immunoglobulin plus glucocorticoids, and 0·84 (0·70–1·00; corrected p value=0·22) for glucocorticoids alone, versus intravenous immunoglobulin alone. Treatment escalation was less frequent for intravenous immunoglobulin plus glucocorticoids (OR 0·15 [95% CI 0·11–0·20]; p<0·0001) and glucocorticoids alone (0·68 [0·50–0·93]; p=0·014) versus intravenous immunoglobulin alone. Persistent fever (from day 2 onward) was less common with intravenous immunoglobulin plus glucocorticoids compared with either intravenous immunoglobulin alone (OR 0·50 [95% CI 0·38–0·67]; p<0·0001) or glucocorticoids alone (0·63 [0·45–0·88]; p=0·0058). Coronary artery aneurysm occurrence and resolution did not differ significantly between treatment groups. Interpretation: Recovery rates, including occurrence and resolution of coronary artery aneurysms, were similar for primary treatment with intravenous immunoglobulin when compared to glucocorticoids or intravenous immunoglobulin plus glucocorticoids. Initial treatment with glucocorticoids appears to be a safe alternative to immunoglobulin or combined therapy, and might be advantageous in view of the cost and limited availability of intravenous immunoglobulin in many countries. Funding: Imperial College London, the European Union's Horizon 2020, Wellcome Trust, the Medical Research Foundation, UK National Institute for Health and Care Research, and National Institutes of Health

Immunoglobulin, glucocorticoid, or combination therapy for multisystem inflammatory syndrome in children: a propensity-weighted cohort study

Background Multisystem inflammatory syndrome in children (MIS-C), a hyperinflammatory condition associated with SARS-CoV-2 infection, has emerged as a serious illness in children worldwide. Immunoglobulin or glucocorticoids, or both, are currently recommended treatments. Methods The Best Available Treatment Study evaluated immunomodulatory treatments for MIS-C in an international observational cohort. Analysis of the first 614 patients was previously reported. In this propensity-weighted cohort study, clinical and outcome data from children with suspected or proven MIS-C were collected onto a web-based Research Electronic Data Capture database. After excluding neonates and incomplete or duplicate records, inverse probability weighting was used to compare primary treatments with intravenous immunoglobulin, intravenous immunoglobulin plus glucocorticoids, or glucocorticoids alone, using intravenous immunoglobulin as the reference treatment. Primary outcomes were a composite of inotropic or ventilator support from the second day after treatment initiation, or death, and time to improvement on an ordinal clinical severity scale. Secondary outcomes included treatment escalation, clinical deterioration, fever, and coronary artery aneurysm occurrence and resolution. This study is registered with the ISRCTN registry, ISRCTN69546370. Findings We enrolled 2101 children (aged 0 months to 19 years) with clinically diagnosed MIS-C from 39 countries between June 14, 2020, and April 25, 2022, and, following exclusions, 2009 patients were included for analysis (median age 8·0 years [IQR 4·2–11·4], 1191 [59·3%] male and 818 [40·7%] female, and 825 [41·1%] White). 680 (33·8%) patients received primary treatment with intravenous immunoglobulin, 698 (34·7%) with intravenous immunoglobulin plus glucocorticoids, 487 (24·2%) with glucocorticoids alone; 59 (2·9%) patients received other combinations, including biologicals, and 85 (4·2%) patients received no immunomodulators. There were no significant differences between treatments for primary outcomes for the 1586 patients with complete baseline and outcome data that were considered for primary analysis. Adjusted odds ratios for ventilation, inotropic support, or death were 1·09 (95% CI 0·75–1·58; corrected p value=1·00) for intravenous immunoglobulin plus glucocorticoids and 0·93 (0·58–1·47; corrected p value=1·00) for glucocorticoids alone, versus intravenous immunoglobulin alone. Adjusted average hazard ratios for time to improvement were 1·04 (95% CI 0·91–1·20; corrected p value=1·00) for intravenous immunoglobulin plus glucocorticoids, and 0·84 (0·70–1·00; corrected p value=0·22) for glucocorticoids alone, versus intravenous immunoglobulin alone. Treatment escalation was less frequent for intravenous immunoglobulin plus glucocorticoids (OR 0·15 [95% CI 0·11–0·20]; p<0·0001) and glucocorticoids alone (0·68 [0·50–0·93]; p=0·014) versus intravenous immunoglobulin alone. Persistent fever (from day 2 onward) was less common with intravenous immunoglobulin plus glucocorticoids compared with either intravenous immunoglobulin alone (OR 0·50 [95% CI 0·38–0·67]; p<0·0001) or glucocorticoids alone (0·63 [0·45–0·88]; p=0·0058). Coronary artery aneurysm occurrence and resolution did not differ significantly between treatment groups. Interpretation Recovery rates, including occurrence and resolution of coronary artery aneurysms, were similar for primary treatment with intravenous immunoglobulin when compared to glucocorticoids or intravenous immunoglobulin plus glucocorticoids. Initial treatment with glucocorticoids appears to be a safe alternative to immunoglobulin or combined therapy, and might be advantageous in view of the cost and limited availability of intravenous immunoglobulin in many countries. Funding Imperial College London, the European Union's Horizon 2020, Wellcome Trust, the Medical Research Foundation, UK National Institute for Health and Care Research, and National Institutes of Health

Bioakumulacja arsenu, chromu, manganu i niklu w skrzelach troci wędrownej (Salmo trutta m. trutta L.) z południowej części Morza Bałtyckiego (Region Pomorza Środkowego)

This study aimed to assess the concentrations of arsenic (As), chrome (Cr), manganese (Mn), and nickel (Ni) in the gills of the sea trout (Salmo trutta m. trutta L.) collected in the Baltic Sea (northern region of Poland). The results were then compared to permissible limits to detect whether the metal contamination levels in sea trout from the Baltic sea exceed the values of limits admissible. Frequently consumed sea trout (25 samples) were purchased from local fisherman in January-February 2014, from Ustka (54°34'43''N 16°52'09''E), Pomeranian voivodship, Poland. The element contents in the gills were analyzed using an inductively coupled plasma mass spectrometry (ICP-MS) technique. Metal contents in fish samples were found 0.00313- 0.02069 mg∙kg-1 for As (the mean value was 0.01294±0.0009 mg∙kg-1), 0.0118-0.02161 mg∙kg-1 for Cr (0.01449±0.0003 mg∙kg-1), 0.01895-0.14216 mg∙kg-1 for Mn (0.04137±0.0046 mg∙kg-1), 0.00664-0.01528 mg∙kg-1 for Ni (0.00811±0.00034 mg∙kg-1). According to these data, the ranking order of the mean concentration of the heavy metals in fish gills was Mn (0.04137 mg∙kg-1) ˃ As (0.01294 mg∙kg-1) ˃ Cr (0.01449 mg∙kg-1) ˃ Ni (0.00811 mg∙kg-1). The mean concentration of arsenic in gill samples (0.01294±0.0009 mg∙kg-1) was much below the permissible limit of USFDA (1993b) and FAO/WHO (1976). The mean Cr content in the gill of sea trout samples was well within the toxic limit of USFDA (1993a). The samples had lower Cr concentration as compared to the limits of 0.200 set by FSANZ (2002) and 0.100 by EUROPA (2004). Our study reported that the accumulation of Mn was exceeding the maximum permissible limit (by 8.27-16.55-fold) according to WHO/EPA standard (0.0025-0.005 mg∙kg-1) (FAO/WHO 1976). The proposed limit of Ni concentrations in marine fish species as recorded by FAO (1983) is about 10 μg/g and 0.5-0.6 μg/g according to WHO Guidelines for drinking water quality (1985). In general, it can be seen that the concentrations of Ni found in gills of the sea trout in this study are still considered as those of uncontaminated fish. In conclusion, the assessment of element contents in the organs of the sea trout appears to be a useful biomarker to evaluate the toxic effects of heavy metal pollution as well as for human consumption

Ocena ryzyka zachorowalności i umieralności na nowotwory tarczycy wśród mieszkańców województw pomorskiego i zachodniopomorskiego (Polska)

The objective of our study was to compare recent secular trends in the morbidity and mortality rates of thyroid cancer among the children and adult populations of West Pomeranian and Pomeranian Voivodeships in 2000 and 2016. The number of thyroid cancer cases and incidence rates were retrieved from the Regional Cancer Registries for the period 2000-2016. The number of deaths and mortality rates was obtained from the cancer mortality database (2000 and 2016 by regions). The increase in the incidence rates among the female population in the Pomeranian Voivodeship was observed (from 11.31 in 2000 to 32.04 per 100,000 persons in 2016). Among the child population, the incidence has increased slightly among girls. The adult mortality rate remained unchanged during the study period and was not recorded among other populations. The highest incidence in West Pomeranian Voivodeship is observed among women in 2016 and stands at 22.46 per 100,000 population. Mortality increased slightly during the study period among the female population. The relative risk of thyroid cancer mortality was increased among the adult population of West Pomeranian Voivodeship. Therefore, both thyroid cancer morbidity and mortality are occurring mainly at the expense of the female population. These trends, combined with overall high mortality and high 15-year increase of morbidity, raise concerns on the extent to which the situation may be taking place

Discrimination Of Conductive Surface Electron States By Laser Terahertz Radiation In Pbse-A Base For Pb1-XSnXSe Topological Crystalline Insulators

We report on the influence of oxidation on features of surface electron states in PbSe films-materials belonging to the family of topological crystalline insulators Pb1-xSnxSe. These states are detected through observation of the photoelectromagnetic effect induced by terahertz laser pulses. It is demonstrated that highly conductive surface electron states in PbSe are inherent to the semiconductor itself and are not related to the material oxidation. This allows excluding surface states induced by oxidation as a reason for high surface conductivity in topological crystalline insulators based on Pb1-xSnxSe