PECULIARITIES OF STRUCTURAL CHANGES IN THE BRAIN SUBSTANCE IN PATIENTS WITH ARRHYTHMIAS DEPENDING ON THE SEVERITY OF COGNITIVE DISORDERS.

OBJECTIVE: The aim: To evaluate the structural changes of the brain in relation to the formation of cognitive disorders (CD) in patients with arrhythmias. PATIENTS AND METHODS: Materials and methods: 147 patients with different clinical forms arrhythmias against the background of ischemic heart disease were examine. At the first stage, all patients with arrhythmias assessed cognitive functions. At the second stage, patients were distributed divided into two groups: the main group patients with CD, control - patients without CD. These groups underwent computed tomography examination of the brain. RESULTS: Results: CD were established in 83% patients with arrhythmias. Mild CD were more often diagnosed in patients with persistent form of atrial fibrillation (AF), severe CD - in patients with permanent form of AF and atrioventricular blockade ІI-III degrees. Neuroimaging changes were found in 73.8% patients with CD and in 36% patients without CD. They were manifested by atrophic changes of the cortex, internal hydrocephalus, a decrease in the density of the brain sub¬stance of the periventricular area. In patients with CD, compared to patients without CD, showed lacunar foci with predominant localization in the parietal and frontal lobes of the brain, periventricular and subcortical leukoaraiosis. Multiple correlations were established between CD and structural changes of the brain. CONCLUSION: Conclusions: The increase in the severity of CD in patients with arrhythmias is associated with atrophic changes at the cortical-subcortical level, accompanied by the phenomena of internal hydrocephalus, periventricular and subcortical LA, lacunar foci, with a predominant localization in the frontal-temporal-occipital lobes, in the visual hump and basal ganglia of both cerebral hemispheres.

The 5-year dynamics of cardiac structure and function in patients with coronary artery disease after myocardial revascularization.

OBJECTIVE: The aim: To estimate the dynamics of echocardiographic parameters in patients with CAD within 5 years after revascularization. PATIENTS AND METHODS: Material and methods: 50 persons (males/females 39/11; mean age 59.9±9.3 years; STEMI 76%, non-STEMI 24%) were divided into two groups: n=38 after PCI with stenting (PCIwS); n=12 after CABG. Observation included regular echocardiography with LV myocardial mass (LVMM) and geometry estimation. RESULTS: Results: Groups were comparable by age, co-morbidity, BP, heart rate and BMI. Significantly severe baseline LV hypertrophy (LVH) and left atrial enlargement (LAE) in group 2 explained by spread coronary atherosclerosis. Later progressive LAE (4.37±0.22 cm, P0-60<0.05) in group 1, and aortic/LV dilatation (+0.4/+1.0 cm, respectively, both P0-60<0.05) in group 2 developed. In two years LVMM index increased by 13.4/17.5% in groups 1/2, respectively. Normal geometry and concentric remodeling completely disappeared in 3/1.5 years after PCIwS/CABG, respectively. CONCLUSION: Conclusions: Within the 1st year after revascularization, patients with CABG had more severe LVH. In 5 years after PCIwS the ratio between concentric/eccentric LVH was 2:1, whereas after CABG - 1:2.

Social media for research, education and practice in rheumatology.

Online social networking offers numerous opportunities for continuing medical education, professional development, and scholarly collaboration. Available social media channels proved useful for expanding education and research perspectives, particularly in rapidly developing academic disciplines such as rheumatology. Although there are numerous advantages of social media, busy clinicians should be aware of some drawbacks related to misinformation, unethical promotion, and unprofessional behavior in globally expanding platforms. Filtering credible and expert-proven information by skilled users is, therefore, increasingly important. Enforcing ethical norms and advancing professional etiquette in the field is strongly advisable. This article overviews the advantages and shortcomings of social media and reflects on available platforms for education and research in rheumatology.

Chronic heart failure course prognosis depending on body weight and endogenous intoxication syndrome.

OBJECTIVE: Introduction: Over the years, heart failure remains one of the most common and prognostically unfavorable conditions. The aim of our study was to determine the frequency of complications in patients with CHF depending on the body weight and intoxication syndrome of varying degrees of severity. PATIENTS AND METHODS: Materials and methods: A complete clinical examination was performed in 58 patients (41 (70.6%) men and 17 (29.4%) women) with CHF. In addition to the standard examination in accordance with the protocol, the level of endogenous intoxication was determined by the level of medium-weight molecules (MWM254) and leptin. The patients were randomized into 4 groups depending on their body mass index and the degree of endogenous intoxication. Statistical processing of the results was carried out using the methods of variation statistics "Statistica 6.0". RESULTS: Results: It was revealed that the worst survival rate is observed in patients with normal body mass against the background of the expressed endogenous intoxication syndrome, the best survival rate is observed provided that there are a normal body mass and endogenous intoxication of a minimum degree. An inverse correlation between the body mass index and the endogenous intoxication indicator (blood MWM) was detected. Patients with CHF should have their leptin level evaluated. An increase in its level was associated with arterial hypertension, an increase in blood glucose levels and lipid metabolism disorders. CONCLUSION: Conclusions: Increased level of blood MWM worsens the forecast of CHF. The unfavorable outcome was observed in patients with the combination of hypoleptinemia with severe endogenous intoxication.

Correlations between lipid metabolism indices in patients with hypertension and hypothyroidism.

OBJECTIVE: Introduction: Hypertension is a major reason behind morbidity, disability and mortality. Elevated blood pressure is a huge risk factor for cardio-vascular diseases. Almost 90% of hypertension patients have internal comorbidities, in particular hypothyroidism. For now, however, the specificities of the clinical course of hypertension in hypothyroid patients are understudied and the data on lipid metabolism in patients with primary hypothyroidism and hypertension are inconclusive. The study aims at establishing the effect of the lipid metabolism indices in hypertensive patients with hypothyroidism using correlation analysis. PATIENTS AND METHODS: Materials and methods: The total of 198 patients with stage 1 and stage 2 hypertension were examined. The patients were divided into two groups based on whether they have hypothyroidism or normal thyroid function. RESULTS: Results: The study revealed that in patients with hypertension and hypothyroidism, hypercholesterolemia is associated with hypocoagulation, hyperkalaemia, decreased bilirubin levels and adrenal cortex activation. Hyperbetalipoproteinemia is linked to the reduced thyroid gland, activation of the lymphocytic component of the inflammatory response, predisposition to hypocoagulation, probable unfavourable acute stress response and development of the eccentric hypertrophy of the left ventricle myocardium. Elevated triglycerides have an effect on the progression of arterial hypertension and are associated with diastolic dysfunction of the left ventricle and hepatic dysfunction. CONCLUSION: Conclusion: The combination of hypothyroidism and hypertension is an unfavourable factor in the development and progression of dyslipidaemia, which, in its turn, can cause blood coagulation disorders, adrenal glands activation, cardiac, renal and hepatic damage, and negative adaptive responses.