Analiza Wpływu Jakości Usług na Poziom Satysfakcji Klienta

В настоящее время все большее значение, особенно в обслуживании, борьбе за качество обслуживания клиента, в связи с чем повышается и качество продукта

High-density lipoprotein cholesterol, triglycerides, and characteristics of coronary atherosclerosis in patients with significant coronary artery disease newly diagnosed by computed tomography coronary angiography

Background: The Current European Society of Cardiology guidelines indicate specific target low-density lipoprotein cholesterol (LDL-C) levels for different cardiovascular risk categories in terms of prevention. However, the target for high-density lipoprotein cholesterol (HDL-C) and triglycerides has not been established.Aim: The study aims to investigate the associations between HDL-C, triglycerides, and coronary plaque characteristics.Methods: This was a prospective single-center study with enrolled consecutive patients with newly diagnosed significant (≥1 stenosis ≥50%) CAD on computed tomography coronary angiography (CTCA). Patients had lipids and CTCA analysis, including high-risk plaque (HRP) features: low-attenuation plaque (LAP), napkin-ring sign (NRS), positive remodeling (PR), and spotty calcium (SC), type of the plaque (calcified, noncalcified, mixed), and their composition (calcified, fibrous, fibro-fatty, necrotic core).Results: The study included 300 patients (191 men, 66 [8] years). Sixty-six percent of them had lipid-lowering therapy. HRP was found in 208 patients. There was no association between LDL-C, plaque composition, and HRP presence. There was a negative correlation between HDL-C, fibro-fatty and necrotic core plaque components (P = 0.0002, P = 0.0009). There was a positive correlation between triglycerides and necrotic core (P = 0.038). There were differences in HDL-C and triglycerides in patients with and without NRS (47 vs. 53 mg/dl, P = 0.0002 and 128 vs. 109 mg/dl, P = 0.02). In logistic regression, HDL-C (odds ratio [OR], 0.95; 95% confidence interval [CI], 0.93–0.98; P <0.001), triglycerides (OR, 1.00; 95% CI, 1.00–1.01; P = 0.02), and male sex (OR, 3.04; 95% CI, 1.41–6.52; P = 0.004) were NRS predictors. In multivariable regression, only HDL-C (OR, 0.96; 95% CI, 0.93–0.99; P = 0.02) was an independent predictor of NRS.Conclusion: Lower HDL-C and higher triglycerides were associated with NRS presence and more necrotic core plaque components in coronary plaques in patients with newly diagnosed CAD

Pharmacological Aspects of Vipera xantina palestinae Venom

In Israel, Vipera xantina palestinae (V.x.p.) is the most common venomous snake, accounting for several hundred cases of envenomation in humans and domestic animals every year, with a mortality rate of 0.5 to 2%. In this review we will briefly address the research developments relevant to our present understanding of the structure and function of V.x.p. venom with emphasis on venom disintegrins. Venom proteomics indicated the presence of four families of pharmacologically active compounds: (i) neurotoxins; (ii) hemorrhagins; (iii) angioneurin growth factors; and (iv) different types of integrin inhibitors. Viperistatin, a α1β1selective KTS disintegrin and VP12, a α2β1 selective C-type lectin were discovered. These snake venom proteins represent promising tools for research and development of novel collagen receptor selective drugs. These discoveries are also relevant for future improvement of antivenom therapy towards V.x.p. envenomation