Clinical and prognostic value of determining the level of neopterin in patients with chronic heart failure with preserved ejection fraction

Objective: to analyze the level of neopterin in patients with chronic heart failure (CHF) with a preserved fraction ejection fraction depending on the stage of the disease. Materials and methods: were examined 148 patients with CHF with preserved ejection fraction (50% and >) and 30 as a control group. Patients with CHF were divided into groups depending on the stage of CHF (from I to III). The level of neopterine was determined by the method of enzyme immunoassay in blood plasma. Results: in patients with CHF with preserved ejection fraction there was a tendency to increase the level of neopterin from stage I to stage III compared to the control group. In the group of patients with CHF IIB+III the level of neoplasm was statistically slightly lower compared to patients of stage I and IIA, but statistically signifi cantly higher than in the control group. Conclusion: it was revealed the change in the level of neopterin in patients with CHS with retained ejection fraction depending on the stage of the disease

Methodological Basis of KPI Motivation

A well-built system of motivation can become a source of long-term competitiveness of the enterprise development. The article presents an overview of the main stages of the KPI motivation development and its deployment process. The purpose of this research paper is to reveal the fundamental aspects of building a motivation system based on KPI. The general theoretical basis of this study is the concept of methodology "Management by Objectives", method of "Performance management". It is proposed to integrate the KPI's system into the enterprise management system. It has been proven that the KPI system is a tool for specifying and bringing business strategy to each department and employee through the mechanism of motivating each employee to achieve this goal. The article identifies the place of the KPI system in the structure of business processes. A typology of KPI system options is based on the resources required to develop and implement such system. It has been proven that the system of motivation based on the KPI is a tool for achieving long-term and short-term company goals and is not just a monetary and non-monetary incentive system

Clinical and diagnostic significance of apoptosis markers in myocardial infarction in the setting of chronic obstructive pulmonary disease

Objective: To study the levels of heat shock protein 70 (HSP70) and annexin V-dependent apoptosis of cells in myocardial infarction (MI) with a different course of the disease and in the setting of chronic obstructive pulmonary disease (COPD).Materials and Methods: Sixty-five patients with MI were examined; 37 of them developed MI in the setting of COPD, and 28 patient had MI without COPD. The subjects were divided into subgroups depending on the presence of ST segment elevation. The control group included 30 somatically healthy individuals.Results: In all examined patients with MI and in patients with MI with COPD, the number of annexin V-associated apoptotic cells and the level of HSP70 was statistically significantly higher than in healthy individuals. The value of the studied biomarkers was statistically significantly higher than in patients without COPD. In patients with MI with ST segment elevation, the values of the studied biomarkers were statistically significantly higher in patients without ST segment elevation in all the examined patients.Conclusions: Higher values of the studied biomarkers in the group of comorbid patients compared with those with MI without COPD may be associated with intensified apoptosis in the setting of chronic systemic inflammation, which worsens the clinical course of both diseases. The greater significance of the levels of HSP70 and annexin V-dependent cell apoptosis in patients with MI with ST segment elevation compared with patients without ST segment elevation is due to the volume of myocardial lesion

Methodological Basis of KPI Motivation

A well-built system of motivation can become a source of long-term competitiveness of the enterprise development. The article presents an overview of the main stages of the KPI motivation development and its deployment process. The purpose of this research paper is to reveal the fundamental aspects of building a motivation system based on KPI. The general theoretical basis of this study is the concept of methodology "Management by Objectives", method of "Performance management". It is proposed to integrate the KPI's system into the enterprise management system. It has been proven that the KPI system is a tool for specifying and bringing business strategy to each department and employee through the mechanism of motivating each employee to achieve this goal. The article identifies the place of the KPI system in the structure of business processes. A typology of KPI system options is based on the resources required to develop and implement such system. It has been proven that the system of motivation based on the KPI is a tool for achieving long-term and short-term company goals and is not just a monetary and non-monetary incentive system

Dynamics of Stroke Incidence and Mortality Indicators over Eight-Year Period in the Territories Included into the Federal Program of Reorganization of Care for Patients with Stroke

Background. Stroke is a severe medical, social and economic burden for all countries of the world. The leading indicators characterizing the “epidemiological picture” of stroke are the incidence and mortality rates from stroke.Aims. Analyze the dynamics of stroke incidence and mortality rates in the regions of Russia that were included in the federal program for reorganizing care for patients with stroke for the period from 2009 to 2016.Material and methods. The study was based on the data of the territorial-population register for seven study areas in the regions of Russia that were included in the federal program for reorganizing care for patients with stroke (Republic of Bashkortostan, Sverdlovsk region, Republic of Tatarstan, Sakhalin region, Stavropol Territory, Ivanovo Region and Irkutsk Region). The age of the examined persons was 25 years and older.Results. In the period from 2009 to 2016, in the studied territories, there was a consistent stable decrease in the value of the stroke incidence rate. Stroke mortality rates fluctuated with a single increase in 2012. When comparing the average incidence of stroke and mortality from it between 2009 and 2016, we discovered a statistically significant decrease in the incidence of stroke – by 1.4 times and in the rate of mortality from stroke – by 2.3 times. According to the results of the cluster analysis, we revealed a significant conformity (similarity) of mortality rates between regions by 2016 and the absence of monotony (stability) of the rate of stroke incidence.Conclusion. In all the regions under study, an almost systematic annual decrease in the incidence and mortality rates from stroke among the adult population was revealed in seven studied territories. The results of cluster analysis of the “picture” of stroke incidence and mortality from it also demonstrate a positive trend by 2016 in all studied territories. Only one of the studied territories – the Republic of Tatarstan – despite the presence of a positive dynamics of stroke incidence over an eight-year period, in 2016 belonged to the rank with a high integral incidence rate

Мнение отоларинголога

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Proinflammatory cytokines in patients with acute myocardial infarction against the background of chronic obstructive pulmonary disease

Objective: To study and analyze serum levels of interleukins (IL): IL-1β, IL-2 and IL-6 in patients with myocardial infarction and chronic obstructive pulmonary disease.Materials and methods: In 85 people were examined: 28 patients with myocardial infarction, 37 patients with comorbid pathology (myocardial infarction and chronic obstructive pulmonary disease) and 20 somatically healthy volunteers as a control group. Determination of IL-1β, IL-2 and IL-6 levels was basing on enzyme immunoassay.Results: The median and inter-percentile range of IL-1β, IL-2 and IL-6 in the donors did not differ significantly from the data of the manufacturer. In the group of patients with myocardial infarction and in patients with comorbid pathology a statistically significant increase in the level of median and inter-percentile range of cytokines was revealing compared with the control group. The highest levels of IL-1β, IL-2 and IL-6 were detecting in the group of patients with comorbid pathology. IL-6 was found to be an independent marker of increased risk of STEMI and an increase in its concentration later than 12 hours after hospitalization is associated with the risk of future cardiovascular death or new myocardial infarction.Conclusion: Analysis of the dynamics of the level of IL-1β, IL-2 and IL-6 has a high prognostic value in patients with myocardial infarction and in patients with comorbid pathology

Retinal neurovascular coupling in patients with glaucoma and ocular hypertension and its association with the level of glaucomatous damage

Purpose: To analyze neurovascular coupling in the retina of untreated primary open-angle glaucoma (POAG) and ocular hypertension (OHT) patients. Patients and methods: Maximal vessel dilation in response to flicker light was analyzed with Retinal Vessel Analyzer (RVA) in temporal superior/inferior arterioles and veins in 51 POAG patients, 46 OHT and 59 control subjects. RVA parameters were compared between groups, between contralateral POAG eyes, and correlated to intraocular pressure, visual field mean defect and retinal nerve fiber layer thickness. Results: POAG eyes demonstrated generally smaller response of all vessels to flicker light than the other two groups (ANOVA p = 0.026; mean arterial flicker response in percent of baseline, averaged superior and inferior was 3.48 ± 2.22% for controls , 2.35 ± 2.06 % for POAG patients , and 2.97 ± 2.35 % for OHT patients; corresponding values for venules were 3.88 ± 1.98%, 2.89 ± 1.72%, 3.45 ± 2.77%). There was no difference in flicker response between the eye with more and less advanced damage in each patient of the POAG group (ANOVA p = 0.79). Correlation of flicker response to intraocular pressure (IOP) was borderline at best, correlations to the level of glaucomatous damage were not significant. Correlation of flicker response of superior and inferior vessels of the same eye was significant for the arteries (Pearson r = 0.23, p = 0.004), as well as venules (r = 0.52, p < 0.001). Conclusion: General vessel response to flicker light was decreased in POAG patients, compared to normal controls and OHT patients. In contrast to significant correlation between the two contralateral eyes of the flicker response itself, only its borderline correlation to IOP was seen. There was no correlation to the level of damage, altogether indicating a systemic dysregulation phenomenon. Grants: Swiss National Foundation Grant 3200B0-113685, Velux Stiftung Grant, Freie Akademische Gesellschaft (FAG) Grant, Pfizer Inc. Grant Clinical trial registration reference number: ClinicalTrials.gov NCT0043020

Dynamics of retinal vessel response to flicker light in glaucoma patients and ocular hypertensives

Purpose: To analyze dynamics of retinal vessel dilation response to flicker light in patients with glaucoma and ocular hypertension. Patients and methods: Response to flicker light was measured in retinal vessels by means of Retinal Vessel Analyzer. After the baseline 50seconds long diameter recording of inferior and superior temporal artery and vein, three flicker stimulations of 20seconds duration was applied, with a 80seconds break in between. Area under the curve of the vessel diameter (AUC) was compared during 3 flicker periods in the open angle glaucoma patients group (POAG, n = 47) and ocular hypertensives (OHT, n = 46) and age-matched healthy controls (n = 56) Results: POAG eyes demonstrated smaller response of all vessels to flicker light in general than the other two groups (p = 0.0008), but the response dynamics was significantly different between the groups (p = 0.038), showing in three flicker periods a delayed increasing response in the POAG and OHT groups, and remaining stable in healthy subjects. Conclusion: General vessel response to flicker light was decreased in POAG patients despite the slow improvement in repeated flicker stimulation, indicating an altered response patter