ФАКТОРИ РИЗИКУ ТА ЛІКУВАННЯ ГОСТРОГО ПОШКОДЖЕННЯ НИРОК

Работа посвящена анализу последних данных касающихся риска развития острого повреждения почек (ОПП), а также вопросов лечения и исходов у пациентов с ОПП

PHARMACOKINETICS AND PHARMACODYNAMICS OF DRUGS IN PATIENTS WITH RENAL DYSFUNCTION

This review is dedicated to drugs` pharmacokinetics and pharmakodynamcs in patients with renal dysfunction

PROJECT OF NATIONAL CLINICAL GUIDELINES OF DIAGNOSIS, PREVENTION AND TREATMENT OF ACUTE KIDNEY INJURY

This is a draft of national clinical guidelines of diagnosis, prevention and treatment of acute kidney injury

Risk factors in patients with atrial fibrillation and coronary heart disease

The aim of the study was to evaluate the risk factors and the incidence of comorbidity in patients with coronary heart disease depending on the presence of atrial fibrillation

Hemodynamic features in patients with chronic heart failure and preserved ejection fraction

The aim of the study was to determine the clinical features and hemodynamics in patients with CHF with preserved ejection fraction depending on age

Long-term restraint stress as a predictor of insulin resistance development in experimental rats

The aim of the work was to define the pattern of changes and pathogenetic mechanisms of glycemic curve shape during a glucose tolerance test in rats at 6, 15, and 21 weeks of environmental space restriction. Materials and methods. A total of 55 male Wistar rats aged 6–10 months were used and divided into 4 groups (1 – intact control, 10 rats; 2, 3 and 4 of 15 rats each, which were in conditions of restricted environmental space for 6, 15 and 21 weeks, respectively). Fasting plasma levels of glucose (test strips Test Strip II on a Glucocard glucometer (ARKRAY Inc., Japan)), insulin and corticosterone (by an immunoenzymatic method using commercial kits for rats from Monobind, USA) were measured, glucose tolerance tests (GTT) were performed, the HOMA index and the insulin/corticosterone ratio were calculated. Results. The 6-week environmental space restriction, immobility and complex communication relations resulted in a hypoinsulinemic-hypoglycemic type of the glycemic curve with high tissue glucose sensitivity in animals which were in the conditions described (the HOMA index was significantly decreased to 0.21 versus 0.55 in the control), the characteristic delayed hyperglycemic peak at the 30th min of the test slowly returned to the euglycemic level by only the 90th min against the 30th min in the controls. The 15-week restriction caused a hypoinsulinemic curve with preserved tissue glucose sensitivity (the HOMA index 0.33 versus 0.55 in the controls). Alterations in postprandial glucose absorption were manifested by the highest glucose concentration at the 15th min of the test, a very slow decrease in the glucose level in the post-absorption period not being restored to baseline values by the 90th min. The 21-week restriction shaped a diabetic type of the glycemic curve, impaired tissue glucose sensitivity (a substantial and significant increase in the calculated HOMA index from 0.55 in the controls to 0.95) and resulted in the development of insulin resistance. Conclusions. The environmental space restriction, immobility and complex communication relations gradually induce a range of disorders in animals and change the glycemic response shape to glucose load, impair prandial insulin secretion, augment hyperglycemic effects of counterinsular hormones (corticosterone), and realize dysfunctional manifestations of prandial/postprandial glycemia. 6 weeks of restrictions and challenges shape the hypoinsulinemic-hypoglycemic type of the glycemic curve with high tissue glucose sensitivity, while 15 weeks result in the hypoinsulinemic curve with preserved tissue glucose sensitivity. 21 weeks show the diabetic type of the glycemic curve with impaired tissue glucose sensitivity and the development of insulin resistance

Pathogenetic characteristics of the hormonal profile in rats subjected to restraint stress of different duration

The aim of the work is to ascertain the character of changes in the hormonal profile (concentrations of corticosterone, insulin, and adrenocorticotropic hormone) in conjunction with metabolic alterations and elevated blood pressure, which are induced in rats by restraint stress at 6th, 15th and 21st weeks of environmental space restriction. Materials and methods. A total of 55 normotensive male Wistar rats, aged 6–10 months, were assigned into 4 experimental groups (1 – intact control (10 rats); 2, 3 and 4 (15 rats each exposed to restricted space allowance)). All the animals were subjected to blood pressure (BP), blood glucose level and body weight measurements twice: at the stage of forming groups and at the 6th, 15th and 21st weeks. Plasma hormone concentrations (insulin, corticosterone, and ACTH) were examined by the immunoenzymatic method using commercial kits (Monobind, USA). Results. The body weight of the animals was significantly reduced by 20.72 % after 6 weeks of space allowance restriction, it was restored to baselines by the 15th week and exceeded control values by 26.1 % at the 21st week. BP levels showed an increasing trend, a dynamic increase in systolic pressure by 7 %, 17 % and 26 % was detected, respectively, as well as diastolic from the 15th week to the 21st week by 21.4 % and 37.0 %, respectively. Glucose concentration was within the euglycemic range. Changes in the hormonal profile showed an increase in the concentration of ACTH by more than 50 % and a decrease in insulin – by 34 % at the 6th week with a subsequent twofold decrease in the insulin concentration (at week 15) and a further more than twofold increase in ACTH at the 21st week. As for changes in the concentration of corticosterone, a peak increase of 3.77 times was noticed at the 15th week, followed by a decrease and restoration to the normative values by the 21st week. Conclusions. Even minor and unremarkable continuously acting stressors, which cannot be coped, become important triggers for hormonal profile and carbohydrate metabolism alterations as well as for a persistent increase in blood pressure, which manifest first by hypoinsulinemia, an increase in the level of ACTH, and a constant concentration of corticosterone. Long-term stress exposure contributes to a transient “peak” increase in the corticosterone level, a significant increase in insulin and a sustained increase in ACTH. Multidirectional changes in the levels of the studied hormones occur amidst a gradual increase in blood pressure and a stable increase in the level of glycemia

Pattern of changes in morpho-densitometric parameters of magnocellular neurons of the hypothalamic paraventricular nucleus under restraint stress of different duration

The aim of the work was to define the nature of changes in morpho-densitometric parameters of magnocellular neurons of the hypothalamic paraventricular nucleus in rats at 6, 15 and 21 weeks of restricted living space. Materials and methods. A total of 55 male Wistar rats aged 6-10 months were used and divided into 4 groups (1 – intact control, 10 rats; 2, 3 and 4 – experimental groups of 15 rats each, which were in conditions of restricted environmental space for 6, 15 and 21 weeks, respectively). Morpho-densitometric analysis of 5-μm-thick rat brain sections was performed after preliminary standard histological processing and 48 hours of halocyanine-chrome staining by Einarson using an AxioImager-M2 microscope (Carl Zeiss, Germany). Images of magnocellular neurons of the hypothalamic paraventricular nuclei (PVN), which were topographically identified according to the stereotaxic atlas of the rat brain, were captured using a highly sensitive AxioCam-ERc 5s video camera (Carl Zeiss, Germany) and recorded as a computer file using AxioVision 40 V 4.8.2.0 software (license number 3005339). Quantitative data on the area of neurons, their nuclei and nucleoli, the content of heterogeneous DNA and RNA in the cell cytoplasm, nuclei and nucleoli were obtained in a semi-automatic mode using the open source software ImageJ (National Institutes of Health, USA). Results. Chronic stress condition modelled in rats for 6, 15, and 21 weeks (limited living space, inactivity, and complicated communications) resulted in a decrease in the area of cytoplasm and nuclei of magnocellular neurons of the hypothalamic PVN. The decrease was directly proportional to restrain stress duration: cytoplasm and nuclei by 18 % and 9 % at week 6 and by 40 % and 25 % at week 21, respectively, and only cytoplasm by 23 % at 15 weeks. On the contrary, the area of neuronal nuclei was increased by 31 % at 6 weeks of stress and 33 % at 15 weeks, and by 15 % at 21 weeks of stress compared to the control. The content of nucleic acids in the cytoplasm of magnocellular neurons of the hypothalamic PVN in the group of rats with 6-week restriction was 39 % less than in the control group, 34 % less than that in the group with 15-week restriction, and 42 % less than that in the group of 21-week restrain stress. In the nuclei of cells after 6 and 15 weeks of restriction, the content was decreased approximately equally by 37 % and 35 %, respectively, and long-term restriction (21 weeks) contributed to a 41 % decrease. In the neuron nucleoli, the content of nucleic acids was changed similarly: in the group of 6 weeks, a decrease of 40 % was characteristic, after 15 weeks – by 39 %, and after 21 weeks – by 43 %. Conclusions. Changes in the morphometric parameters of magnocellular neurons of the hypothalamic PVN in rats with long-term limitation of living space are characterized by time dependence and multidirectionality, which is related to the functional features of the neuron structural components (cytoplasm, nucleus and nucleoli). There is a progressive decrease in the cytoplasmic area of PVN neurons and their nuclei, while the nucleolar area increases with increasing length of living space limitation. The content of nucleic acids in the studied structures of the hypothalamic PVN magnocellular neurons after prolonged stress at each time point (6, 15, 21 weeks) becomes less than the control values by more than a third. Comparison of nucleic acid content in the neuron cytoplasm, nuclei, and nucleoli shows a narrow range of variations in the parameters of the experimental group rats between different periods

Стимулювання персоналу Державної служби України з питань праці до впровадження міжнародного досвіду в управлінні охороною праці

The subject matter of the research of the motives of state officials are socio-economic and legal relations that arise in the process of improving the activities of the State Labor Service of Ukraine (SLS) in the field of “Labor Protection”. The object of the research is the system of state management of labor protection and technology of personnel incentives in the regional departments of the SLS. The purpose of the work is theoretical substantiation and development of recommendations for improving the activities and increasing motivation of the staff of the SLS of Ukraine in Sumy region, in particular the implementation of the experience of advanced world countries into the management strategies. Implementation of the current regulatory base in the field of labor protection in Ukraine, in accordance with international requirements, requires high qualification and motivation of the staff of the relevant executive authorities, the development of effective tools to stimulate the efficient work of those state officials. The authors have studied the role and place of the SLS of Ukraine regarding the adaptation and implementation of the experience of advanced world countries into the management strategies of labor protection defined in the Conventions of the International Labor Organization and the Directives of the European Union. The authors have determined the subjects of influence in the field of protection of labor rights, labor protection, preservation of life and health of the participants in the production process, in particular the executive authorities of public administration and the Federation of Trade Unions of Ukraine. The authors have developed suggestions on encouraging the staff of the SLS to implement high-quality international labor protection standards on the basis of motivational profiles and their monitoring. Ukraine has chosen an effective model of supervision and control over the compliance with labor legislation. The advantage of this model is the ability of inspections to delegate their powers from central authorities to local agencies. The conducted study is of theoretical and practical interest in regard to the systems of labor inspections in different countries, it allows us to determine the place of national government in the overall system of such inspections. The results of the research can be recommended for implementation in public administration and local self-government agencies in the field of labor protection in Ukraine.Исследованы роль и место Государственной службы Украины по вопросам труда в адаптации и имплементации опыта передовых стран мира в управленческие стратегии охраны труда, определенные в конвенциях Международной организации труда и директивах Европейского Союза. Определены субъекты влияния в сфере защиты трудовых прав, охраны труда, сохранения жизни и здоровья участников производственного процесса, в частности органы исполнительной власти государственного управления и Федерация профсоюзов Украины. Разработаны предложения по стимулированию персонала Государственной службы Украины по вопросам труда к качественному внедрению международных стандартов охраны труда на основе мотивационных профилей и их мониторинга.Досліджено роль і місце Державної служби України з питань праці щодо адаптації та імплементації досвіду передових країн світу в управлінські стратегії охорони праці, що визначені в конвенціях Міжнародної організації праці та директивах Європейського Союзу. Визначено суб’єктів впливу у сфері захисту трудових прав, охорони праці, збереження життя і здоров’я учасників виробничого процесу, зокрема органи виконавчої влади державного управління і Федерацію профспілок України. Розроблено пропозиції щодо стимулювання персоналу Державної служби України з питань праці до якісного впровадження міжнародних стандартів охорони праці на основі мотиваційних профілів та їх моніторингу