Left ventricular remodeling and diastolic function in patients with arterial hypertension and rheumatoid arthritis

Pathologic left ventricular (LV) remodeling was registered in 96. 4 % of patients with arterial hypertension (AH) and rheumatoid arthritis (RA). For AH patients, concentric LV hypertrophy (LVH) was quite typical (85 %); RA patients demonstrated similar prevalence of all LVH types: eccentric LVH (22.3 % > ), concentric LVH (27.2 % > ), concentric remodeling (36.9 %). Ln individuals with RA and AH, LV remodeling structure was similar to that in RA-free hypertensive patients. For early RA debut, eccentric LVH was more typical; development of concentric LVH depended mostly on AH characteristics. Ln combination ofRA and AH, LV systolic dysfunction was relatively rare; at the same time, silent diastolic dysfunction (DD) was registered in 70 % > of cases. Silent DD, detected during stress echocardiography, was observed in 24 % > of patients with AH and RA; Type 1 DD - in 46 % >

RSTRUCTURAL AND FUNCTIONAL FEATURES OF THE HEART IN PATIENTS WITH OBSTRUCTIVE SLEEP APNOEA SYNDROME DEPENDING ON ITS SEVERITY AND THE MAGNITUDE OF METABOLIC SYNDROME

Objective: to assess the nature and degree of the impact of metabolic syndrome (MS) and obstructive sleep apnoea syndrome (OSAS) severity on myocardial structural and functional changes.Subjects and methods. The study covered 80 patients of both sexes, whose mean age was 49.62 ± 9.87 years. The patients were divided into 3 groups according to the severity of OSAS. All the patients underwent general clinical examination with anthropometric measurements, as well as cardiorespiratory monitoring and biochemical studies.Results. The mean body mass index in the examinees was 34.52 ± 4.91 kg/m2. In severe apnoea, there was a significant increase in abdominal adipose tissue redistribution (p = 0.005), an elevation in systolic and diastolic blood pressures and uric acid levels, progression of impaired lipid profile and insulin resistance (p &lt; 0.05). More significant hypertrophy of the left ventricle and its reduced systolic function were recorded in severe OSAS (р &lt; 0.05). The frequency of type 1 diastolic dysfunction was lower in the mild apnoea group (30% of the patients) than that in the severe apnoea group (67 %) (p = 0.01).Conclusion. The found myocardial structural and functional changes are due to the degree of OSAS and to the impact of MS components. Due to inadequately effective antihypertensive and hypolipidemic therapy performed in patients with MS, it is necessary to diagnose OSAS and to define the degree of its severity for its correction.</p

RELATIONSHIP OF THE MARKERS OF ENDOTHELIAL DYSFUNCTION AND FIBROSIS IN CHRONIC HEPATITIS AND CIRRHOSIS

The aim – assessing the relationship of markers of endothelial dysfunction and fibrosis (AF) in patients with chronic viral hepatitis and liver cirrhosis (LC).Materials and methods. We examined 40 patients with chronic hepatitis C in the phase of reactivation. The second group included 15 patients with viral CP in stage of decompensation. Using the method of ELISA tests was studied evaluating the functional state of endothelium in the blood serum with a level of total nitrogen oxide (OA), endothelin-1 (ET-1), vascular-endothelial growth factor (VEFR). Evaluated the functional activity of Willebrand factor (WF), calculated the number of desquamated endothelial cells (DETS) in blood plasma, determined the level of hyaluronic acid (HA) in serum. Established diagnostic sensitivity (Qh), specificity (DS) and efficiency (DE) of laboratory parameters.Results. In chronic hepatitis (CH) found an inverse significant relationship of HA and OA, and direct relationship with Civil ET-1, VEFR, WF, indicating the association of fibrosis with the severity of the damage of the endothelium. Patients with CKD also had a direct correlation between HA and ET-1,VEFR, PV. Ratio of aspartate and alanine aminotransferase (AST/ALT) with hCG was associated with OA, ET-1, VEFR, DETS. In patients with CKD significant coefficient de Rytis nteractions with OA, ET-1, VEFR are found. At the point of separating the concentration of SC &gt; 120.0 ng / ml for the diagnosis of CKD has Qh 92 %, FS –76 %, DE – 82 %. In evaluating the operating characteristics of the indicators of endothelial dysfunction capacity of tests to stratify CG and CP were installed, the sensitivity was 73–92 %, specificity – 50–96 %, and efficiency – 69–86 %.Conclusion. CG and CP demonstrated the relationship of indicators of endothelial dysfunction with markers OP – HA, AST/ALT. The results suggest that indicators of endothelial damage may serve as indirect markers of AF.</p

Arterial hypertension: interrelation between heart, arterial and venous structure and function, their prognostic role in antihypertensive treatment optimization

Aim. To investigate principal interrelations between heart, arterial and venous parameters, characterizing the common process of cardiovascular system (CVS) remodeling during arterial hypertension (AH) development and progression.Material and methods. The study included 184 patients with primary AH. CVS structure and function were assessed at baseline and after treatment with antihypertensive medications (AHM).Results. The module approach to AH structural and hemodynamic type description is proposed. Modern AHM are studied in regard to their venotropic action, effects on orthostatic tolerance and interrelations between structural and functional parameters of CVS components in AH patients. Mathematical algorithms assessing modern AHM potential for individual patients, taking into account baseline clinical, functional, structural and hemodynamic parameters, are presented.Conclusion. Antihypertensive therapy could be optimized by taking into consideration modern AHM effects on individual CVS components and their interrelations in AH patients

COMPARATIVE EFFICIENCY OF THE COMBINED THERAPY IN PATIENT’S WITH ARTERIAL HYPERTENSION

Objective — to assess influence of the combined therapy on a functional condition endothelium, the central haemodynamics and geometry of heart in patients with hypertensive disease.Subjects and methods. The volume of supervision has made 40 patients with arterial hypertension grade II hypertension, moderate — highrisk. Patients of the first group received the combined therapy lisinopril — 20 mg and hydrochlortiazid — 12.5 mg (iruzid — “Belupo”, Croatia), patients of the second group — therapy trandolapril and verapamil (tarka — “Ebbot”, Germany) — 2 and 180 mg accordingly.Results. The combined therapy trandolapril and verapamil renders more expressed antihypertension effect, than lisinopril and hydrochlortiazid.Appointment of the combined therapy promoted normalization morphofunctional heart indicators: in group of tarka ejection fraction(EF) has authentically increased by 4.34 % (р = 0,02), the thickness to a back wall of the left ventricle has decreased for 5.8 % (р = 0,03) in group of iruzid. Also in both groups optimization functional a condition endothelium vessels as on level desquamation endotheliocytes, a function indicator endothelium and on a level of a factor of Willebrand was marked. Authentically more expressed positive influence on endothelium tarka in comparison with iruzid has been noticed.Conclusion. At comparison of combinations fat-soluble ACE inhibitor with verapamil (tarka) and water-soluble ACE inhibitor in a combination with hydrochlortiazid (iruzid) the insignificant superiority of the first combination over the second for level of positive influence on endothelium of vessels has been revealed, more expressed antihypertensive effect and ability authentically to increase EF.</p

CASE OF THE LATE DIAGNOSIS OF POEMS-SYNDROME

POEMS-syndrome (P — polyneuropathy, O — organomegaly, E — endocrinopathy, M — M-protein, S — skin) in 64-year old patient isdescribed in the article. The clinical picture was marked by such symptoms, as polyneuropathy, multiple myeloma, organomegaly (hepatosplenomegaly), endocrinopathy (diabetes), skin changes (redness and induration of the dermis in the neck), fever, hypoproteinemia, edema, weight loss, thrombocytosis. Bone-destructive syndrome was absent. In myelogram 18 % of the cells with signs of some plasmatic anaplasia were found. In blood, low level of paraprotein secretion Aλ, increased β2-microglobulin was fixed. A course of therapy with prednisolone and alkeranom was accompanied by slight positive effect. However, a second course was interrupted in the third day due to worsening of concomitant cardiac disease (ischemic heart disease in combination with hypertension). Last episode of recurrent of pulmonary edema occurred fatal. Autopsy study was not conducted. This observation illustrates the need for more rigorous examination (myelogram, immunochemical study of blood and urine) in the presence of clinical signs of POEMS-syndrome for the timely diagnosis of the underlying disease and its treatment.</p

IMPACT OF ANTIVIRAL THERAPY FOR CHRONIC HEPATITIS C ON CYTOKINE SYNTHESIS AND HEPATIC FIBROSING PROCESSES

Objective: to estimate the time course of changes in the levels of tumor necrosis factor-α (TNF-α), interleukin-4 (IL-4), IL-6, and the hepatic fibrosis indicators hyaluronic acid (HA) and liver elasticity index during combined antiviral therapy (AVT) with interferon alpha-2b and ribavirin in patients with chronic hepatitis C (CHC). Subjects and methods. Fifty patients with CHC were examined. Serum TNF-α, IL-6, IL-4, and HA were estimated using an enzyme immunoassay. The stage of hepatic fibrosis was determined by fibroelastography with the liver elastic index being measured; the time course of changes in the indicators was assessed in 20 patients at the end of AVT. A virological response was monitored at therapy completion and 6 months later. Results. The patients with CHC in the reactivation phase were found to have enhanced TNF-α, IL-6, and IL-4 activities in 84, 60, and 100 % of the cases, respectively (р &lt; 0.001, р = 0.01, р &lt; 0.001, respectively). The median serum concentration of HA in CHC was 1.8-fold higher than that in the control group (p = 0.03); the liver elastic index averaged 6.5 kPa. TNF-α and IL-6 levels correlated with viremia, transaminases, and hepatic fibrosis indicators. At combined AVT completion, the virological response rate was as high as 85 %, which was attended by a considerable reduction in cytolysis, HA concentrations, and liver density index to 5.4 kPa (3.6–6.8 kPa) (p &lt; 0.04), and in the activity of the examined cytokines. The sustained virological response rate was 80 %. Only IL-4 levels decreased and TNF-α and IL-6 concentration remained at the baseline level in patients unresponsive to AVT. Conclusion. It is expedient to monitor TNF-α, IL-4, IL-6, and HA to evaluate the severity of liver involvement in CHC and to predict the efficiency of AVT

Комплекс для вимірювання та реєстрації електромагнітних полів в діапазоні ННЧ - ДНЧ

Measurement of alternating magnetic fields in the low frequency range is used in various fields of research, such as geophysics, radio physics and technical areas related to management issues, EMC and remote monitoring of powered devices - electric motors, generators, power supplies, switches, electrical power networks etc. Therefore, the creation of universal means of measurement of the magnetic field to meet the varied requirements of the customers and simplified methods for calculating the optimal parameters of the measuring complex components is an actual issue for a developer. Scientific novelty of the present work is that the proposed method for calculating broadband induction magnetic field sensors, which allows you to choose the optimal design parameters of the sensor, meeting the requirements of sensitivity and bandwidth while reducing the requirements for noise parameters of the input amplifier. The technique also allows you to calculate the parameters of the amplifier channel, which provide the required dynamic range of the measured signals. The practical value of the work lies in the fact that by creating a three-channel hardware and software system for measuring atmospheric electromagnetic noise in the low frequency range the choice of the design parameters of the magnetic and electric field sensors and the amplification paths is described and justified in order to obtain the required sensitivity and frequency range of the recorded signals. Measuring the parameters of the receiving part of the complex has shown a fairly good agreement with calculations. The software part of the complex, implemented on a personal computer allows to estimate the absolute level, spectral composition, and polarization characteristics of the detected pulse, narrow-band and quasi-monochromatic fields in the real time and store the received data in the round-the-clock mode.Измерения переменных магнитных полей в диапазоне низких частот используются в различных областях научных исследований, таких как геофизика, радиофизика, а также  технических областях, связанных с проблемами управления, электромагнитной совместимости и дистанционного мониторинга работы силовых устройств – электродвигателей, генераторов, источников питания, переключателей, электрических силовых сетей и т.п. Поэтому создание универсальных средств измерения магнитного поля, удовлетворяющим широким требованиям потребителей и упрощенных методик расчета оптимальных параметров компонентов измерительного комплекса представляет актуальную задачу для разработчика. Научная новизна представленной работы состоит в том, что предложена методика расчета широкополосных индукционных датчиков магнитного поля, которая позволяет выбрать оптимальные конструктивные параметры датчика, удовлетворяющие требованиям чувствительности и полосы пропускания при сниженных требованиях к шумовым параметрам входного усилителя. Методика также позволяет рассчитать параметры усилительного тракта, которые обеспечивают необходимый динамический диапазон измеряемых сигналов. Практическая ценность работы состоит в том, что на примере создания трехканального программно-аппаратного комплекса для измерений атмосферных электромагнитных помех в диапазоне низких частот описан и обоснован выбор конструктивных параметров датчиков магнитного и электрического поля и трактов усиления с целью получения требуемой чувствительности и частотного диапазона регистрируемых сигналов. Измерения параметров приемной части комплекса показали достаточно хорошее согласие с расчетом. Программная часть комплекса, реализованная на персональном компьютере, в режиме реального времени позволяет оценивать абсолютный уровень, спектральный состав, а также поляризационные характеристики регистрируемых импульсных, узкополосных и квазимонохроматических полей, и накапливать полученные данные в круглосуточном режиме. Вимірювання змінних магнітних полів в діапазоні низьких частот використовуються в різних галузях наукових досліджень, таких як геофізика, радіофізика, а також технічних областях, пов'язаних з проблемами управління, електромагнітної сумісності та дистанційного моніторингу роботи силових пристроїв - електродвигунів, генераторів, джерел живлення, перемикачів, електричних силових мереж і т.п. Тому створення універсальних засобів вимірювання магнітного поля, що задовольняє широким вимогам споживачів і спрощених методик розрахунку оптимальних параметрів компонентів вимірювального комплексу представляє актуальну задачу для розробника. Наукова новизна представленої роботи полягає в тому, що запропонована методика розрахунку широкосмугових індукційних датчиків магнітного поля, яка дозволяє вибрати оптимальні конструктивні параметри датчика, що задовольняють вимогам чутливості та смуги пропускання при знижених вимогах до шумових параметрів вхідного підсилювача. Методика також дозволяє розрахувати параметри підсилювального тракту, які забезпечують необхідний динамічний діапазон вимірюваних сигналів. Практична цінність роботи полягає в тому, що на прикладі створення трьохканального програмно-апаратного комплексу для вимірювань атмосферних електромагнітних завад в діапазоні низьких частот описаний і обґрунтований вибір конструктивних параметрів датчиків магнітного та електричного поля і трактів підсилення з метою отримання необхідної чутливості і частотного діапазону реєстрованих сигналів. Вимірювання параметрів приймальної частини комплексу показали досить гарну узгодженість з розрахунком. Програмна частина комплексу, реалізована на персональному комп'ютері, в режимі реального часу дозволяє оцінювати абсолютний рівень, спектральний склад, а також поляризаційні характеристики реєстрованих імпульсних, вузькосмугових та квазімонохроматичних полів, і накопичувати отримані дані в цілодобовому режимі

Concentration of ions in the topside ionosphere as measured onboard the DEMETER satellite: Morphology and dependence on solar and geomagnetic activity

International audienceVariations in concentration of ions H+, He+, and O+ are studied at a height of about 700 km using the data of continuous observations onboard the DEMETER satellite at the decline and in the minimum of solar activity from 2004 to 2008. Latitudinal distributions, seasonal behavior, and irregular variations in ion concentrations and their dependence on solar and geomagnetic activity are considered. Within this altitude range, for the first time an analysis is performed of the dataset of many-year continuous observations in both hemispheres from the equatorial to subauroral latitudes. This made it possible to describe the seasonal and irregular variations of the concentrations of main ion species with better time and spatial resolution than in the available empirical models. The dependence of concentrations of three types of ions on solar and geomagnetic activity is studied at time scales from several days to several years, and it is shown that the anti-phase change in concentrations of O+ and light ions known from publications is partly a result of mutual dependence of solar and geomagnetic activity and is observed only at time scales beginning from several months. At time scales from several days to several weeks, variations in the concentration of O+ and light ions are governed mainly by solar and geomagnetic activity, respectively