The effectiveness of short-term pulmonary rehabilitation program in patients with comorbid asthma, chronic obstructive pulmonary disease and obesity.

The effectiveness of pulmonary rehabilitation (PR) has not yet been established in patients with asthma - chronic obstructive pulmonary disease overlap (ACO) depending on their nutritional status. We aimed to evaluate the effectiveness of a short-term PR program in patients with comorbid asthma, chronic obstructive pulmonary disease (COPD), and obesity. We included 40 ACO patients and divided them into 3 groups according to body mass index (BMI) and then subdivided them into PR (n=21) and control (n=19) groups. The COPD Assessment Test (CAT), the Asthma Control Test (ACT), and the modified Medical Research Council dyspnea scale (mMRS) were used to evaluate symptoms levels. BODE index (body mass index, forced expiratory volume in one second, dyspnoea, and 6-min walk distance) was used to evaluate the effectiveness of pulmonary rehabilitation. In addition, spirometry and bioimpedansometry were performed. All measurements were done before and after a 6-month PR program. A significantly lower decline in the BODE index was observed in overweight patients (decreased by 43.6% compared to baseline and lower by 40.7% compared to the control group). The six-minute walking test (6MWT) significantly increased in all groups (p<0.001). There was a decrease in total CAT score by 25.4% and by 31.2% in the overweight group (p<0.001). The BMI decreased more in the obese group (by 9.4% compared to baseline). Our study result showed that early use of PR program significantly improves functional capacity and BODE index, leads to dyspnea and CAT scores reduction and improvement in pulmonary function, cause a decrease in BMI, body fat percentage, and visceral fat level, and an increase in muscle mass in overweight and obese patients with ACO.

Systemic inflammation in the pathogenesis of irritable bowel syndrome associated with obesity.

Investigation of the mechanisms promoting the development of irritable bowel syndrome (IBS) in obese patients is one of the most important issues of modern medicine. We examined 97 patients suffering from IBS. The group of comparison included 10 individuals with obesity. The control group included 21 practically healthy individuals. The levels of C-reactive protein (CRP) in the blood serum, tumor necrosis factor-α (TFNα), transforming growth factor-ß1 (TGFß1), interleukin-10 (IL-10), 8-isoprostane (IP), ceruloplasmin (CP) were examined. Endotoxicosis intensity was identified by the content of average molecular peptides in the blood and the Limulus Amebocyte Lysate (LAL) test. In the case of IBS with prevailing diarrhea, especially its comorbid course with obesity, cytokine imbalance was observed, which was manifested by a decreased amount of IL-10 in the blood serum and increased levels of TNFα and TGFß1. Patients suffering from irritable bowel syndrome with prevailing diarrhea associated with obesity were characterized by high levels of C-reactive protein, fibrinogen and average molecules, increased content of pro-inflammatory cytokines (TFNα and TGFß1) with a decreased content of IL-10, as well as imbalance of the pro-oxidant and anti-oxidant blood systems (increased content of 8-isoprostane and ceruloplasmin).

The Role of MDR1 (C3435T) Gene Polymorphism in Patients with Chronic Obstructive Pulmonary Disease Associated with Type 2 Diabetes Mellitus.

Chronic obstructive pulmonary disease is a multifactorial disease characterized by gene-gene interaction as well as environmental effects. The incidence of type 2 diabetes mellitus is proved to be higher in the presence of chronic obstructive pulmonary disease than in the case of its absence. We aimed to study the genotypes of MDR1 (C3435T) gene polymorphism and its relationship with clinical, instrumental, and laboratory parameters in chronic obstructive pulmonary disease associated with type 2 diabetes mellitus. All the patients were divided into two groups. The first group included 53 patients with chronic obstructive pulmonary disease, and the second group included 49 patients with chronic obstructive pulmonary disease with comorbid type 2 diabetes mellitus. The COPD assessment test (CAT), 6-minute walk test, BODE integral index, spirometry, and bioimpedansometry were used for examination. Lipid spectrum, carbohydrate metabolism, endothelial functional status, leptin, adiponectin, and serum levels were also determined by means of enzyme immunoassay. Our study results showed no significant difference between the genotypes of the control group of healthy individuals and patients with chronic obstructive pulmonary disease and comorbid type 2 diabetes mellitus. Though, a certain association of this gene polymorphism with clinical findings by CAT-test, specific parameters of carbohydrate (fasting glucose) and lipid metabolism (total cholesterol and low-density cholesterol lipoproteins), endothelial functional state (nitrate/nitrite level) with the minor allele T available was found.

Study of the lifestyle of economically active population of the chernivtsi region: the prevalence of risk factors among business entities in the market.

OBJECTIVE: Introduction: To reduce the burden of non-communicable diseases (NCDs) and premature mortality, it is necessary to influence the risks of their occurrence at all stages of life. Economically active population, which can be more at risk, is required the special attention. The aim of the study is to investigate the prevalence for risk factors of major NCDs among the economically active population of the Chernivtsi region in the example of business entities in the market. PATIENTS AND METHODS: Materials and methods: The survey of the Chernivtsi business entities (n = 633) conducted in 2017-2018 on the territory of ME CSC (the Municipal Enterprise City Shopping Complex) "Kalynivskyi market" has been used in the research. RESULTS: Results: There is the high level of the prevalence of the main risk factors for NCDs (unhealthy diet, lack of physical activity, smoking) among those working in the territory of the market. Only 17% consume a sufficient amount of fruit and fish. Only 35% of respondents systematically do physical exercises and special physical exercises. The most common unhealthy diet has been found among young men (25-44 years), in this group, about 40% are smoking. An acute problem of female smoking (25%) among market workers has been revealed. It is shown that, in general (taking into account passive smoking), 65% of respondents suffer from harmful effects of tobacco. CONCLUSION: Conclusions: The established features of the lifestyle of workers indicate the need to make maximum efforts to focus on improving medical literacy and the formation of motivation to preserve health.