Common clinical laboratory features among women with polycystic ovary syndrome and metabolic syndrome.

Women with polycystic ovary syndrome (PCOS) have a high prevalence of metabolic syndrome (MS), with rates up to 33%. This is associated with long-term consequences such as cardiovascular diseases, type 2 diabetes mellitus (T2DM), cancer, sleep apnea, and psychological issues. The prevalence of MS worldwide is often associated with obesity and T2DM, yet regional variations are reported. In this study, 122 women consulting general practice and family medicine physicians were evaluated, revealing a BMI exceeding 30 kg/m2. Among MS criteria, the most common diagnoses were T2DM in 29 patients, insulin resistance (IR) in 36, arterial hypertension (AH) in 51, reduced HDL levels in 53, and elevated triglycerides in 39. Further analysis revealed 16 unique combinations of MS components in these patients, with 75% of PCOS cases exhibiting three MS components and 25% having four. Additionally, research indicated that most women with PCOS face persistent, treatment-resistant obesity, with a notably higher BMI (ρ=0.87; r=0.76). These findings highlight the multifactorial nature of PCOS and MS etiology.

A randomized, double-blind, placebo-controlled, multicenter study assessing the efficacy of magnesium oxide monohydrate in the treatment of nocturnal leg cramps.

BACKGROUND: Magnesium supplements are widely used for prophylaxis and treatment of nocturnal leg cramps (NLC). However, there is little evidence in support of their effectiveness. The main impediment stems from the lack of assessments of cellular absorption. In the current study, we tested the efficacy and safety of a magnesium supplement - magnesium oxide monohydrate (MOMH), for which increased cellular absorption rates were demonstrated in an ex-vivo setting. METHODS: A randomized, double-blind, placebo-controlled multicenter study was conducted in hospitals and outpatient clinics in Ukraine, from February to August 2018. Eligible subjects received a capsule with MOMH 226 mg or placebo, once daily, at bedtime, for a 60-day period. The assessed parameters included frequency and duration of NLC episodes, quality of sleep, NLC-induced pain and quality of life sub-scores. The Fisher's Exact Test for comparison of groups by categorical variables was used. The Student's test or Mann-Whitney test were used for between-group comparison at different timepoints. ANCOVA followed by contrast analysis was used for comparison of groups at the end of the study. RESULTS: 175 (81%) out of 216 initially screened subjects completed the study. The number of NLC episodes has significantly decreased by the end of the study period as compared to baseline in both groups (p < 0.001 for both). There was a significant between-group difference in the magnitude of reduction in NLC episodes (p = 0.01), indicating a higher decrease in the MOMH group as compared to the placebo group (- 3.4 vs - 2.6, respectively). In addition, MOMH treatment resulted in a greater reduction in NLC duration (p < 0.007) and greater improvement in sleep quality (p < 0.001) as compared to placebo. CONCLUSIONS: MOMH was shown to be effective in the treatment of NLC as well as safe and well-tolerated. TRIAL REGISTRATION: NCT03807219 , retrospectively registered on January 16, 2019.

SPECTRUM OF CAUSATIVELY RELEVANT AEROALLERGENS OF SOUTHERN UKRAINE WHICH PROVOKE ALLERGIC REACTION IN PATIENTS WITH POLLINOSIS ON THE EXAMPLE OF KHERSON REGION.

OBJECTIVE: The aim: the analysis of spectrum of causatively relevant aeroallergens of southern Ukraine which provoke allergic reaction in patients with pollinosis. PATIENTS AND METHODS: Materials and methods: ambulatory medical records data and skin prick-testing results of 477 patients afflicted with pollinosis in Kherson (250 women - 52,41 % and 227 men - 47,59 %) aged from 19 to 66 years old (38,05±0,45) have been analyzed retrospectively. RESULTS: Results: all patients revealed clinical implications mainly during the September-October period. Clinically 151 patients (31,66%) showed severe and 326 (68,34%) moderate to severe clinical progression. Composite family plants (composites) proved to be the most widespread plants (69,76 %) among all pollen aeroallergens of Kherson region. Weeds and sunflower showed the highest percentage among composites: Ambrosia topped to 79,87 %, Helianthus (sunflower)- 75,68 %, Artemisia - 42,98 %, and Cyclachaena (sump weed) - 36,48 %. Wild and cultivated grains' aeroallergens toped to 28,22 %. Among them the sensibility to Lolium perenne (19,28 %), Festuca pratensis (17,82 %), Dactylis glomerata (17,82 %) has been noticed more often. Tree aeroallergens topped to 2,03 %. CONCLUSION: Conclusions: The third wave of pollen formation (September-October period) appeared to be the most significant and clinically hard for Kherson region. According to the specific allergologic research data, allergens of the composite family plants, among which pollen of Ambrosia, Helianthus, Artemisia and Cyclachaena cause more frequent sensibility, turned to be the most widespread causatively relevant aeroallergens in Kherson region which provoke allergic reaction in patients with pollinosis. The second place was taken by wild and cultivated grains' aeroallergens, among which sensibility to Lolium perenne, Festuca pratensis, Dactylis glomerata proved to be the most common.

A responsible patient: from theory to practice on a model of a patient with bronchial asthma.

OBJECTIVE: Introduction: The medicine of today is focused on personalized aid to a patient, which involves partnership and mutual responsibility between the patient and the doctor. In our reality, the patient believes that the responsibility for the treatment and outcome depends on the doctor in most cases. The aim: Induce the patient to develop responsibility for the course of asthma against the background of EBW or obesity and introducing this program into the practice of family physicians. PATIENTS AND METHODS: Materials and methods: By design, the study included 75 patients with asthma with varying degrees of severity, persistent course in the remission stage against the background of EBW or obesity. According to the randomization method, the patients were divided into 3 groups: the main group - 30 patients (the use of medication), the comparison group - 30 patients (training in the "Asthma School"), the 3rd group was controls of 15 patients (basic therapy). RESULTS: Results: According to the anthropometric study, 75 patients enrolled in the study were found to have EBW or obesity and the mean BMI was 31.67 ± 0.53 kg / m2. It was also found that 20 (66.67%) patients in the main group and 21 (70.00%) patients in the comparison group did not regularly use basic therapy and cancelled or changed the drugs without permission. After the training, 45 patients (76.66%) of the total patients of the main group and the comparison group began to perform respiratory movements with the inhalation device correctly. patients in the main group reduced body weight on an average by 4.5 kg, and BMI from 32.00 kg / m2 changed to 29.7 kg / m2 (p <0.05), although they did not reach 25.0 kg / m2 of the target level because the follow-up period was not long. CONCLUSION: Conclusion: Only patients in the main group had significant positive changes in asthma control, the patients in the comparison group also had positive dynamics, but it did not show statistically significant differences. The doctor should be interested in the fact that at the first and subsequent visits regarding the disease, in our case it is bronchial asthma, the patient will feel responsible for the disease. Therefore, when communicating with the patient, the physician should focus on this, provide the most complete answers to the patient's questions, provide educational literature and, if necessary, diaries of self-control.

Assessment of complex treatment influence on systemic inflammation in overweight type 2 diabetes patients.

OBJECTIVE: Introduction: Long-term systemic inflammation may cause type 2 diabetes. Medications used to treat type 2 diabetes don't target inflammation therefore it's necessary to study how hypoglycemics can improve patient prognosis through modification of systemic inflammation. The aim: Our goal was to assess influence of liraglutide in complex therapy on proinflammatory cytokine levels in overweight patients with type 2 diabetes and compare it with metformin. PATIENTS AND METHODS: Meterials and methods: The study included 80 overweight patients with type 2 diabetes. We studied clinical parameters as well as antropometric: height, weight, BMI, abdomen circumference; hsCRP, proinflammatory cytokine (TNF-α, IL-1ß, IL-6) levels. Patients were treated according to an individualized treatment plan which included eating habit modification and dosed physical exercise. First and second groups were comparison groups. Patients in the first group received metformin as primary treatment up to 2500 mg/day (n=20). Patients in the second group received liraglutide up to 1.8 mg/day (n=30). Patients in the third (main) group received a combination of metformin (up to 2500 mg/day) and liraglutide up to 1.8 mg/day (n=30). RESULTS: Results and conclusions: Main group achieved a decrease in BMI from 28,48±2,1 kg/m2 to 23,9±1,8 kg/m2 (р<0,05), whereas such decrease in the liraglutide monotherapy group was from 28,59±2,5 kg/m2 to 25,87±2,3 kg/m2 (р<0,05) and from 28,65±3,2 kg/m2 to 27,46±2,8 kg/m2 (р>0,05) in the metformin monotherapy group. Liraglutide was more efficient in lowering inflammatory cytokine concentrations with TNF-α and IL-6 being more sensitive to its effects. Main group saw a decrease in TNF-α levels from 10,14±0,6 to 7,49±0,33 pg/ml (<0,001) and IL-6 levels from 11,12±0,7 to 7,84±0,62 pg/ml (<0,001).

Peculiarities of the course of bronchial asthma in patients with excessive body weight or obesity.

OBJECTIVE: Introduction: Clinical studies that were devoted to the analysis of the asthma course during concomitant obesity or excessive body weight, demonstrated a number of typical features. Both asthma and obesity or overweight are diseases that form a persistent chronic inflammatory process in the body. The combination and mutual enhancement of the factors of chronic inflammation leads to a more severe clinical course of asthma and reduced control of the disease. The aim: The main goal of our study was to determine the peculiarities of the course of bronchial asthma of various degrees of severity in patients with excessive body weight or obesity. PATIENTS AND METHODS: Materials and methods: Anamnesis and examination of 86 patients with a major diagnosis of bronchial asthma were performed. According to the body weight index, patients were divided into two groups: main and comparison, and 20 somatic-healthy patients who were included in the control group also participated in the study. RESULTS: Results and conclusions: The patients had upper respiratory tract diseases, namely rhinitis, sinusitis, bronchitis, and pneumonia. A different incidence rate of respiratory infections in a child was noted in patients, depending on the severity of the course. The patients in the main group took an antibiotic on an average 3-4 times a year, of whom patients with severe bronchial asthma took antibiotics 4-5 times a year. In the comparison group, the average level of antibiotic ingestion coincided with that of the control group, namely 1-1.5 times a year. The patients have a close direct correlation between the asthma test and the body mass index. 28.75% of the patients in the main group had no symptoms of allergy. Damp basements, rooms with lots of dust or outdoor work with high concentrations of dust or pollen have a negative effect on the patients with asthma. 81% of the patients in the main group did not adhere to the appointments of the doctor, it should be noted that these are patients with any course of asthma.