The correlations of glycated hemoglobin and carbohydrate metabolism parameters with heart rate variability in apparently healthy sedentary young male subjects

Introduction Sedentary lifestyle is a major risk factor for diabetes, cardiovascular and many other age-related diseases. Heart rate variability (HRV) reflects the function of regulatory systems of internal organs and may sensitively indicate early metabolic disturbances. We hypothesize that quantitative and qualitative changes of HRV in young subjects may reflect early metabolic derangements responsible for further development of clinically significant disease. Aim The aim of our study was to determine whether the parameters of carbohydrate metabolism (fasting blood glucose, HBA1c and surrogate insulin sensitivity/resistance indices) correlate with anthropometric data and HRV. Methods The study group consisted of 30 healthy sedentary male subjects aged 20–40, nonsmokers, mainly office and research employees, medical staff and students. Athletes, actively training more than one hour per week, severely obese and men of physical work were excluded from the study. HRV parameters were derived from short term ECG records (five minutes intervals) in supine position and during orthostatic test. Anthropometric data included height, weight, body mass index (BMI), age and body composition (estimation by bioelectric impedance method). The fasting blood glucose, insulin and C-peptide, homeostatic model assessment (HOMA-IR) index and glycated hemoglobin (HbA1c) were evaluated. Linear correlation coefficient (r) was calculated using Statistica 10.0 software. Results and discussion HOMA-IR index correlated positively with body weight, visceral fat and BMI (p=0.047, 0.027 and 0.017 respectively). In supine position pNN50 positively correlated with glucose/insulin ratio (p=0.011) and heart rate with HOMA-IR (p=0.006). In orthostatic test negative correlations of HBA1c with standard deviation, total and low frequency power were determined (p=0.034, 0.400 and 0.403 respectively), which indicates a gradual worsening of functional capacity of cardiovascular system with low-grade increase (under the conventional threshold) of HBA1c. Conclusions In apparently healthy sedentary subjects HRV reduction correlates with the age advancement, subclinical deteriorations of carbohydrate metabolism and excessive fat accumulation

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049

Benfotiamine and Long-Chain Omega-3 and Omega-6 Polyunsaturated Fatty Acids in Treatment of Cardiac Autonomic Neuropathy in Patients with Type 2 Diabetes Mellitus

Introduction. The cardiovascular form of diabetic autonomic neuropathy (DANP) in patients with type 2 diabetes mellitus (DM), is characterized by the damage of the nerve fibers of the parasympathetic and sympathetic parts of the autonomic nervous system, and is considered to be one of the main causes of cardiac arrhythmias, an independent risk factor of cardiovascular mortality. Therefore, the problem of prevention and treatment of DANP is especially relevant. The pathogenetic treatment of DANP includes rational nutrition and physical activity, optimization of glycemic control, treatment of dyslipoproteinemia (DLP), correction of metabolic disorders of the myocardium, prevention and treatment of thrombosis, use of aldose reductase inhibitors, γ-linolenic acid, acetyl-L-carnitine, antioxidants, in particular α-lipoic acid (α-LA), long-chain ω-3 and ω-6 polyunsaturated higher fatty acids, vasodilators, fat-soluble vitamin B1, aminoguanidine, substitution treatment with myoinozitol, growth factors, etc. Aim. To evaluate the efficacy of treatment with benfotiamine, long-chain ω-3 and ω-6 polyunsaturated higher fatty acids of the cardiovascular form of diabetic autonomic neuropathy in patients with type II DM. Materials and methods. Тhe study involved 59 patients with type 2 diabetes mellitus (DM) and cardiovascular autonomic neuropathy (CAN), aged 50–59 years, with a disease duration of 1–6 years and HbA1c index (7.1 ± 0.6 %). Patients with type 2 DM and CAN were allocated to four treatment groups: patients of the 1st group received traditional hypoglycemic therapy (n=15); to patients from the 2nd group (n = 21), in addition to the standard treatment, was prescribed 1 capsule of “Omacor®” daily; to the 3rd group of patients (n = 12) – benfotiamine 300.0 mg per day; to the 4th group (n = 11) – “Omacor®” (1 capsule/day) in combination with benfotiamine 300.0 mg per day. Results. It has been established, that combined prescription of “Omacor ®” and benfotiamine is accompanied by more significant positive changes in HDL, triglycerides and leptin levels comparing to control group and group treated with benfotiamine, but no statistically significant changes compared to the therapy with “Omacor®” have been obtained. Application of this combination was accompanied by more significant positive changes in IRI, hsCRP and TNF-α levels compared to other groups. Conclusions. The efficacy of combined therapy with “Omacor®” and benfotiamine is not determined by the improved compensation of type 2 DM, but is the result of direct effect of pharmacological agents on the investigated metabolic parameters

Estimation of diagnostics of fibers failure in composite materials by the method of acoustic emission

The model of acoustic emission caused by formation of penny-shaped cracks in fiber composite materials taking into account stress relaxation in breaking fibers is proposed. It is found that the maximal values of components of displacement vector are directly proportional to the total area of defect, which is formed, and inverse proportional to the relaxation time

Calculation and optimization of waveguide geometry for acoustic emission signals

Optimization of geometrical sizes of the waveguide of elastic acoustic emission (AE) waves, which is used in the search of hydrogen induced cracking during thermal cycling of structure alloys in a gaseous hydrogen environment, is considered. A waveguide is considered as on acoustic system that has the discrete spectrum of eigenfrequencies. Distribution of temperature field along the waveguide is calculated, decay of elastic AE waves is estimated. Basing on the obtained results the design implementation of the waveguide is carried out

Portable multi-channel device for acoustic emission monitoring of structures and products

In the paper eight channel acoustic emission (AE) device for selection, recording and processing signals of AE intended for use in the sphere of non-destructive testing of materials, products and structures of various forms and functional applications is described. The device is designed using a wide range of SMD elements and is adapted to work with Windows family operating systems. Specially developed software realizes functions of input data processing and its visualization, determination of defect position and storing the obtained results into computer memory. The above-listed characteristics as well as high rate of data exchange between the device and PC (12 Mbit/s), enables to work in real-time mode, and efficient software allow to compete with developments of such world leading manufacturers as PAC, Vallen Systeme, Interunis etc

Oзонотерапія генералізованого пародонтиту у пацієнтів з ускладненнями виразкової хвороби дванадцятипалої кишки

The study involved 71 patient with generalized periodontitis, who were divided into 3 groups: I – patients with DPUD, complicated by bleeding; II – patients with DPUD, complicated by perforation and III – control group – patients without DPUD. Dental examination of patients of groups I and II was carried out in 3 stages: 1st – on a bed in the department of anesthesiology and intensive care, 2nd – in the department of maxillofacial surgery, 3rd – in the university clinic. Patients of group III were only examined in the university clinic before the treatment of generalized periodontitis. Clinical evaluation of periodontal tissues was performed to determine the intensity of the inflammatory process by using Schiller-Pisariev probe. The study had revealed an expressed gingivitis in patients with complicated DPUD, especially by ulcer bleeding, which was the result of poor oral hygiene in acute period of the complication. Early use of ozonated water improves the condition of periodontal tissues.Обследовано 71 больного генерализованным пародонтитом, которых разделено на три группы: I – больные с язвенной болезнью двенадцатипёрстной кишки (ЯБДПК), осложненной кровотечением, II – пациенты с ЯБДПК, осложненной перфорацией язвы и III – контрольную – пациенты, которые не страдали ЯБДПК. Стоматологический осмотр пациентов I и II групп осуществляли в три этапа: первый - на кровати больного в отделении анестезиологии и интенсивной терапии, второй – в отделении челюстно-лицевой хирургии, третий – в университетской клинике. Пациентов ІІІ группы осматривали только в университетской клинике перед началом лечения генерализованного пародонтита. Клиническая оценка состояния тканей пародонта заключалась в определении интенсивности воспалительного процесса с помощью пробы Шиллера-Писарева. Исследование выявило выраженное воспаление десен у больных с осложнениями ЯБДПК, особенно кровотечением из язвы, которое стало следствием неудовлетворительной гигиены полости рта в остром периоде осложнения. Раннее применение озонированнойводы способствует улучшению состояния тканей пародонта.Обстежено 71 хворого на генералізований пародонтит, яких розподілено на три групи: І – хворі на виразкову хворобу дванадцятипалої кишки (ВХДПК), ускладнену кровотечею, ІІ – пацієнти із ВХДПК, ускладнену перфорацією виразки і ІІІ – контрольну – пацієнти, які не страждали ВХДПК. Стоматологічний огляд пацієнтів І та ІІ груп здійснювали в три етапи: перший – на ліжку хворого у відділенні анестезіології та інтенсивної терапії, другий – у відділенні щелепно-лицевої хірургії, третій – в університетській клініці. Пацієнтів третьої групи оглядали тільки в університетській клініці перед початком лікування генералізованого пародонтиту. Клінічна оцінка стану тканин пародонта полягала у визначенні інтенсивності запального процесу за допомогою проби Шиллера-Писарєва. Дослідження виявило виражене запалення ясен у пацієнтів з ускладненнями ВХДПК, особливо кровотечею з виразки, яке стало наслідком незадовільної гігієни порожнини рота в гострому періоді ускладнення. Раннє застосування озонованої води сприяє покращанню стану тканин пародонта