Навчально-науковий медичний інститут (НН МІ)
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Item Поєднаний перебіг псоріатичної та гіпертонічної хвороб в практиці сімейного лікаря: оцінка гемодинамічного профілю пацієнтів(Луганський державний медичний університет, 2019) Деміхова, Надія Володимирівна; Демихова, Надежда Владимировна; Demikhova, Nadiia Volodymyrivna; Кириченко, І.І.; Хіра, Харпріт Сінгх; Бабій, Л.М.Досліджено та доведено наявність взаємозв’язків між станом центральної гемодинаміки та PASI, які реалізуються, в першу чергу, на рівні гладких м’язів судин та, загалом, шляхом ремоделюванням лівого шлуночка. Стан системної гемодинаміки, функціональних параметрів серця та метаболічних його резервів у хворих з поєднаними клінічними варіантами характеризується більш виразними, ніж при ізольованих клінічних варіантах, зі збільшенням швидкості (р<0,05) центрального кровотоку на тлі порушень скоротливої здатності міокарду та зростанням (р<0,05) кінцевого діастолічного об’єму. Ремоделювання міокарду у хворих на псоріатичною хворобою з поєднаною гіпертонічною хворобою супроводжується зростанням (р<0,05) м’язової маси, в першу чергу за рахунок концентричного потовщення (р<0,05) стінки лівого шлуночка.Item Correction of myocardial changes on an animal experimental model with meldonim(Oxford University Press, 2022) Ярмоленкo, Ольга Сергіївна; Ярмоленко, Ольга Сергеевна; Yarmolenkо, Olha Serhiivna; Бумейстер, Валентина Іванівна; Бумейстер, Валентина Ивановна; Bumeister, Valentyna Ivanivna; Приходько, Ольга Олексіївна; Prykhodko, Olha Oleksiivna; Гордієнко, Олена Володимирівна; Гордиенко, Елена Владимировна; Hordiienko, Olena Volodymyrivna; Деміхова, Надія Володимирівна; Демихова, Надежда Владимировна; Demikhova, Nadiia VolodymyrivnaProlonged hypoosmolar overhydration causes a volume overload necessitating cardioprotectors together with a complex of measures aimed at stabilizing the water and electrolyte balance. The content of water and electrolytes in the human body changes throughout life, so the body's response to the disorder of water and salt balance may be different depending on age. The fluid overload positively correlates with adverse outcomes in critically ill patients. One of the main tasks of modern cardiology is to find the means of leveling the influence of adverse factors on myocardium in different aged patients. The aim of our study was the determination of morphological changes in the myocardium of old laboratory animals under the influence of severe hypoosmolar hyperhydration and attempt to correct the identified changes by means of meldonium.Item Aspects of somatogenic asthenic syndrome in patients with high cardiovascular risk(Oxford University Press, 2022) Деміхов, Олексій Ігорович; Демихов, Алексей Игоревич; Demikhov, Oleksii Ihorovych; Деміхова, Надія Володимирівна; Демихова, Надежда Владимировна; Demikhova, Nadiia Volodymyrivna; Руденко, Тетяна Миколаївна; Руденко, Татьяна Николаевна; Rudenko, Tetiana Mykolaivna; Орловський, Олександр Вікторович; Орловский, Александр Викторович; Orlovskyi, Oleksandr ViktorovychAim: To study frequency and nature of psychopathological symptoms in various forms of somatogenic asthenic syndrome in patients with high cardiovascular risk (CVR). Methods: The quantitative anamnestic analysis of medical history, the variational statistics, the probabilistic allocation of clinical signs with estimation of reliability of the results. Among the 199 persons with high CVR and non-psychotic mental disorders: 31 patients had somatogenic asthenic syndrome (SAS), stratified by clinical variants: asthenic (1n2=14); asthenic-anxious (2n2=8); asthenic-subdepressive (3n2=6) and dyssomniac (4n2=3).Item Dental status and oxidative homeostasis state in patients exposed to occupational vibration: superoxide dismutase and catalase content in oral fluid(Medpress, 2022) Cherkashyna, L.; Haidash, I.; Hlazkova, N.; Деміхова, Надія Володимирівна; Демихова, Надежда Владимировна; Demikhova, Nadiia Volodymyrivna; Shklyar, A.; Sukhonosov, R.; Barchan, G.; Куц, Лариса Вікторівна; Куц, Лариса Викторовна; Kuts, Larysa Viktorivna; Деміхов, Олексій Ігорович; Демихов, Алексей Игоревич; Demikhov, Oleksii IhorovychAim: The aim of the research involved determination of catalase and superoxide dismutase content in oral fluid of patients exposed to occupational vibration depending upon their dental status. Materials and methods: The assessment of dental status (DS) and superoxide dismutase (SOD) and catalase (CAT) content in oral fluid (OF) was performed in three groups of patients: control group (n0=129) included the persons exposed to occupational vibration and whose results of combined medical examination excluded the presence of vibration disease (VD); the second (n1=63 patients with VD stage I) and the third (n1=66 patients with VD stage II) groups consisted of the patients, who underwent treatment at the clinical department of the Research Institute of Occupational Hygiene and Occupational Diseases of Kharkiv National Medical University of the Ministry of Health of Ukraine. DS determination was carried out according to the method of K. M. Kosenko (Patent No. 57512, Ukraine) for in-patients and controls (during medical checkups) using the following indices: PMA, OHI-S, DMFT, with assessment of vacuum-pressory resistance of gingival capillaries (VPRC) (according to V. I. Kulazhenko) and community periodontal index of treatment needs (CPITN). SOD content was determined by the nonenzymatic method; CAT content was revealed spectrophotometrically. Primary data were statistically processed with the determination of accuracy by Student's test. Results: SOD content depending upon PMA intensity in VD patients ranged from 14.1±0.2 U/min to 15.7±0.5 U/min , was reliably (p<0.05) lower in patients with VD versus the controls (17.8±0.2 U/min and 14.2±0.2 U/min respectively, when PMA>2.1) and did not differ depending upon VD severity (15.7±0.5 U/min in VD stage I and 15.3±0.3 U/min in VD stage II, respectively). SOD content in OF in patients depending upon their OHI-S ranged from 13.5±0.3 U/min to 16.3±0.2 U/min and was reliably (p<0.05) lower in patients with OHI-S≥1.7 U. A comparative analysis showed that the activity of the enzymatic protection of the periodontal membrane could be also determined by the state of hard tissues, in particular by such DS index as DFTM. The activity of SOD in VD stage II was found to be reliably (p<0.05) reduced in patients with DFTM index exceeding 15 pts. A somewhat different pattern of SOD activity was found in OF in patients with VD stage I: SOD activity in OF was similar in all DFTM indices and it became reduced depending upon an increase of DFTM index. SOD content depending upon VPRC index in patients with VD ranged from 10.7±0.5 U/min to 16.8±0.3 U/min and was reliably (p<0.05) lower in cases with VPRC index ≤40 sec. CAT content depending upon PMA intensity in VD patients ranged from 4.6±0.4 U/min to 11.3±0.3 U/min and was reliably (p<0.05) higher in patients with VD stage I versus the controls and differed according to the severity. CAT content in OF in patients depending upon OHI-S ranged from 5.2±0.2 U/min to 10.1±0.3 U/min, was reliably (p<0.05) lower in cases with OHI-S ≥1.7 U, did not differ from the indices observed in the control group and was also found to be reliably lower in patients with VD stage II versus those with VD stage I (7.3±0.3 U/min and 8.6±0.2 U/min, respectively, when OHI-S ranged within 0.7÷1.6 U). CAT content in OF depending upon VPSC index in patients with VD ranged from 5.8±0.2 U/min to 8.6±0.6 U/min and was reliably (p<0.05) lower in cases with VPSC index ≤40 sec. Thus, CAT activity in OF in patients was reliably (p<0.05) reduced (in VPRC>40 sec it was equal to 7.8±0.2 U/min, and in VPRC≤40 sec it was 8.6±0.1 U/ min) in VD stage I with decreased VPRC. Conclusions: A trend (p>0.05) towards an increase in SOD activity in VD stage I versus the controls was revealed, whereas VD stage II demonstrated a reliable (p<0.05) reduction of the above activity. At the same time, an unsatisfactory state of oral hygiene was shown to promote inhibition of the enzymatic protection of their periodontal membrane in patients with VD stage I. A trend (p>0.05) towards an increase of SOD activity in VD stage I versus the controls was revealed, whereas VD stage II demonstrated a reliable (p<0.05) reduction of the above activity. The assessment carried out in cases requiring combined treatment with surgical or non-surgical debridement and also in patients with supraor subgingival dental calculus found out that SOD activity was reliably reduced only in cases with VD stage II. CAT activity assessment in OF in VD patients having different levels of CPITN showed that the above activity in persons requiring combined treatment (including prosthodontic treatment; CPITN≥3.1points) was markedly and reliably reduced. All the above facts determine peculiarities in oral treatment strategies for this group of patients.Item The effect of the experimental chronic hyperglycemia on the kidney and myocardium(State Institution «Institute of Nephrology NAMS of Ukraine", 2021) Ярмоленкo, Ольга Сергіївна; Ярмоленко, Ольга Сергеевна; Yarmolenkо, Olha Serhiivna; Бумейстер, Валентина Іванівна; Бумейстер, Валентина Ивановна; Bumeister, Valentyna Ivanivna; Polak, S.; Гордієнко, Олена Володимирівна; Гордиенко, Елена Владимировна; Hordiienko, Olena Volodymyrivna; Приходько, Ольга Олексіївна; Prykhodko, Olha Oleksiivna; Деміхова, Надія Володимирівна; Демихова, Надежда Владимировна; Demikhova, Nadiia Volodymyrivna; Шкатула, Юрій Васильович; Шкатула, Юрий Васильевич; Shkatula, Yurii Vasylovych; Деміхов, Олексій Ігорович; Демихов, Алексей Игоревич; Demikhov, Oleksii Ihorovychhe number of patients with diabetes increases annually. Modern forecasts predict that diabetes will be the seventh leading cause of death in 2030. Despite many significant advances in the research of diabetes and the use of new modern treatments, the disease is still progressing, and it is necessary to continue to study the effects of diabetes on human systems and organs: kidney and myocardium.Methods. A total of 24 rats of reproductive age (6 months old) were involved in this experimental study. Experimental rats were injected with alloxan intraperitoneally once at a dose of 20 mg/100 g on an empty stomach. In addition, they received a 10% glucose solution 24 hours after alloxan injection and a 5% glucose solution during the experiment. We measured glucose level with Accu-Chek Advantage (Boehringer, Germany) after 2, 12, and 24 hours after alloxan injection, and then weekly. The subjects of the investigation were kidney and heart of the experimental (n=12) and control (n=12) animals for correct comparative analysis.Results. The average blood glucose level remained at 11 mmol/L ± 2 mmol/L. During the experimental period, the rats’ weight gain, dilation of both ventricles and relative renal weight gain were determined. By the histological examination of the myocardium, we revealed polymorphic nuclei, perinuclear cytolysis, fragmentation, wavy-like deformation of cardiomyocytes, stromal and perivascular edema, uneven filling of blood vessels, and local fibrosis. Thinning of fibrous capsule and cortical layer, destruction of nephrons, and hemorrhages were detected in the kidney. Conclusions. Our study confirms the robustness of alloxan-induced hyperglycemia in rats. We came to this conclusion because the early changes in the kidneys and heart are explained by the development of microangiopathies, which is a typical feature of the pathogenesis of diabetes. With prolonged exposure to chronic hyperglycemia, structural disorders of vital organs are worsened. This experimental model could be used for conducting comprehensive research aimed to study the mechanisms of diabetes mellitus, the effects of hyperglycemia on organs and tissues, and correct the complications.Item Chronic inflammation and progression of chronic kidney disease in patients with type 2 diabetes(State Institution "Institute of Nephrology NAMS of Ukraine", 2021) Мазур, Тетяна Станіславівна; Мазур, Татьяна Станиславовна; Mazur, Tetiana Stanislavivna; Деміхова, Надія Володимирівна; Демихова, Надежда Владимировна; Demikhova, Nadiia Volodymyrivna; Руденко, Тетяна Миколаївна; Руденко, Татьяна Николаевна; Rudenko, Tetiana Mykolaivna; Юрченко, Алла Владиславівна; Юрченко, Алла Владиславовна; Yurchenko, Alla Vladyslavivna; Єжова, Ольга Олександрівна; Ежова, Ольга Александровна; Yezhova, Olha Oleksandrivna; Бокова, Світлана Іванівна; Бокова, Светлана Ивановна; Bokova, Svitlana Ivanivna; Деміхов, Олексій Ігорович; Демихов, Алексей Игоревич; Demikhov, Oleksii IhorovychChronic inflammation, atherosclerosis, tubulointerstitial fibrosis, and vascular damage play a crucial role in the progression of chronic kidney disease (CKD) in patients with type 2 diabetes mellitus (DM). However, specific biomarkers that can determine the progression of diabetic kidney disease, including patients with minimal albuminuria, remain undefined. The present study aimed to determine markers of chronic inflammation as indicators of CKD progression in patients with type 2 DM. Methods. 45 patients with type 2 DM and stage 1-3 CKD were involved in this cross-sectional observational study. Analysis of cellular mechanisms of CKD progression was performed on the concentrations of endothelin-1 (ET-1), fibronectin (FN), tumor necrosis factor-alpha (TNF-α), transforming growth factor beta-1 (TGF-β1), and monocyte chemoattractant protein (MCP) -1) in the serum. Results. In patients with type 2 DM, an increasing trend in the majority of endothelial and proinflammatory mediators was found according to the CKD stages, despite normal albuminuria. Conclusions. Concentrations of TNF-α, ET, TGF-β1 and MCP-1 can be used to assess the progression of CKD in patients with type 2 DM with normal albuminuria. Further researches are needed to determine early indicators of diabetic kidney disease progression.Item Cholinesterase in different types of the muscle tissue during the early postmortem period for diagnosis of death coming(Bangladesh Academy of Sciences, 2021) Cherkashyna, L.; Shklyar, A.; Sukhonosov, R.; Miroshnikova, O.; Naguta, L.; Olkhovskiy, V.; Деміхова, Надія Володимирівна; Демихова, Надежда Владимировна; Demikhova, Nadiia Volodymyrivna; Куц, Лариса Вікторівна; Куц, Лариса Викторовна; Kuts, Larysa Viktorivna; Barchan, G.; Sukhomlyn, G.; Кіптенко, Людмила Іванівна; Киптенко, Людмила Ивановна; Kiptenko, Liudmyla IvanivnaThe purpose of the research: consisted in study of postmortem regularitiesin the content of cholinesterase in different types of muscle tissue (MT) for improving accuracy of determination of the prescription of death coming PDC.Materials and methods: The activity/level of cholinesterase was determined in homogenates of the myocardial (MMH), oesophageal (OMH), diaphragm (DMH) and intercostal muscles (IMH)within the early PMP (3-13 hours after the coming of death) on 30 human corpses. MT was sampled in conditions of postmortem biopsy with use of special instruments; MT homogenates were prepared following the standard technique with subsequent determination of cholinesterase content in MT homogenates. Results and discussion: The analysis of postmortem changes in the content of cholinesterase in MT depending upon PDC revealed that after 3 hours from the moment of death coming its highest content was in muscles of the oesophagus, the least one being in MT of the intercostal muscles (respectively, (2,717.1±37.1) and (883.5±6.2) U/g, р<0.001). Levels of cholinesterase content in MT of the myocardium and diaphragm were rather close, though they differed (respectively, (1,213.8±8.8) and (1,512.8±11.5) U/g, р<0.05), and occupied an intermediate place between the corresponding values of MT of the intercostal muscles and oesophagus.A common pattern for the content of cholinesterase in different types of MT was characterized by a decrease of this content with an increase in PDC terms; besides, the dynamic lines of its changes, that we obtained, became basic ones for substantiating quantitative time dependencies and construction of relevant nomograms for forensic diagnosis of PDC by cholinesterase content in MT. Conclusions: It was proved that the content of cholinesterase in all MT homogenates, which we studied, changed regularly (and nonlinearly), but the initial and final levels of cholinesterase content differed depending upon the type of MT. Besides, the dynamics in changes of the content of cholinesterase within the time period of 3÷13 hours from the moment of death coming differed upon the type of MT too. Advantages of the technique consist in theintegrity of biochemical examination of different types of MT and simplicity in interpretation of findings. The application of the nomogram technique for assessing PDC by cholinesterase content in MT makes it possible to improve the accuracy of diagnosis for terms of the coming of death up to 60 minutes.Item Arterial hypertension prevention as an actual medical and social problem(Ibn Sina Medical College, 2020) Деміхов, Олексій Ігорович; Демихов, Алексей Игоревич; Demikhov, Oleksii Ihorovych; Дегтярьова, Ія Олександрівна; Дегтярева, Ия Александровна; Dehtiarova, Iia Oleksandrivna; Rud, O.; Khotyeev, Y.; Куц, Лариса Вікторівна; Куц, Лариса Викторовна; Kuts, Larysa Viktorivna; Cherkashyna, L.; Деміхова, Надія Володимирівна; Демихова, Надежда Владимировна; Demikhova, Nadiia Volodymyrivna; Орловський, Олександр Вікторович; Орловский, Александр Викторович; Orlovskyi, Oleksandr ViktorovychSocial changes, technological re-equipment, intensive formation of urban infrastructure have led to a constant increase in stress factors and an excessive growth of the nervous and psychological population burden. As a result of these processes in economically developed countries, acute diseases are becoming less and less significant, unlike the group of chronic disorders, such as arterial hypertension. Data from the review of the literature and the data we have received indicate that there is an increase in the level of cortisol in the blood in the phase of anxiety, which reduces in the resistance phase. A significant role is played by another hormone - insulin, which plays a key role in the development of the general adaptive syndrome. Through it the body implements numerous counter-defects in relation to the regulatory influence of catecholamines and cortisol. In conditions of prolonged stress, the level of insulin in the blood decreases and diabetes develops. The effect of cortisol and catecholamines in the resistance phase persists. The level of oxidative modification of blood plasma proteins indices depends on the behavior of the individual and changes in his psycho-emotional state, while a prolonged increase in the levels of catecholamines and cortisol in peripheral blood causes the development of psychosomatic pathology. It is proved that under the influence of complex action of risk factors there are significant changes in the psycho-emotional state that cause hypertension. This is confirmed by the presence of the highest level of reactive anxiety in patients with hypertension of the 1st stage on the background of the lowest personal anxiety which is the basis for the occurrence of the disease. With the progression of hypertension there are more profound changes in the personality of the patient, which is accompanied by the accumulation of personal anxiety, which can lead to a depressive state of neurotic genesis, which we observed with its complication. On the basis of a comprehensive study, the effect of stress on the occurrence of a syndrome of psychoemotional stress is shown, which leads to a steady increase in blood pressure - hypertension, and with its subsequent action complicates its course.Item The relationship between lipid metabolism and the level of albuminuria with single nucleotide polymorphism - 204a>c [rs 3808607] cyp7a1 gene in patients with type 2 diabetes mellitus and diabetic nephropathy(Romanian National University, 2019) Деміхова, Надія Володимирівна; Демихова, Надежда Владимировна; Demikhova, Nadiia Volodymyrivna; Cherkashyna, L.; Чернацька, Ольга Миколаївна; Чернацкая, Ольга Николаевна; Chernatska, Olha Mykolaivna; Mazur, T.; Алексахіна, Тетяна Олексіївна; Алексахина, Татьяна Алексеевна; Aleksakhina, Tetiana Oleksiivna; Demikhov, ОThe purpose of our study was to determine the features of diabetic nephropathy, to identify the relationship between the level of albumin excretion, urine and lipid profile, genotype variants of the CYP7A1 gene in people with type 2 diabetes and diabetic nephropathy. Material and methods. Patients were divided into three groups. Normoalbinuria was detected in group I, and II - microalbuminuria, and III - macroalbuminuria. Determination of albumin to creatinine ratio was more accurate, although more expensive method. We examined single nucleotide polymorphism -204A> C [rs 3808607] of the promoter region of the CYP7A1 gene. Results. It was established that homozygotes by the major allele with genotype AA had lower values of albuminuria, atherogenic lipoproteins, total cholesterol, triglycerides and higher levels of anti- atherogenic lipoproteins than patients with AС and СС genotypes. Conclusion. The СС genotype was most unfavorable in the prognostic plan, since homozygotes for this minor allele were characterized by higher values of albuminuria, total cholesterol, triglycerides, and lower values of high-density lipoprotein.Item Оценка коррекции липидного профиля у пациентов сартериальной гипертензией и сахарным диабетом 2-го типа(Азербайджанский медицинский университет, 2019) Чернацька, Ольга Миколаївна; Чернацкая, Ольга Николаевна; Chernatska, Olha Mykolaivna; Деміхова, Надія Володимирівна; Демихова, Надежда Владимировна; Demikhova, Nadiia Volodymyrivna; Руденко, Тетяна Миколаївна; Руденко, Татьяна Николаевна; Rudenko, Tetiana Mykolaivna; Демихов, А.И.Представлені результати дослідження, проведеного з метою оцінки впливу терапії аторвастатином на показники ліпідного спектра у хворих з артеріальною гіпертензією та цукровим діабетом 2-го типу. Досліджено динаміку змін ліпідного спектра крові на тлі лікування аторвастатином (10-40 мг / добу) у осіб з вказаною коморбидной патологією, що проходили обстеження на базі Сумської міської клінічної лікарні №1, що мали в анамнезі серцево-судинні ускладнення. Встановлено, що протягом 6 місяців прийому аторвастатину цільового рівня загального холестерину вдалося досягти у 30 осіб (31,91%), ліпопротеїнів низької щільності - у 10 осіб (10,64%), ліпопротеїнів високої щільності - у 26 осіб (27,66 %), тригліцеринів - у 34 осіб (36,17%). Таким чином, у хворих з артеріальною гіпертензією та цукровим діабетом 2-го типу доцільно призначати аторвастатин (10-40 мг / добу) з метою корекції дисліпідемії, запобігання маніфестації атеросклеротичного процесу