ScienceRise: Medical Science

Gender differences in the elastic properties of the arterial wall in patients with arterial hypertension during the age-related evolution

2024-06-24T17:29:49+03:00

Age-related changes in the elastic properties of the arterial wall in patients with arterial hypertension increase the risk of CV events. Additional CV risk factors in women lead to gender differences in vascular stiffness.

The aim: to determine changes in the elastic properties of the arterial wall in patients with hypertension depending on gender, with considering of the age-related changes.

Materials and methods: 258 patients with arterial hypertension stage II were examined: 132 women (55.56±7.69 years) and 126 men (51.75±8.42 years). By age, patients were divided into 5 subgroups (37–45, 45–49, 49–54, 54–58 and 58–69 years). The following were assessed: pulse wave velocity in the aorta (PWVao), central systolic blood pressure in the aorta (SBPao), central pulse blood pressure (cPBP), augmentation index in the aorta (Aix ao) and on the brachial artery (Aix br), PWV index (PWVind), amplification blood pressure (BPamp), pulse blood pressure index (C/B indPBP).

Results: In the absence of differences in peripheral hemodynamics in all groups, women aged 49-54 years had a magnification of the PWV by 2 m/s, and, in comparison with men, this difference was 1.65 m/s (p <0.05). Aix br and Aix ao were also superior to men in all groups, and in 49-54 years old, this difference was greatest and amounted to 39 % and 20 %, respectively. At this age, SBPao was also significantly raised in women, with a difference of 15 mmHg relative to men (p=0.038). In all age groups, women had negative values of the BPamp in contrast to men. In women, PWV correlated with the duration of hypertension (r=0.21; p<0.05), SBP (r=0.40), DBP (r=0.35), cPBP (r=0.43), in contrast to men, where PWVao was associated only with the heart rate (r=0.30).

Conclusion: In women with hypertension, changes in vascular wall stiffness occur earlier than in men with significant growth at 49–54 years. In women, the elastic properties of arteries are associated with the level of blood pressure and duration of the disease, and in men - with the level of the heart rate

Features of lipid metabolism in patients with type 2 diabetes mellitus and gout

2024-06-19T13:32:12+03:00

The aim: To study the relationship between lipid metabolism parameters, chemerin, and adenosine monophosphate-activated protein kinase (AMPK) activity in patients with type 2 diabetes mellitus (T2DM), as well as in patients with a combined course of T2DM and gout.

Materials and methods. To assess lipid metabolism disorders, 100 patients were examined and divided into 2 groups: - 1st group – patients with T2DM and gout (n=70), 2nd group – patients with gout (n=30), control group (CG) - practically healthy individuals (n=20). The levels of total cholesterol (TC), triglycerides, high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), and very low-density lipoprotein cholesterol (VLDL) were analyzed. As markers of insulin resistance (IR), the content of AMPK and chemerin was investigated. Statistical data processing was carried out using the statistical data processing program package version 8.0 STATISTICA (StatSoft Inc).

The results. A significant difference was found between the levels of lipid parameters (except HDL) when comparing patients with the combined pathology of T2DM and gout, with a monocourse of gout and representatives of CG (р<0.001). It was also found that among lipidogram indicators, in all groups, an inverse correlation of AMPK value with LDL level was found (strong for patients of the 1st group and medium strength for representatives of the 2nd group and CG). Another indicator with which AMPK levels in all groups were statistically reliably correlated was TC. The presence of a direct correlation between the levels of LDL and chemerin in the 2nd group and CG, as well as the levels of TC and chemerin in patients with a combination of T2DM with gout and an inverse correlation in the other groups (all p<0.05) was established.

Conclusions: Statistically significant relationships were found between lipid metabolism indicators, chemerin and AMPK activity in patients with T2DM, as well as in patients with combined course of T2DM and gout

Gut microbiota and its correlations with body mass index and age in patients with type 2 diabetes mellitus and thyroid dysfunction

2024-07-12T12:34:34+03:00

Modern studies show that it is the transit microflora, the percentage of which is negligible compared to the total volume of the intestinal microbiota, that can cause severe damage and cause the appearance of chronic and acute diseases not only of the intestines but also of the immune, nervous, endocrine systems, etc. Instead, the obligate intestinal microbiota and even the opportunistic microbiota exhibit a number of beneficial properties, ranging from the synthesis of short-chain fatty acids, butyrate, and acetate to promoting the synthesis of vitamins and hormones such as dopamine, serotonin, etc. At the same time, the adverse effects of the gut microbiota cannot be discounted.

The aim. The study aims to find correlations between gut microbiota, body mass index, and age in patients with type 2 diabetes and thyroid dysfunction..\

Materials and methods. The study included 84 patients with type 2 diabetes, obesity, and thyroid dysfunction. To analyze the composition of the intestinal microbiota, fecal samples were taken, and the quantitative and qualitative composition was calculated using the principle of PCR sequencing. Statistical methods of comparison and correlation of variables were used.

Results. In patients, several significant correlations were found between the gut microbiota and the parameters studied. A negative correlation was found between body mass index and Bifidobacterium spp. and Escherichia coli, and a positive correlation was found between body mass index and some opportunistic pathogens. Thus, with Shigella spp. and Staphylococcus aureus, there is a direct weak reliable relationship, while an inverse reliable relationship with Helicobacter pylori. Interesting correlations were found with a tendency to confidence with Salmonella spp. and Bacteroides thetaiotaomicron direct weak and a tendency to probable feedback between BMI and Faecalibacterium prausnitzii and Candida spp.

Conclusion. We found that body mass index has a greater impact on the gut microbiota than age. Also, the data obtained indicate that obesity negatively affects the number of some beneficial bacteria. We can assume that, like metformin, one of the most common drugs for the treatment of type 2 diabetes mellitus, it can affect the composition of the intestinal microbiota

Peculiarities of the shape and size of the mandible and the lower dentition with taking into account gender and craniotype

2024-04-06T12:45:44+03:00

The aim of the study: establishment of actual intravital craniometric characteristics of the shape and dimensions of the mandible and lower dentition of an adult person depending on gender and craniotype.

Research materials and methods: the work used dry bone preparations of whole or fragmented human skulls of both sexes in the amount of 39 units, from the collection of the Department of Human Anatomy of the Kharkiv National Medical University, and the results of CT studies of the head of adult people without existing bone tissue pathologies, totaling 85 observations. The basis of establishing a craniotype is the principle of calculating the general facial or facial index, which allows classifying anatomical objects according to the shape of the head structure.

Research results: the straight length of the mandible in adult leptoprosops males is from 88.5 mm to 102.4 mm, for women - from 86.3 mm to 100.7 mm; in mesoprosops men, this parameter gradually decreases to the level - from 81.3 mm to 95.7 mm, in women - from 80.7 mm to 94.9 mm; in euryprosops, the index is the smallest and ranges from 79.7 mm to 91.5 mm in males and from 78.5 mm to 90.8 mm in females. The opposite trend with significant ranges of variation is established for the angular width of the bone. Thus, in male leptoprosops, this parameter was determined from 84.6 mm to 97.5 mm, in female representatives - from 83.6 mm to 96.3 mm; in mesoprosops men, it increased from 89.1 mm to 105.3 mm, in women - from 87.9 mm to 103.1 mm; in euryprosops, regardless of sex, it reached its peak values, from 94.5 mm to 116.1 mm and from 92.7 mm to 114.1 mm, respectively. The height of the mandibular body also showed a certain dependence on the type of skull structure, in leptoprosops men it tended to the highest values and was fixed at the level from 29.1 mm to 38.9 mm, as well as in women - from 27.5 mm to 37.8 mm; at the same time, in mesoprosops men, the size decreased from 25.9 mm to 36.3 mm, in women, in turn, from 24.6 mm to 35.1 mm; in euryprosops men, this parameter ranged from 22.3 mm to 33.1 mm, and next to women - from 21.9 mm to 31.9 mm, it was at the level of the lowest indicators. When analyzing such a complex and multidirectional parameter as the arch of the mandible, it was also possible to obtain a characteristic of its dependence on the type of structure of the facial department of the skull. It was established that the range with the smallest values of the length of the arc is characteristic of leptoprosops, ranging from 135.8 mm to 149.4 mm in males and from 133.5 mm to 147.3 mm in females; average indices are characteristic of men - from 139.1 mm to 154.6 mm and women - from 136.4 mm to 151.2 mm with a mesoprosopic craniotype; in euryprosops of both sexes, the index tends to the greatest values at the level of 141.2 mm to 158.3 mm and from 139.7 mm to 155.7 mm, respectively.

Conclusions: the main craniometric parameters of the mandible are significantly dependent on the type of structure of the facial department of the skull. Thus, the leptoprosopic craniotype is characterized by maximum values of longitudinal and height dimensions with minimal indicators of width and arc length. Mesoprosops are characterized by the definition of intermediate, averaged values equidistant from marginal, terminal forms. In representatives with the euryprosopic type of skull structure, a significant decrease in the length and height of the jaw with a significant increase, up to the maximum values, width and length of the arch was observed. At the same time, unlike leptoprosops, which had a shortened and pointed arch, in euryprosops, the arch tended to be smoothed and lengthened. The assessment by sex leads to the fact that all sizes of the lower jaw predominate in men, but, nevertheless, a certain number of differences in indicators were within the limits of statistical error, which does not allow making absolute conclusions in this matter

The value of computer reconstruction in the treatment of intra-articular fractures of the distal part of the humerus

2024-07-12T12:51:47+03:00

The aim of the work was to study the role of computer reconstruction and additive technologies in the planning of surgical treatment of intra-articular fractures of the distal part of the humerus in the early post-traumatic period.

Materials and methods: the results of treatment of 44 patients with fractures of the distal part of the humerus aged from 22 to 65 years were studied.

All patients underwent MSCT in the preoperative period. In 45.5 % (20) cases, in order to increase the effectiveness of preoperative planning, simulation osteosynthesis was performed on an individual printed model of the damaged bone.

After completion of preoperative planning, all patients underwent osseous metallo-osteosynthesis in the first week after receiving the injury. In order to assess the effectiveness of the application of visualization techniques, a survey of the operating team was carried out regarding the informativeness of the conducted instrumental studies.

Results. The average duration of surgical intervention among patients in the clinical group with standard preoperative planning was 105.9 ± 9.15 minutes. The average results of the survey of the surgical team after the surgical interventions in the specified clinical group were 21.2 ± 2.8 points.

The average duration of surgery among patients of the second clinical group, whose preoperative planning included not only the assessment of MSCT results of the damaged segment, but also simulated osteosynthesis with the selection and application of optimal metal fixators, was 54.6 ± 7.14 minutes. The average results of the survey of the surgical team were 31.2 ± 1.7 points.

Conclusions. The use of a combination of visualization technologies and 3D printing allows to reduce the time the patient spends in the operating room and increase the effectiveness of preoperative planning.

Performing simulated osteosynthesis in the preoperative period allows you to develop an individual technique of repositioning bone fragments and use the optimal standard size of the cortical metal fixator with the distribution of the most favourable compression points of bone fragments

Assessment of biomechanical stability of the thoracolumbar junction with a burst fracture of Th12 following surgical stabilization under rotational loading

2024-06-17T22:48:01+03:00

The thoracolumbar junction is the most vulnerable to traumatic injuries, with over 65 % of injuries to the thoracolumbar spine occurring in this region.

Objective: To examine the stress-strain state of the thoracolumbar spine model with a burst fracture of the Th12 vertebra under various transpedicular fixation options influenced by rotational loading.

Materials and Methods: A mathematical finite-element model of the human thoracolumbar spine was developed, including a burst fracture of the Th12 vertebra and a transpedicular stabilization system containing eight screws implanted in the Th10, Th11, L1, and L2 vertebrae. Four variants of transpedicular fixation were modelled using short and long screws passing through the anterior surface of the vertebra, with and without two crosslinks.

Results: The analysis showed sufficiently high loading values for both the bone structures of the models and the elements of the metal construct. The maximum stress level in the body of the damaged vertebra was 33.2, 26.7, 30.1, and 24.2 MPa, respectively, for models with monocortical screws without crosslinks, bicortical screws without crosslinks, monocortical screws with crosslinks, and bicortical screws with crosslinks. High values were also recorded for the vertebrae adjacent to the damaged one: 13.0, 8.4, 10.9, and 7.1 MPa for the L1 vertebra and 10.2, 8.9, 7.1, and 6.2 MPa for the Th11 vertebra in the respective models. The stress on the supporting rods was registered at 582.0, 512.5, 512.6, and 452.7 MPa respectively.

Conclusion: The conducted analysis demonstrated that under rotational loading, the model with monocortical screws without crosslinks shows the highest peak loads at control points, whereas the model with bicortical screws and crosslinks shows the minimum. Meanwhile, models with short screws and crosslinks and long screws without crosslinks exhibit comparable results

Postsurgical pain intensity in children on the VAS and FLACC scale across various analgesic techniques. Mathematical prediction as a component of justification

2024-04-15T15:56:54+03:00

Nowadays, in pediatric practice, the Visual Analogue Scale (VAS) and the Face, Legs, Activity, Cry, Consolability (FLACC) scale are effective for assessing postsurgical pain. The modern concept of pain management includes a multimodal approach, including regional analgesia techniques.

The aim of the study was to present a mathematical model to assess the efficacy of regional analgesia techniques in managing postsurgical pain intensity on the VAS and FLACC scale up to the fifth day of the study and predict the behaviour of the experimental data function up to day 87 following surgery using the autoregressive probability model.

Materials and Methods. 89 patients operated on the anterior abdominal wall were divided into 3 groups depending on the type of anesthesia. The assessment of pain management quality and the presence of acute pain was conducted using the VAS and FLACC scale on days 1, 2, 3, and 5 post-operatively in all children. The ‘predict’ function in РТС MathCad Prime 7.0. software was used to automate calculating predictions based on the Burg method.

Results. Studying the efficiency of the proposed treatment using regional analgesia techniques versus conventional analgesia enabled the prediction of varying postsurgical pain intensities on the VAS and FLACC scale based on their mathematical models, with coefficient of determination R²=0.9876, R²= 0, 9827, R²=0.9952 for the FLACC scale and R²=0.9868, R²=0,915, R²=0.9774 for the VAS.

Conclusions. The use of regional analgesia techniques in children undergoing anterior abdominal wall surgery has been confirmed to be associated with a significant reduction in postsurgical pain intensity to the fifth day of observation and predicted to remain so up to day 87

Features of eating behavior of early school-age children in the context of the implementation of the school meals reform

2024-07-11T12:03:58+03:00

The aim of this study is to study the peculiarities of the eating behaviour of children of primary school age, their food preferences, choice of products and attitudes towards school meals, food habits in the choice of products and attitudes towards the school canteen in the context of the implementation of the school meal reform.

Materials and methods. A large-scale medical and sociological study was conducted, which included children (5,401) of primary school age (from 6 to 10 years old) and their parents (4,347 people) from various schools in Kyiv, Vinnytsia, and Donetsk regions. The questionnaires included questions about food preferences, frequency of consumption of different foods, attitudes towards school meals and factors that influence food choices. The collected data were processed and analyzed using descriptive statistics methods in Excel.

Research results indicate a significant level of awareness of the importance of a healthy diet by most children, but an insufficient level of water consumption, an insufficient understanding of the importance of nutrition for maintaining health by children, high popularity of high-carbohydrate products and a low level of satisfaction of some parents with school meals.

Conclusions. The conducted analytical research revealed several educational and organizational problems related to the introduction of healthy food in schools, especially within the framework of reforming school food programs. According to the Strategy for reforming the school nutrition system, compliance with the principles of healthy nutrition, ensuring high-quality, safe and healthy nutrition, and improving the taste properties of school nutrition compliance with the principles of healthy nutrition, is extremely important for the preservation of children's health and the prevention of chronic non-infectious diseases. The results of our research indicate the need for additional educational programs for children and parents, the gradual introduction of new food standards, as well as ensuring the availability of healthy food in school canteens, and the implementation of social projects that will contribute to the formation of healthy eating habits