Rigid indicators of knee meniscus strength on data of shear-wave elasticity imaging depending on the stage of prim ary osteoarthritis

Остеоартрит залишається одним із найбільш розповсюджених та інвалідізуючих захворювань сьогодення. Відомо, що колінні суглоби відносяться до місць із найбільшим ризиком розвитку остеоартриту серед інших суглобів організму людини. У той же час, відомо, що у розвитку та прогресуванню остеоартриту приймають участь як внутрішньосуглобові, так і позасуглобові структури, серед яких найбільшу увагу заслуговують меніски. Серед різноманітних методів дослідження на сьогодні тільки еластометрія дозволяє визначити стан менісків без зовнішніх ознак їх ураження. Метою нашого дослідження було визначення відмінностей показників пружності менісків у пацієнтів в залежності від стадії остеоартриту. Було виявлено, що у пацієнтів із ОА навіть І ст. присутня суттєва різниця по пружності менісків із пацієнтами контрольної групи, при чому відмічається статистично достовірна відмінність перш за все по пружності медіальних менісків. Показник щільності менісків збільшується із підвищенням ступеню артрозних змін та пов'язаний із ступенем дегенеративних змін менісків у суглобі. Еластометрія є високочутливим методом діагностики дегенеративних змін менісків колінних суглобів і може бути використаною для виявлення ранніх, доклінічних стадій патологічних змін менісків; Osteoarthritis is one of the most common and debilitating diseases of our time. Osteoarthritis of the knee is a complex peripheral joint disorder with multiple risk factors. The molecular basis of osteoarthritis has been generally accepted; however, the exact pathogenesis is still not known. Management of patients with osteoarthritis involves a comprehensive history, thorough physical examination and appropriate radiological investigation. Knee joints are known to be at the highest risk for developing osteoarthritis among other joints in the human body. At the same time, it is known that in the development and progression of osteoarthritis participate both intra-articular and extra-articular structures, among which meniscuses deserve the most attention. Among the various methods of investigation today, only elastometry can determine the status of meniscuses, provided there are no external signs of their lesion. The purpose of our study was to determine the differences in meniscus elasticity in patients depending on the stage of osteoarthritis by shear-wave elasticity imaging. It was found that in patients with minimal changes in the joints there is a significant difference in the shear-wave elasticity imaging of the meniscus with the patients of the control group, with a statistically significant difference noted primarily in the elasticity of the medial meniscus. The index of meniscus density increases with the degree of arthrosis changes in the joint and is associated with the degree of degenerative changes of the meniscus in the joint. Ultrasound elastometry has been used as a method of evaluating the stiffness of soft tissues, particularly abdominal tissues in which neoplastic or global organ diseases alter composition and increased stiffness. Elastometry may be an ideal tool to assess loss of stiffness in tissues such as diseased or damaged cartilage and damaged knee meniscus. The shear-wave elasticity imaging is a highly sensitive method of diagnosing degenerative changes in the meniscus of the knee joints and can be used to detect early, preclinical stages of pathological changes in the menisci

Determine the effectiveness of lipid-lowering therapy in patients with chronic obstructive pulmonary disease combined with coronary heart disease

Introduction: In complex treatment of chronic obstructive pulmonary disease (COPD) combined with ischemic heart disease (IHD) more and more attention is drawn to pleiotropic effect of statins. The aim of our researches became determining the effectivity of utilization of rosuvastatin (Crestor®, IPR Pharmaceuticals, Inc.) in complex treatment of COPD combined with IHD. Materials and methods: Basing on pulmonology department of Poltava regional clinical hospital, 30 patients with COPD combined with IHD have been examined (stable effort angina FC II) aged from 51 to 67 y.o. (average age was 57,03±3,51). The patients were divided into two age compatible groups. Patients of the main group (n=15) underwent regular COPD and IHD treatment, addind 20 mg of rosuvastatin per night. The observed group (n=15) didn't receive rosuvastatin. The examination of patients was held before and half year of treatment, included the estimation of respiratory symptoms of the disease, the degree of intensity of dyspnea (Medical Research Council Dyspnea Scale). The tolerance to physical exercise was studied with 6 minute walking test. The cholesterine level, HDL, LDL, function of ventilation have been tested as well. The average frequency of aggravations during the year was estimated through retrospective examination of anamnesis. Results: After the treatment the improvement of clinical state has been noticed at both groups due to decrease of intensity of respiratory symptoms of the disease, such as cough, amount of expectoration, dyspnea and also increase of tolerance to physical exercise and improvement of laboratory-instrumental indexes. Though the patients of the main group were noticed to have significantly less amount of expectoration and cough. The distance covered in 6 minutes was positively longer (р<0,05). It has to be noted that the patients of the main group had positive decrease of wheezing after treatment, due to increase of FEV1, GI (р<0,01). The retrospective studying of the anamnesis revealed that the frequency of arrogations during the year was 1-2 times a year (1,6±0,48). Conclusions: Including rosuvastatin into the treatment scheme allows to decrease and stabilize the main clinical symptoms of this constellation of diseases, improving the quality of life, reduce the frequency of exacerbations

Modernization of therapy in patients with chronic obstructive pulmonary disease and ischemic heart disease

During the combination treatment of chronic obstructive pulmonary disease in association with ischemic heart disease, the increasing attention is paid to pleiotropic effects of statins. Inclusion of rosuvastatin in the treatment regimen allows reducing and stabilizing the main clinical manifestations of this disease constellation, improving the quality of life

Improved functionalization of oleic acid-coated iron oxide nanoparticles for biomedical applications

Superparamagnetic iron oxide nanoparticles can providemultiple benefits for biomedical applications in aqueous environments such asmagnetic separation or magnetic resonance imaging. To increase the colloidal stability and allow subsequent reactions, the introduction of hydrophilic functional groups onto the particles’ surface is essential. During this process, the original coating is exchanged by preferably covalently bonded ligands such as trialkoxysilanes. The duration of the silane exchange reaction, which commonly takes more than 24 h, is an important drawback for this approach. In this paper, we present a novel method, which introduces ultrasonication as an energy source to dramatically accelerate this process, resulting in high-quality waterdispersible nanoparticles around 10 nmin size. To prove the generic character, different functional groups were introduced on the surface including polyethylene glycol chains, carboxylic acid, amine, and thiol groups. Their colloidal stability in various aqueous buffer solutions as well as human plasma and serum was investigated to allow implementation in biomedical and sensing applications.status: publishe

Effect of sitagliptin on cardiovascular outcomes in type 2 diabetes

BACKGROUND: Data are lacking on the long-term effect on cardiovascular events of adding sitagliptin, a dipeptidyl peptidase 4 inhibitor, to usual care in patients with type 2 diabetes and cardiovascular disease. METHODS: In this randomized, double-blind study, we assigned 14,671 patients to add either sitagliptin or placebo to their existing therapy. Open-label use of antihyperglycemic therapy was encouraged as required, aimed at reaching individually appropriate glycemic targets in all patients. To determine whether sitagliptin was noninferior to placebo, we used a relative risk of 1.3 as the marginal upper boundary. The primary cardiovascular outcome was a composite of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for unstable angina. RESULTS: During a median follow-up of 3.0 years, there was a small difference in glycated hemoglobin levels (least-squares mean difference for sitagliptin vs. placebo, -0.29 percentage points; 95% confidence interval [CI], -0.32 to -0.27). Overall, the primary outcome occurred in 839 patients in the sitagliptin group (11.4%; 4.06 per 100 person-years) and 851 patients in the placebo group (11.6%; 4.17 per 100 person-years). Sitagliptin was noninferior to placebo for the primary composite cardiovascular outcome (hazard ratio, 0.98; 95% CI, 0.88 to 1.09; P<0.001). Rates of hospitalization for heart failure did not differ between the two groups (hazard ratio, 1.00; 95% CI, 0.83 to 1.20; P = 0.98). There were no significant between-group differences in rates of acute pancreatitis (P = 0.07) or pancreatic cancer (P = 0.32). CONCLUSIONS: Among patients with type 2 diabetes and established cardiovascular disease, adding sitagliptin to usual care did not appear to increase the risk of major adverse cardiovascular events, hospitalization for heart failure, or other adverse events

APPLICATION OF INNOVATIVE TECHNOLOGIES ON THE CREATION OF QUALIFICATION OF DOCTORS

New, particulary, interactive learning technologies are coming for the support of classical technological aspects. The term interactivity has came to us from the English language from the word interact where inter is a reciprocal, act - to act. Therefore, interactivity is the ability to have the interactive dialogue All participants in the interactive learning process can interact with each other, share of information, collectively solve the problems, simulate different situations, evaluate the actions of their colleagues and their own behavior, and immerse themselves in the real atmosphere of business cooperation to solve a series of problems in accordance with their interests, needs and requests. In this case, there are constant changes in the types of educational activities. The objective of the work was to study the feasibility of introducing of innovative technologies and interactive methods of teaching cadets in the cycle of thematic improvement in the specialty General Practice - Family Medicine . The research was conducted on the basis of the Department of Family Medicine and Therapy of the Ukrainian Medical Stomatological Academy. At the time of the conducting classes for cadets-doctors in the specialty General Practice - Family Medicine , for the cycle of thematic improvement, innovative technologies and interactive teaching methods were used, in particular, brainstorming, discussion, case study, presentation, role-playing game. The positive effect of using interactive methods for teaching people has been long since proven and there was not doubt. The following innovative technologies and interactive teaching methods were introduced by the teachers of the Family Medicine and Therapy Department during the classes of family doctors: brainstorming, discussion, case study, presentation, role play. Thus, the motivation of doctors to continuous self-improvement, active participation in the educational process; the comprehensive complex theoretical and practical training, laying the foundations for clinical thinking and ensuring the acquisition of general clinical competencies. To achieve maximum material absorption, to make the class interesting and dynamic, easy to master the material, it is necessary to use various interactive teaching methods discussed above: brainstorming, work in mini-groups, discussion, case-method, role-playing game, presentation. Modeling the pedagogical process of the proposed study in accordance with the concept of a systematic approach guarantees the development of family doctors of research competence