[INFLUENCE OF LIPID METABOLISM CONTROL ON THE TELOMERES RELATIVE LENGTH IN PATIENTS WITH ISOLATED HYPERTENSION AND IN COMBINATION WITH DIABETES MELLITUS TYPE 2].

Aim - to determine the influence of different levels of lipid metabolism on the relative blood leukocytes telomeres length (RLTL), relative buccal epithelium cells telomeres length (RBTL) in hypertensive (H) individuals with type 2 diabetes mellitus (DM2T) and without DM2T. In 60 patients with H stage II (group 1), and 96 patients with H and DM2T (group 2) lipid metabolism indexes (total cholesterol (TC), triglycerides (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C)), anthropometric parameters were measured. Relative telomeres length (RTL) was determined by a real time quantitative PCR. The most significant shortening of RLTL and RBTL were found in group 2. In both groups, the achievement of target blood lipid levels was accompanied by multidirectional changes in RTL. Analysis of variance revealed a significant effect of TC (p=0.036) on the RBTL, LDL -C (p=0.036) on the RBTL in group 1, and significant influence of TG (p = 0.049) on RBTL, TC (p=0.019) and HDL-C (p=0.032) on RLTL in group 2. Achieving target levels of lipid metabolism did not demonstrate the expected significant effect on the elongation of the relative length of telomeres, both with isolated hypertension and with a combined course of hypertension and DM2T.

CARDIOVASCULAR CHANGES IN HUMANBODY AFTER CHANGING POSITION SUPINE TO PRONE.

Prone position is known to be accompanied by several physiologic changes, but they are not described comprehensively in modern literature and sometimes controversial. Aim was to examine cardio-vascular changes in non-anesthetized humans after turning them into prone position and influence on these changes by age and body mass index. We performed an observational prospective study without control group of 200 (118 male and 82 female) patients 18-75 y.o. The patients were examined the day before elective lumbar spine surgery using thoracic electrical bioimpedance and non-invasive measurement of blood pressure in supine position (SP), 5 min and 20 min after turning into prone position (PP5 and PP20). Diastolic BP increased significantly after turning (PP5) and stayed increased during the time of investigation (PP20). Stroke volume index (SVI) decreased after turning into prone position (PP5 and PP20) by 18%. Systemic vascular resistance index (SVRI) increased by 34% (PP5). The duration of asynchronous contraction phase increased by 35% and the duration of all ejection phases decreased after changing the position from supine to prone. Rapid ejection reduced by 30%, reduced ejection - by 7%. We found the influence of age >60 y.o. on increasing of SVRI (p=0.006) and influence of age > 60 y.o. and BMI > 25 on decreasing of SVI (p=0.01 and p=0.04 respectively). In healthy non-anesthetized people turning from supine to prone position leads to decreasing of SVI by 18%, increasing of SVRI by 34% and increasing of diastolic blood pressure increased by 7%. Changes of SVRI are influenced by age and changes of SVI are influenced by age and BMI. Positioning prone are accompanied by shortening of both ejection periods and prolonging of asynchronous contraction period.

ECONOMIC EFFECTIVENESS OF DIFFERENT METHODS OF ANESTHESIA OF CURETTAGE OF UTERINE CAVITY.

Anesthesia of curettage of uterine cavity (CUC) at postoperative period causes additional expenses. Preventive intraoperative anesthesia makes it possible to reduce these expenses and provide significant positive economic effect on state budget. The objective of this research is determination of influence of different methods of anesthesia of CUC on cash value of anesthetic maintenance of CUC and the possibility of saving of budgetary funds. 128 women took part in the research. They underwent the procedure of CUC. Anesthetic maintenance was performed using different medicamental combinations and their dosages. Mathematical calculation of the cost of each CUC stage was done considering the cost of consumables, medical preparations and value of labor of medical staff. In the course of this research, it was proven that a combination of additional use of dexketoprofen (at the stage of premedication of CUC) and performing preventive intraoperative applicational anesthesia with bupivacaine solution can save 130 452,26UAH of wage fund per year and general budget savings within the confines of a state can each 9 954 617,67UAH per year.