PULMONARY ARTERY INFLAMMATION IN NON-SPECIFIC AORTOARTERITIS. Review

Relevance. Nonspecific aortoarteritis (NAA) or Takayasu's disease can exacerbate life-threatening arteritis of the pulmonary artery (LA), which is usually diagnosed with delay and lead to a poor prognosis. Objective: to review the literature data on LA lesions in NAA to improve the diagnosis and timely appointment of appropriate treatment for better the prognosis of the overall outcome. Methods. Review of scientific literature in international electronic databases PubMed, Google Scholar by keywords for the period 2007-2022. The search was conducted by two independent authors. 90 sources were selected for analysis, of which 43 were used, which were written in English and met the search criteria. Results. In NAA, LA lesions are not a rare pathology, which is observed in 5.7-66% of cases. LA arteritis can manifest itself in the form of stenosis, occlusion, dilatation, aneurysm, thrombosis in situ, and thickening of the arteries. When LA is involved in the pathological process, the risk of developing pulmonary hypertension (LH), heart failure, and lung parenchymal lesions increases, which worsens the prognosis of such patients. The pathology of LA is often diagnosed with a delay due to nonspecific symptoms. It should be noted that in NAA LH can develop not only due to LA arteritis but also due to the presence of pathology in the left heart. Conclusions. LA lesions are common in patients with NAA, however, are often diagnosed with a delay. Involvement of LA in the pathological process can lead to the development of LH, HF, and lung parenchymal lesions and worsen the prognosis, so early diagnosis and timely appropriate treatment are important to reduce morbidity and mortality due to LA lesions in NAA. In addition, pulmonary blood flow and intracardiac hemodynamics should be monitored regularly

Ювенільний ідіопатичний артрит у дорослих пацієнтів: аналіз клінічних даних

Aim. To study the connection of the disease with social and clinical parameters of adult patients with JIA in the anamnesis for improve the observation of them and decrease remote results.Methods. There were examined adults with JIA in the anamnesis, age – 24,3±8,3 years, the disease duration - 13,6±9,3 years, with the assessment of the diagnosis determination, disease activity in the child and adult age (JADAS, VAS), received treatment with glucocorticoids (GC) and its duration, life quality (SF-36), functional activity disorders (HAQ), psychological state, cardio-vascular risk, remote results of JIA (JADI-A, JADI-E).Result. Adult women had the more active disease by JADAS (p<0,05) and JIA remote results by JADI-A took place in them more often (p<0,05). Patients with a higher education had the more disease duration (p<0,05). The influence of social factors on the health state was more (p<0,05) in patients with a finished higher education comparing with ones with an incomplete one, although the life quality (SF-36), anxiety and depression level didn’t differ in these groups. Patients with invalidism, developed as a result of JIA had the worse general state by VAS (p<0,05), glucocorticoids were prescribed longer (p<0,05), JADI-E extra-articular results developed more often (p<0,05), although their psychological state didn’t differ from patients without invalidism. Patients, divided in groups depending on ACCP/RF, ANA, HLA-B27 presence and negative by all markers, differed by the age of the disease start, SF-36, disease activity (DAS28), remote results by JADI-E and JADI-A. The treatment duration and GC cumulative dose didn’t differ in these groups.Conclusions. 1. In female adult patients with JIA was reveled the more disease activity by JADAS and remote articular results of JIA took place more often that testify to the need of the more aggressive therapy and more accurate rheumatologists’ survey for decreasing the number of remote results of this disease. 2. Patients’ education level indicated that the influence of social factors on the health state was higher (p<0,05) in patients with a finished higher education comparing with ones with an incomplete one, although the anxiety and depression level and life quality didn’t differ in both groups, and the psychological state of adult patients with JIA invalidism was the same as in patients without invalidism that testifies to the good social adjustment of JIA patients in the adult age. 3. Clinical differences between groups of patients, divided by immunological parameters (ACCP/RF, HLA-B27, ANA), prove a hypothesis that their pathogenetic mechanisms of JIA development are different and need a differentiated approach to the diagnostics, treatment and observationОбстежено 68 хворих з ЮІА віком старше 18 років, яких розділено на групи за статтю, інвалідністю, рівнем освіти, наявністю ACCP/RF, ANA, HLA-B27 та негативні за всіма показниками не залежно від ILAR класифікації. Значні відмінності між ними, підтверджують гіпотезу різних патогенетичних механізмів розвитку, що потребує диференційованого підходу до діагностики, лікування та спостереженн

CARDIOVASCULAR DISEASES AND OBSTRUCTIVE SLEEP APNEA SYNDROME. REVIEW

Background.  Cardiovascular disease (CVD) is one of the main causes of morbidity and mortality among adults worldwide. On another hand, obstructive sleep apnea syndrome (OSAS) is common in patients with CVD, and can worsen the patients prognosis due to late diagnosis.  Aim: to analyze and summarize the published researches about interrelation between CVD and OSAS, its influence on CVD, and the effects of continuous airway pressure (CPAP) treatment of OSAS on CVD in order to pay attention to OSAS potential risks, improve the investigation of this syndrome and management. Materials and methods. Review of scientific literature in the international electronic scientometric databases PubMed, Google Scholar by key words for the period 2008-2023. The search was carried out by two independent authors. 150 sources were selected, 48 English–language articles of which met all the search criteria and  were used for analysis. Results. OSAS is one of the widespread sleep disorders that frequently occurs in patients with CVD, impairs quality of life. Its increases cardiovascular and all-cause mortality and cardiovascular morbidity. OSAS is observed in patients with arterial hypertension in 30-83%, coronary heart disease in 38-65%, stroke in 57-65%, heart failure in 12-55%, heart rhythm disorders - in 20-50%. In addition, the relationship between OSAS and diabetes, metabolic syndrome, insulin resistance, depression, and cognitive impairment has been established. OSAS is often not diagnosed or not diagnosed in time. Thus, there are data that 86-95% OSAS, clinically manifestated, were  missed diagnosis, that  worsens the prognosis of such patients. Conclusions. OSAS is a common sleep breathing disorder in patients with CVD that is often diagnosed late. Most studies have shown that OSAS worsens the CVD course and outcomes. Therefore early diagnosis and timely appropriate treatment reduce morbidity and mortality

Multi-purpose transport monitoring of passenger-cargo traffic in Ukraine

Background: The epidemiological and environmental security of states is the most important component forthe functioning of the International Transport Corridors (ITC). The growing capacity of passenger and cargoflows increases the risk of the spread of dangerous infectious diseases in the territories of the countrieson the route of the ITC. Preventing the introduction of dangerous infections by various vehicles and theactivation of local natural foci are the priority in the anti-epidemic provision of the population of Ukraine.Materials and methods: The study of the features of the functioning of border checkpoints (BCPs) for varioustypes of transport in different regions of Ukraine made it possible to create their classification, taking intoaccount the nature of the goods and the intensity of passenger traffic.Results: The functioning of 204 checkpoints in 20 different localities, employing more than 29,000 specialists,was studied. When conducting a retrospective epidemiological analysis of documentation for maritime,aviation, road and rail transport for 2000–2013, non-compliance with sanitary-hygienic and anti-epidemicrequirements to prevent the introduction and spread of dangerous infections and their carriers were revealed.The authors scientifically substantiated recommendations on sanitary-hygienic and anti-epidemicsupport of the BСP. Based on the results of a survey of 112 BCPs (54.9 ± 1.2%), taking into account thedegree of epidemiological danger in the areas of their operation, indicators of the presence of rodents,blood-sucking insects and the nature of the goods transported, five epidemic zones were identified.Conclusions: Inadequate operation of the BCP was expressed in non-compliance with sanitary and anti--epidemic requirements. Control of the personal property of passengers and luggage was less than 30%.The analysis of the functioning of the BCPs made it possible to unify their work and identify priority areasfor improvement

Long-Term Effects of Articular and Extra-Articular Damage in Adult Patients with Juvenile Idiopathic Arthritis and Different Immunogenic Markers

To assess the long-term effects of juvenile idiopathic arthritis in adulthood, unified diagnostic methods for articular and extra-articular lesions should be used which depend on the juvenile idiopathic arthritis variants, the disease activity and treatment. The objective of the research was to compare the clinical manifestations in adult patients with different juvenile idiopathic arthritis-specific immunogenic markers and to evaluate their impact on the long-term articular and extra-articular damage.Materials and methods. We observed 132 young patients with different juvenile idiopathic arthritis variants. According to genetic/immunological markers the following groups were formed:  Group I - 38 positive human leukocyte antigen B27 patients; Group II - 13 positive antinuclear antibody patients; Group III - 26 positive rheumatoid factor/anti-cyclic citrullinated peptide patients and Group IV - 55 patients with all negative markers. Long-term effects of juvenile idiopathic arthritis were estimated by the articular juvenile arthritis damage index (JADI-A) and the extra-articular juvenile arthritis damage index (JADI-E). Descriptive statistics, the Student’s T-test, the Fisher’s exact test and Mann-Whitney U-test were performed.Results. 70 women and 62 men with the disease duration of 13.6±9.3 years at the age of 24.3±8.3 years were included into the study: 12 (9.1%) patients with positive rheumatoid factor polyarthritis, 30 (22.7%) patients - with negative rheumatoid factor polyarthritis, 32 (24.2%) patients with persistent oligoarthritis, 19 (14.4%) patients with extendent oligoarthritis, 20 (15.2%) patients with entesitis-related arthritis and 19 (14.4%) patients with systemic arthritis; there were no patients with psoriatic arthritis. There were no differences between groups in age, disease-modifying antirheumatic drug cumulative dose, mean dose of prednisolone and quality of life according to the SF-36. In Group I, the delay in the diagnosis was more than one year (18.6±24.2 months). In this group, less painful (p<0.005) and deformed (p<0.01) joints as compared to Group ІІІ, and higher levels of the ESR and C-reactive protein as compared to Group ІV were found, although the Juvenile Arthritis Disease Activity Score index in childhood was lower (p<0.005) as compared to Group ІІ. They received a lower cumulative dose of the glucocorticoids as compared to Group II (p<0.01), respectively. They had lower (p<0.01) JADI-E as compared to Group II (1.31 ± 1.49) and lower (p <0.01) JADI-A as compared to Group III. In Group III, the diagnosis was made the fastest in comparison with other groups (6.4±8.4 months, p<0.05); more painful joints (p <0.05) and ankylosis (p<0.05) were observed as compared to Group I, JADI-A was significantly higher (p<0.05) in Group III as compared to Group I. The most pronounced JADI-A was found in Group III, while in Group I and Group II, this index was the lowest. JADI-E was the most pronounced in Group II, and the most favorable course was found in Group І and Group ІІІ (p<0.05).Conclusions. Presence of anti-cyclic citrullinated peptide/rheumatoid factor in adults with juvenile idiopathic arthritis has negative impact on joint damage (JADI-A) indicating the need for aggressive therapy in both childhood and adulthood. Presences of antinuclear antibodies are associated with more often extra-articular damages in adulthood as compared to other groups

Overview on reutilization of combustion residues

su CD-RO

The temporally varying roles of rainfall, snowmelt and soil moisture for debris flow initiation in a snow-dominated system

Debris flows represent frequent hazards in mountain regions. Though significant effort has been made to predict such events, the trigger conditions as well as the hydrologic disposition of a watershed at the time of debris flow occurrence are not well understood. Traditional intensity-duration threshold techniques to establish trigger conditions generally do not account for distinct influences of rainfall, snowmelt, and antecedent moisture. To improve our knowledge on the connection between debris flow initiation and the hydrologic system at a regional scale, this study explores the use of a semi-distributed conceptual rainfall-runoff model, linking different system variables such as soil moisture, snowmelt, or runoff with documented debris flow events in the inner Pitztal watershed, Austria. The model was run on a daily basis between 1953 and 2012. Analysing a range of modelled system state and flux variables at days on which debris flows occurred, three distinct dominant trigger mechanisms could be clearly identified. While the results suggest that for 68% (17 out of 25) of the observed debris flow events during the study period high-intensity rainfall was the dominant trigger, snowmelt was identified as the dominant trigger for 24% (6 out of 25) of the observed debris flow events. In addition, 8% (2 out of 25) of the debris flow events could be attributed to the combined effects of low-intensity, long-lasting rainfall and transient storage of this water, causing elevated antecedent soil moisture conditions. The results also suggest a relatively clear temporal separation between the distinct trigger mechanisms, with high-intensity rainfall as a trigger being limited to mid- A nd late summer. The dominant trigger in late spring/early summer is snowmelt. Based on the discrimination between different modelled system states and fluxes and, more specifically, their temporally varying importance relative to each other, this exploratory study demonstrates that already the use of a relatively simple hydrological model can prove useful to gain some more insight into the importance of distinct debris flow trigger mechanisms. This highlights in particular the relevance of snowmelt contributions and the switch between mechanisms during early to mid-summer in snow-dominated systems.Water Resource