PROGNOSTIC VALUE OF P-SELECTIN IN PATIENTS WITH STABLE ANGINA PECTORIS

Coronary artery disease for many years is being the main cause of death in many developed countries. Currently, cardiovascular disease (CVD) plays the main role in the evolution of the total mortality in the world. Most deaths occur as a result of coronary heart disease (more than 300 thousand per year). It is known that chronic inflammation is a marker of global endothelial dysfunction and may be associated with the increased risk of cardiovascular events in patients with coronary artery disease. Nowadays, it is very promising in terms of assessing the prognosis and course of the disease to study P-selectin

ДОСВІД ФОРМУВАННЯ ЛІДЕРСЬКОЇ КОМПЕТЕНТНОСТІ ВИКЛАДАЧІВ ХАРКІВСЬКОЇ МЕДИЧНОЇ АКАДЕМІЇ ПІСЛЯДИПЛОМНОЇ ОСВІТИ

The scientific works on the study of leadership competence and professional level of teachers at higher medical schools are analyzed in the article; the experience of formation of  Kharkiv Medical Academy of Postgraduate Education teachers’ leadership skills is described. It is proved that in the conditions of intellectual competition the continuous-improvement, teaching search and use of innovative technologies are mandatory requirements that are made demands on teacher-leader. Different approaches using self-monitoring and self-evaluation of activities and encourage the development of leadership qualities of teacher’s personality are described.У даній статті проведено аналіз наукових праць щодо дослідження лідерської компетентності та професійного рівня викладачів вищих медичних  навчальних закладів і висвітлюється досвід формування лідерських здібностей викладачів Харківської медичної  академії післядипломної освіти. Доведено, що  в умовах інтелектуальної конкуренції безперервне самовдосконалення, педагогічний пошук і використання інноваційних технологій є обов’язковими вимогами, які пред’являються до викладача-лідера. Приведено опис різних підходів із використанням самоконтролю та самооцінки власної діяльності й стимулювання розвитку лідерських якостей особистості викладача

ІНСТИТУЦІЙНИЙ РОЗВИТОК ВИЩОГО МЕДИЧНОГО НАВЧАЛЬНОГО ЗАКЛАДУ ЯК ОСНОВА ЗАБЕЗПЕЧЕННЯ ЯКОСТІ ВИЩОЇ МЕДИЧНОЇ ОСВІТИ

The aim of the study – to present the experience of Kharkiv Medical Academy of Postgraduate Medical Education in resource potential and environmental factors usage for capacity building and postgraduate medical education quality providing.The main body. Activity of KhMAPE as the organization of effective interaction with objects in the external environment is represented. It includes providing demand for educational services, the creation of educational environment that enriched with information, increasing resource potential and creation of a exible management system. These institutional changes have caused the necessity of the development, discussion and approval of the project target of KhMAPE. Its realization is going to provide discovery and characterize up-coming transition of educational institution.Conclusion. The institutional changes are manifested in staff development, creative implementation of educational objectives, full use of the resource potential, the attraction of additional resources.Мета роботи – висвітлення й обґрунтування досвіду Харківської медичної академії післядипломної освіти щодо використання власного ресурсного потенціалу та факторів зовнішнього середовища для інституційного розвитку і забезпечення якості післядипломної медичної освіти.Основна частина. Представлена діяльність ХМАПО щодо організації ефективної взаємодії з об’єктами зовнішнього середовища, забезпечення попиту на освітні послуги, створення інформаційно збагаченого освітнього середовища, нарощування ресурсного потенціалу та створення гнучкої системи управління.Такі інституційні зміни зумовили необхідність розробки, обговорення та затвердження цільового проекту розвитку ХМАПО, реалізація якого забезпечить отримання позитивного результату та характеризує перехід навчального закладу на вищий щабель діяльності.Висновок. Інституційні зміни виявляються у підвищенні кваліфікації персоналу, творчій реалізації освітніх завдань, у повному використанні ресурсного потенціалу, залученні додаткових ресурсів

P931Assosiation of the levels of galectin-3 and MMP-1 with the type of myocardial dyssynchrony in patients with heart failure and concomitant type 2 diabetes mellitus

Abstract Background Myocardial dyssynchrony  leads to heart remodeling and the progression of heart failure (HF) in patients with type 2 diabetes mellitus. Studying the mechanisms of the development of myocardial dyssynchrony can help in timely diagnosis and treatment. Aims To study the association of the level of galectin-3 and matrix metalloproteinase 1 (MMP-1) and the type of myocardial dyssynchrony in patients with heart failure and concomitant type 2 diabetes mellitus. Methods 98 patients with heart failure and concomitant type 2 diabetes mellitus were examined, average age (67.45 + 10.32) years. Patients were divided into two groups due to the presence or absence of myocardial dyssynchrony: the first group: with myocardial dyssynchrony (n = 56), the second group: patients without myocardial dyssynchrony ( n = 42). All patients were examined for electrical (enhanced QRS ≥ 120 ms) and mechanical myocardial dyssynchrony using echocardiographic and electrocardiographic methods for assessing intraventricular, interventricular, atrioventricular and combined myocardial dyssynchrony, as well as serum concentration of fibrosis markers - galectin-3 and MMP-1. The determination of percentage of interstitial collagen volume fraction (CVF) was performed in both groups. Results To determine the levels of fibrosis markers depending on the presence of diabetes, the results of patients with myocardial dyssynchrony (n = 56) were compared with the results of the control group without myocardial dyssynchrony (n = 42). In patients with myocardial dyssynchrony, there was an increase in the levels of galectin-3 (7.49 + 0.6 ng / ml) and CVF (7.6 ± 4.03%), a decrease in MMP-1 (0.46 + 0.2 ng / ml ) compared with the group without myocardial dyssynchrony (p &amp;lt;0.05). An increase in galectin-3 levels was observed in the presence of combined forms of myocardial dyssynchrony. In patients with a combination of intraventricular, interventricular, or atrioventricular myocardial dyssynchrony (n = 28), the levels of galectin-3 (9.03 + 0.3 ng / ml) and CVF (8.04 + 1.6%) were the highest; in patients with isolated forms of myocardial dyssynchrony, the levels of galectin-3 (6.67 + 0.2 ng / ml) and CVF (6,93 + 1,4%) were significantly lower. MMP-1 was greater in patients with isolated forms of myocardial dyssynchrony (0.78 + 0.2 ng / ml), compared with patients with combined forms of myocardial dyssynchrony (0.2 + 0.01 ng / ml) (p &amp;lt;0.05 ). Conclusions An association is observed between myocardial dyssynchrony and the levels of galectin-3 and MMP-1 in the blood. These findings are important for prognostic implications and require further research. </jats:sec

FIBROTIC CHANGES IN PATIENTS WITH CHRONIC HEART FAILURE WITH CARDIAC DYSSYNCHRONY AND ASSOCIATED TYPE 2 DIABETES MELLITUS

The study of fibrosis markers was carried out on 72 observed patients (mean age (69 ± 10.37) years) with chronic heart failure (CHF) of ischemic genesis with manifestations of cardiac dyssynchrony (CD) and concomitant type 2 diabetes mellitus – Galectin 3 and matrix metalloproteinase 1. All patients were divided into 2 groups, depending on the presence of CD. The CD was evaluated according to a conventional technique, the volume fraction of interstitial collagen was measured using the formula of J. Shirani and co-authors, the levels of Galectin-3 and matrix metalloproteinase 1 – by the enzyme-linked immunoassay according to the manufacturer's instructions. The data were processed using parametric and nonparametric statistics. It was revealed that the level of fibrosis development was higher in the group of patients with CD than in the group without CD. This indicates the dependence of the development of myocardial sites asynchronous reduction with the presence of interstitial collagen development. That further requires the study of the effect of anti-fibrotic, anti-ischemic and hypoglycemic agents on the progression of CD to prevent subsequent myocardial remodeling

ДОСВІД ФОРМУВАННЯ ЛІДЕРСЬКОЇ КОМПЕТЕНТНОСТІ ВИКЛАДАЧІВ ХАРКІВСЬКОЇ МЕДИЧНОЇ АКАДЕМІЇ ПІСЛЯДИПЛОМНОЇ ОСВІТИ

The scientific works on the study of leadership competence and professional level of teachers at higher medical schools are analyzed in the article; the experience of formation of  Kharkiv Medical Academy of Postgraduate Education teachers’ leadership skills is described. It is proved that in the conditions of intellectual competition the continuous-improvement, teaching search and use of innovative technologies are mandatory requirements that are made demands on teacher-leader. Different approaches using self-monitoring and self-evaluation of activities and encourage the development of leadership qualities of teacher’s personality are described.У даній статті проведено аналіз наукових праць щодо дослідження лідерської компетентності та професійного рівня викладачів вищих медичних  навчальних закладів і висвітлюється досвід формування лідерських здібностей викладачів Харківської медичної  академії післядипломної освіти. Доведено, що  в умовах інтелектуальної конкуренції безперервне самовдосконалення, педагогічний пошук і використання інноваційних технологій є обов’язковими вимогами, які пред’являються до викладача-лідера. Приведено опис різних підходів із використанням самоконтролю та самооцінки власної діяльності й стимулювання розвитку лідерських якостей особистості викладача

Morphological Features of the Simulated Gunshot Wounds of Rabbits' Soft Tissues at Different Temperatures of Injuring Object

The article presents the results of experimental modeling of super­ficial fragment gunshot wounds of soft tissues, obtained in low-energy gunshot wounds. The pathomorphosis of gunshot wounds was studied, and the features and timing of their healing were compared depending on the temperature of the damaging fragments. The aim of the work was to study the effect of the temperature of the injuring shrapnel on the healing processes of the soft tissues of experimental animals with superficial low-energy fragment gunshot wounds. Using the random number method, laboratory animals (rabbits) were divided into 3 experimental groups (15 animals each). In each group, wounding was with fragments with different temperatures − 18°С, 50°С and 100°С. The control group consisted of 10 intact animals. On day 14th, 30th and 60th, 5 animals from each group were withdrawn from the experiment. Microscopic examination of soft tissues was performed using a PRIMO STAR light microscope (Carl Zeiss, Germany) at magnification by 56 and 400 times. When assessing the state of tissues in the area of wound damage, it was established that as the temperature of the injuring fragment increases, a slower filling of the defect formed by the necrotic detritus in the process of utilization of necrotic detritus is observed. The high temperature of the injuring fragment along with the mechanical rupture of tissues causes thermal coagulation necrosis. Dense coagulated necrotic masses covering the wound canal from the inside, not only increase the volume of necrotic masses, but also complicate the process of wound healing. At a temperature of wounding fragments 100°C, the formation of a necrotic crust on the surface of the wound occurred on average 3±1.2 days later than at temperatures of 18°C and 50°C, the least pronounced healing took place at the bottom of the wound and in the muscle tissue. Microscopically necrotic, not dystrophic changes were observed in myocytes. Thus, a comparative analysis of the pathomorphosis of soft tissues in a wound when injured from an air rifle MP-532 with different temperature of the fragments showed differences from both the alteration of the tissues and the regenerative potential