Changes in the periodontium against the background of systemic vascular reactions in young individuals with obesity.

BACKGROUND: Overweight and obesity are defined as abnormal or excessive fat accumulation that impairs health. The global prevalence of obesity has been increasing significantly among all age groups. Furthermore, obesity is a comorbid factor for numerous diseases, including cardiovascular and periodontal pathologies. OBJECTIVES: The present study aimed to investigate the influence of overweight and obesity on the periodontium of young adults in relation to the functional state of the cardiovascular system. MATERIAL AND METHODS: The oral health status of 132 males and females aged 18-22 years was examined. They were divided into 4 groups according to their body mass index (BMI): normal weight; overweight; class I obesity; and class II obesity. A periodontal chart, the records on oral hygiene and caries, and periodontal indices were provided for each participant. The main functional parameters of the cardiovascular system were measured before and after the dental examination. RESULTS: Overweight or obesity did not affect the intensity of caries in young adults. The prevalence and severity of gingivitis were significantly higher in obese individuals. A moderate correlation was found between gingivitis and BMI in patients with class I and II obesity. Disturbances in the cardiovascular system function and in the autonomic nervous system tone were also diagnosed in obese patients. An impaired vascular response and significant functional changes in the cardiovascular system developed against the background of obesity. These changes show the development of subcompensation in young adults with obesity. CONCLUSIONS: In obese individuals, significantly worse oral hygiene was observed as compared to normalBMI patients. Moreover, the clinical manifestation and intensity of gingivitis in obese individuals were high even in those with satisfactory oral hygiene. In young obese individuals, the periodontal disease manifested as gingivitis is due to significant adaptive and compensatory mechanisms.

The effect of body weight and psychological characteristics on periodontal disease development.

AIM: The aim of the study was to examine the association between periodontal health in young patients with various body mass indexes and psychological traits such as temperament, level of anxiety, and autonomic nervous system tone.

THE OVERWEIGHT AND OBESITY ROLE IN THE OCCURRENCE OF CHEMOTHERAPY-INDUCED HEPATOTOXIC REACTIONS IN PATIENTS WITH ACUTE MYELOID LEUKEMIA.

OBJECTIVE: The aim: To investigate the frequency of development and nature of cytostatic-induced hepatotoxic reactions in patients with acute myeloid leukemia (AML) with overweight and obesity during remission induction сhemotherapy (CT). PATIENTS AND METHODS: Materials and methods: We examined 25 patients with newly diagnosed acute leukemia (AL), of which 56% (14/25) were men, 44% (11/25) were women. Depending on the body mass index (BMI), patients were divided into groups: I (n=10) - patients with AML and BMI of 18.5-24.9 kg/m2; IІ (n=15) - patients with AML and BMI ≥25.0 kg/m2. The biochemical blood analysis was evaluated twice: before and on the 56th day of CT, which included alanine-, aspartate-aminotransferases, gamma-glutamyltranspeptidase (GGT), alkaline phosphatase (ALP), total protein and total bilirubin. RESULTS: Results: In patients with AML and normal BMI, CT conduction increased the risk of GGT (RR=3.00; 95% CI=1.14-7.91; p<0.05) and ALP activity impairment (RR=2.67; 95% CI=0.98-7.22; p>0.05). The presence of overweight and obesity in patients with AML of group II led to significant risk of increase the GGT (RR=3.00; 95% CI=1.46-6.14; p<0.05) and ALP activity (RR=4.00; 95% CI=1.41-11.35; p<0.05) during CT. GGT and ALP activity in the blood serum of group II patients after CT exceeded the baseline data in 2.4 times (p<0.0001) and 1.6 times (p=0.0007), respectively. CONCLUSION: Conclusions: The remission induction CT of AML is accompanied by the risk of cytostatic-induced liver injury. The presence of overweight, obesity and primary disorders of biochemical liver tests due to the oncohematological disease influence are the risk factors for hepatotoxic reactions development during CT.

THE EFFECT OF S-ADEMETIONINE ON PLASMA CITRULLINE LEVEL DURING CHEMOTHERAPY-INDUCED OXIDATIVE STRESS IN PATIENTS WITH CHRONIC LYMPHOPROLIFERATIVE DISORDERS.

OBJECTIVE: The aim: To investigate the effect of S-ademetionine on plasma citrulline level in patients with chronic lymphoproliferative disorders (CLPD) during chemotherapy-induced oxidative stress. PATIENTS AND METHODS: Materials and methods: 25 patients with CLPD were examined. Examinations were conducted twice: before chemotherapy (CT) and after 3 courses of CT. Several biochemical markers in the blood were determined: the activity of catalase, the level of plasma citrulline, the concentration of N-acetylneuraminic acid (NANA) and the concentration of substances that form a trimethine complex (TBARS) with 2-thiobarbituric acid. Patients were divided into groups: І (n=14) - patients who underwent only CT; ІІ (n=16) - patients who during CT received S-ademetionine, at a dose of 1000 mg/day intravenously for 10 days, then 500 mg twice a day for 20 days. ІІІ (n=20) -the control group of 20 practically healthy individuals. RESULTS: Results: Patients in both groups with CLPD had pre-existed mucosal injury that was characterized by 1.25 (p=0.0025) and 1.26 times (р=0.006) higher blood NANA concentration compared to the control group. The conduction of CT was associated with enterocytes dysfunction, which was characterized by 1,66 times (p=0,0002) lower plasma citrulline level in patients of group I compared to the initial examination. The infusion of S-ademetionine attenuated intestinal dysfunction that was associated with 1,23 times (p=0,0005) higher blood citrulline level after the CT as compared to group I. CONCLUSION: Conclusions: The infusion of S-ademetionine as adjuvant treatment in patients with CLPD provided effective prophylaxis of intestinal injury that was associated with higher blood citrulline level after the conduction of CT.

THE EFFECT OF DOXORUBICIN-INDUCED OXIDATIVE STRESS ON CITRULLINE CONCENTRATION IN THE SMALL INTESTINAL MUCOSA AND PLASMA BLOOD IN RATS WITH NON-ALCOHOLIC STEATOHEPATITIS.

OBJECTIVE: The aim: Is to investigate the effect of doxorubicin-induced oxidative stress on plasma citrulline and citrulline concentration in the small intestinal (SI) mucosa of rats with non-alcoholic steatohepatitis (NASH). PATIENTS AND METHODS: Materials and methods: The studies were carried out on 30 white non-linear adult rats, 15 (50%) males, 15 (50%) females, weighing 160-220 g. The rats were divided into three groups: І (n=10) - rats without NASH, received a standard diet, subsequently were injected with doxorubicin in cumulative dose of 15 mg/kg; ІI (n=10) - rats with NASH, received a high-calorie diet with doxorubicin injection similarly to group I; ІІІ (n=10) -control group, received a standard diet, were injected with placebo. In the SI mucosa, the levels of thiobarbituric acid reactive substances (TBARS), citrulline and catalase were determined. Also the level of plasma citrulline was analyzed. RESULTS: Results: Doxorubicin injection resulted in induction of oxidative stress in rats of group I and II, which was characterized by 2.1 (p=0.002) and 1.4 times (р=0.0059) increase in TBARS and in 3.4 (р=0.002), and 5.2 times (р=0.002) decrease in catalase activity respectively comparing with the control group. Simultaneously plasma citrulline level in group I and II was in 1.4 (р=0.0039) and 1,5 times (р=0.0039) respectively lower, compared to the control group. CONCLUSION: Conclusions: Doxorubicin-induced SI injury was associated with a significant decrease in plasma citrulline in rats regardless of NASH. The plasma citrulline could become an important marker in the assessment of the SI injury in clinical practice.

Arginine/citrulline cycle changes in diet-induced rat model of non-alcoholic fatty liver disease.

OBJECTIVE: The aim: to study the Arginine / Citrulline-cycle features on a diet-induced rat model of non-alcoholic fatty liver disease (NAFLD). PATIENTS AND METHODS: Materials and methods: The studies were carried out on 20 white non-linear adult rats, including 10 (50%) males, 10 (50%) females, weighing 160-220 g. NAFLD was modeled by a 9-week fast food diet. The level of arginine and citrulline, and the arginase activity were investigated in the animals' liver homogenates and in the blood. The morphological analysis of liver tissues changes was done. RESULTS: Results: NAFLD modeling using a 9-week fast food diet resulted in maximum weight gain in male rats (р<0.05). Female rats had 3 times more accumulation of intra-abdominal fat than male rats in the main group (р<0.05). Histopathologic liver examination confirmed NAFLD development in rats on a fast food diet during 9 weeks (р<0.05). NAFLD led to an increment of arginine level in the blood and liver homogenate in the main group compared to controls (р<0.05). NAFLD development was accompanied by a decrease in arginase activity and citrulline level in the blood and liver homogenate compared to control (р<0.05). CONCLUSION: Conclusions: The experimental rat model of NAFLD showed the Arginine / Citrulline cycle disorders, that were characterized by an increased arginine level, a decreased arginase activity and citrulline concentration in the blood and liver tissues.

Do H. Pylori status and small intestinal bacterial overgrowth determine the clinical course of chronic active gastritis in patients with type 2 diabetes mellitus?

OBJECTIVE: The aim: To define clinical peculiarities of chronic active gastritis in patients with type 2 diabetes mellitus (T2DM) considering Helicobacter pylori (HP) status and small intestinal bacterial overgrowth (SIBO). PATIENTS AND METHODS: Materials and methods: 172 patients with chronic active gastritis were enrolled in the study, 92 out of them had concomitant T2DM. Symptoms were collected with the questionnaire, HP infection was diagnosed with stool antigen test, SIBO was assessed with glucose hydrogen breath test. RESULTS: Results: 87.5% (n=70) patients with chronic gastritis without DM had epigastric pain, however those with T2DM reported pain only in 41.3% (n=38) cases. Other symptoms included: nausea, bloating, early satiety, postprandial fullness, heartburn, belching and vomiting. HP infection in patients with chronic gastritis and concomitant T2DM is significantly associated with symptoms of epigastric pain (OR=2.78, 95%CI 0.92-8.41), bloating (OR=3.92, 95%CI 1.40-10.99), nausea (OR=2.32, 95%CI 0.85-0.6.30), postprandial fullness (OR=1.45, 95%CI 0.54-3.87) and belching (OR=1.01, 95%CI 0.32-3.16), whereas SIBO - with bloating (OR=8.82, 95%CI 2.88-27.01), nausea (OR=5.15, 95%CI 1.88-14.10) and belching (OR=2.53, 95%CI 0.67-9.52). CONCLUSION: Conclusions: Patients with T2DM and chronic active gastritis report epigastric pain significantly less than non-diabetics. HP infection probably plays a prominent role in development of epigastric pain in patients with T2DM. Additionally, HP is linked to SIBO, which may lead to bloating, belching and nausea onset.

Planning of effective evaluation of the activities of hospital district at the example of poltava region.

OBJECTIVE: Introduction: Increasing of the availability and quality of health care in rural areas is one of the priority directions of public health and regional development policy. The need for reforming of the network of secondary health care facilities is due to the fact, that they are unable to meet the needs of the population in this specialized type of medical care in the conditions of the existing structure and funding system. The aim: to analyze the existing legislation regulating the establishment and operation of hospital districts; to determine the methodology for monitoring and evaluating of the activity of the hospital district on the example of the Poltava region. PATIENTS AND METHODS: Materials and methods: In this work a set of methods is used: system approach, bibliosemantic, legal, logical modeling. RESULTS: Review: A managerial tool capable of tracking the process and demonstrating the impact of projects, programs and development policies is monitoring and evaluation. The basis of evaluation is the creation of different indicators and indexes. The system of these indicators provides an opportunity to assess the social, medical, economic and environmental aspects of development of hospital district. The monitoring and evaluation program should include monitoring of implementation (contributions and activities) and monitoring of the results of work of the hospital districts (short-term and long-term). CONCLUSION: Conclusions: Hospital districts are created with the aim of optimizing of the organization and functioning of the network of health facilities. The Management Board's decision should be based on valid, reliable information on the development of the hospital district. Compliance with the monitoring and evaluation methodology makes it possible to provide the health care system with qualitative and timely data at all stages of its reformation.