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1
Talha, Mohamed, and Anas Abou El Kalam. "Big Data between Quality and Security: Dynamic Access Control for Collaborative Platforms." JUCS - Journal of Universal Computer Science 27, no. 12 (2021): 1300–1324. http://dx.doi.org/10.3897/jucs.77046.
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Big Data often refers to a set of technologies dedicated to deal with large volumes of data. Data Quality and Data Security are two essential aspects for any Big Data project. While Data Quality Management Systems are about putting in place a set of processes to assess and improve certain characteristics of data such as Accuracy, Consistency, Completeness, Timeliness, etc., Security Systems are designed to protect the Confidentiality, Integrity and Availability of data. In a Big Data environment, data quality processes can be blocked by data security mechanisms. Indeed, data is often collected from external sources that could impose their own security policies. In many research works, it has been recognized that merging and integrating access control policies are real challenges for Big Data projects. To address this issue, we suggest in this paper a framework to secure data collection in collaborative platforms. Our framework extends and combines two existing frameworks namely: PolyOrBAC and SLA- Framework. PolyOrBAC is a framework intended for the protection of collaborative environments. SLA-Framework, for its part, is an implementation of the WS-Agreement Specification, the standard for managing bilaterally negotiable SLAs (Service Level Agreements) in distributed systems; its integration into PolyOrBAC will automate the implementation and application of security rules. The resulting framework will then be incorporated into a data quality assessment system to create a secure and dynamic collaborative activity in the Big Data context.
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Talha, Mohamed, and El Kalam Anas Abou. "Big Data between Quality and Security: Dynamic Access Control for Collaborative Platforms." JUCS - Journal of Universal Computer Science 27, no. (12) (2021): 1300–1324. https://doi.org/10.3897/jucs.77046.
Full textAbstract:
Big Data often refers to a set of technologies dedicated to deal with large volumes of data. Data Quality and Data Security are two essential aspects for any Big Data project. While Data Quality Management Systems are about putting in place a set of processes to assess and improve certain characteristics of data such as Accuracy, Consistency, Completeness, Timeliness, etc., Security Systems are designed to protect the Confidentiality, Integrity and Availability of data. In a Big Data environment, data quality processes can be blocked by data security mechanisms. Indeed, data is often collected from external sources that could impose their own security policies. In many research works, it has been recognized that merging and integrating access control policies are real challenges for Big Data projects. To address this issue, we suggest in this paper a framework to secure data collection in collaborative platforms. Our framework extends and combines two existing frameworks namely: PolyOrBAC and SLA- Framework. PolyOrBAC is a framework intended for the protection of collaborative environments. SLA-Framework, for its part, is an implementation of the WS-Agreement Specification, the standard for managing bilaterally negotiable SLAs (Service Level Agreements) in distributed systems; its integration into PolyOrBAC will automate the implementation and application of security rules. The resulting framework will then be incorporated into a data quality assessment system to create a secure and dynamic collaborative activity in the Big Data context.
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Abou El Kalam, A., Y. Deswarte, A. Baïna, and M. Kaâniche. "PolyOrBAC: A security framework for Critical Infrastructures." International Journal of Critical Infrastructure Protection 2, no. 4 (2009): 154–69. http://dx.doi.org/10.1016/j.ijcip.2009.08.005.
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Iskrov, I. A., V. U. Pogorelov, and U. M. Ryshkevich. "THE EXPERIENCE OF USING THE LOW-FLOW METHODS OF HEMODIAFILTRATION IN TREATMENT PATIENTS WITH POLYORGAN INSUFFICIENCY SYNDROME OF ONCOHEMOTOLOGY PROFILE." Health and Ecology Issues, no. 1 (March 28, 2008): 64–67. http://dx.doi.org/10.51523/2708-6011.2008-5-1-13.
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Using of low-flow methods of substitute therapy in patients with polyorgan insufficiency syndrome allows to mix not only phenomenons of kidney insufficiency but and appearance of inflammatory response system.
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Kutovyi, O. B., V. O. Chaika, and D. O. Kysilevskyi. "Open-access and endoscopic methods of treatment of closed abdominal trauma on background of cranio-cerebral trauma of the middle degree of severity and severe." Klinicheskaia khirurgiia 85, no. 6 (2018): 47–50. http://dx.doi.org/10.26779/2522-1396.2018.06.47.
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Objective. To estimate the treatment efficacy of videolaparoscopy (VLS) in a closed abdominal trauma (CAT) on background of cerebral injury of middle and severe degree.
 Маterials and methods. The experience of treatment of 52 injured persons, suffering CAT on background of cranio-cerebral trauma (CCT) of the middle severity and severe, was analyzed. With the objective to compare the efficacy of various treatment methods for consequences of injuries of abdominal organs all the patients were divided into two Groups: Group I - the patients, in whom VLS interventions were applied, and Group II - the patients, in whom laparotomy was used.
 Results. There was established, that application of carboxyperitoneum in VLS did not influenced negatively a state of the patients’ consciousness (its step-by-step restoration, beginning from the first day were observed in both groups); reduced the level of polyorgan insufficiency, estimated in accordance to the polyorgan dysfunction scale, іntraabdominal hypertension and have promoted more rapid normalization of indices of the blood gas content.
 Conclusion. Application of videolaparoscopy permits effective delivering of help to the injured persons, suffering abdominal trauma, coexistent with the brain damage of the middle severity degree and severe, as well as lowering of lethality in 2.2 times.
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Sycheva, L. P., M. A. Kovalenko, S. M. Sheremeteva, A. D. Durnev, and V. S. Zhurkov. "Study of Mutagenic Activity of Dioxidine by the Polyorgan Micronuclear Method." Bulletin of Experimental Biology and Medicine 138, no. 2 (2004): 165–67. http://dx.doi.org/10.1023/b:bebm.0000048377.39895.99.
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Trefanenko, I. V., N. D. Pavliucovych, O. S. Voievidka, and T. B. Reva. "Pharmacological correction of antioxidant system disbalance in older patients with polyorgan pathology." Bukovinian Medical Herald 19, no. 3 (75) (2015): 188–91. http://dx.doi.org/10.24061/2413-0737.xix.3.75.2015.173.
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Zarubina, Irina Viktorovna. "Metabolic correction of polyorgan failure in the early stage of traumatic toxicosis." Reviews on Clinical Pharmacology and Drug Therapy 10, no. 4 (2012): 3–15. http://dx.doi.org/10.17816/rcf1043-15.
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The development of hepatorenal syndrome and endotoxicosis in severe compression trauma is revewed in the article. The main attention is paid to prevention of organ pathology in traumatic toxicosis by means of antihypoxic drugs. The perspectives of succinate-containing antihypoxants for the correction of functional and metabolic activity of the liver in traumatic toxicosis are observed.
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Lodyagin, A. N., B. V. Batotsyrenov, I. A. Shikalova, and I. A. Voznyuk. "Acidosis and toxic hemolysis – goals of pathogenetictreatment of polyorgan pathology in COVID-19." Bulletin of Restorative Medicine 97, no. 3 (2020): 25–30. http://dx.doi.org/10.38025/2078-1962-2020-97-3-25-30.
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The article presents analyzis of the data of the clinical course of Covid-19 and probable pathogenetic mechanisms of lesions, which are presented in foreign and domestic literature. The hypothesis about the hematotoxic effect of the SARS-CoV-2 virus is considered, which may cause its multi-system action. An analogy is made of the pathogenesis of multiple organ lesions in case of viral infection and in acute poisoning with hemolytic poisons and iron preparations, in which the development of metabolic acidosis, toxic hemolysis, and an increase in free hemoglobin and iron ions in the blood plasma are the central link. The article proposes to use a set of diagnostic measures aimed at confirming the hematotoxic component during SARS-CoV-2 infection and methods for assessing the severity of the condition, adopted in clinical toxicology.Taking into account the experience of treating acute poisoning with hemolytic poisons, attention is focused on the importance of using alkalizing therapy in order to remove the products of hemoglobin breakdown and prevent acute nephritic failure. When confirming the presence of a toxic factor, methods aimed at eliminating toxic products of hemolysis can be used – antidote therapy and methods of surgical detoxification. This complex of therapeutic measures in clinical toxicology is effective, aimed at the prevention of acute renal failure and toxic coagulopathy. The authors believe that the hypothesis of a hematotoxic factor in the pathogenesis of Covid-19 requires a targeted therapeutic strategy and targeted study.
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Gavrilov, I. V., and V. N. Meshchaninov. "Influence of the polyorgan pathology on the biological age of male and female patients." Advances in Gerontology 3, no. 1 (2013): 46–49. http://dx.doi.org/10.1134/s2079057013010062.
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Sycheva, L. P., S. A. Sharova, M. A. Kovalenko, S. M. Sheremet'eva, and V. S. Zhurkov. "Evaluation of Mutagenic Activity of Dioxazid by the Polyorgan Micronuclear Method in Experiments on Rats." Bulletin of Experimental Biology and Medicine 140, no. 5 (2005): 532–34. http://dx.doi.org/10.1007/s10517-006-0016-4.
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Polovyi, V. P., R. I. Sydorchuk, S. M. Vozniuk, and I. V. Shkvarkovskyi. "EFFICACY OF OPTIMIZED THERAPEUTIC REGIMEN IN CASE OF POLYORGAN DYSFUNCTION IN PATIENTS WITH PREVALENT FORMS OF PERITONITIS." Clinical anatomy and operative surgery 11, no. 1 (2012): 75–79. http://dx.doi.org/10.24061/1727-0847.11.1.2012.17.
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Zhanataev, A. K., E. A. Anisina, A. V. Kulakova, et al. "Polyorgan assessment of nuclear and mitochondrial DNA damage in streptozotocin-induced diabetes models in BALB/c mice." Bulletin of Experimental Biology and Medicine 174, no. 9 (2022): 337–42. http://dx.doi.org/10.47056/0365-9615-2022-174-9-337-342.
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Kornelyuk, R. A. "Organ protection and prevention of polyorgan insufficiency during high-risk percutaneous coronary intervention by using extracorporal membrane oxygenation." Complex Issues of Cardiovascular Diseases 10, no. 2 (2021): 27–31. http://dx.doi.org/10.17802/2306-1278-2021-10-2s-27-31.
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Aim. To compare the possibilities of venoarterial extracorporeal membrane oxygenation (VA ECMO) and intra-aortic balloon pump (IABP) to prevent organ damage and the development of multiple organ failure.Methods. According to the inclusion and exclusion criteria, 51 patients underwent the study. The patients were divided into 2 groups depending on the method of mechanical circulatory support used: VA ECMO (n = 29) and IABP (n = 22). To assess organ functions in the intra- and postoperative period, the results of instrumental and laboratory research methods, as well as data from complex scales of organ dysfunction, were analased.Results. Myocardial depression was observed in the IABP group in the intraoperative period of high-risk percutaneous coronary intervention and worse hemodynamic stability compared to the VA ECMO group was traced. Organ dysfunction and multiorgan failure developed more often in the IABP group, which was confirmed by laboratory specific markers.Conclusion. High-risk percutaneous coronary intervention with VA ECMO is accompanied by a lower incidence and severity of organ damage and multiple organ failure. Thus, the VA ECMO has better organ protective effects.
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Karol, I. V. "Surgical tactics in peritonitis, caused by complicated course of colorectal cancer." Klinicheskaia khirurgiia 89, no. 3-4 (2022): 59–62. http://dx.doi.org/10.26779/2522-1396.2022.3-4.59.
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Objective. To improve surgical tactics in peritonitis, caused by complicated course of colorectal cancer.
 Materials and methods. Through the 2017 - 2020 yrs period in Department of Surgery in Brovary Multidisciplinary Clinical Hospital 18 patients with colorectal cancer, complicated by peritonitis, were operated. Among them there were 14 (77.8%) men and 4 (22.2%) women, ageing in spectrum 42 – 83 yrs old. In 12 (66.7%) patients the cancer of Stage III was diagnosed, while in 6 (33.3%) – Stage ІV.
 Results. The right-sided hemicolectomy was performed in 22.2% of the patients, resection of transverse colon – in 3 (16.7%), a left-sided hemicolectomy – 1 (5.6%), Hartmann operation – 9 (50.0%), subtotal colectomy – 1 (5.6%). All the operations were performed without formation of primary anastomoses, and with stoma construction in proximal part of intestine. Reoperation were performed in 4 (22.2%) patients. There were 3 (16.7%) postoperative deaths – in patients with the cancer Stage IV, peritonitis in a terminal stage – due to development of the polyorgan insufficiency syndrome.
 Conclusion. Formation of primary interintestinal anastomoses while doing surgical intervention for colorectal cancer, complicated by peritonitis, is contraindicated because of high risk of the sutures insufficiency presence.
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Osadchuk, A. M., N. A. Fadeeva, and I. D. Loranskaya. "Tactics of managing a patient with fatty liver disease coursing in the background of a polyorgan digestive tract: clinical observation." Meditsinskiy sovet = Medical Council, no. 7 (May 14, 2022): 52–58. http://dx.doi.org/10.21518/2079-701x-2022-16-7-52-58.
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Preparations of glycyrrhizic acid (GA) and ursodeoxycholic acid (UDCA) are effective in the treatment of various forms of non-alcoholic fatty liver disease (NAFLD) and gastroesophageal reflux disease (GERD) occurring against the background of duodeno-gastroesophageal reflux. However, their effectiveness in the treatment of hologenic diarrhea and reflux gastritis has not been sufficiently studied. Currently, there are no clinical guidelines for the diagnosis and treatment of patients with hologenic diarrhea and reflux gastritis, including those with obesity and NAFLD. It is assumed that the combined administration of GA and UDCA can be accompanied by a mutual potentiation of the effect of the drugs. The article presents a clinical case of a patient with NAFLD, obesity, dyslipidemia, GERD, refractory to treatment with proton pump inhibitors, associated with duodenogastroesophageal reflux, reflux gastritis and hologenic diarrhea. It was shown that GERD, reflux gastritis, and hologenic diarrhea developed in the long-term period after cholecystectomy. At the same time, the appointment of a complex preparation containing GA (35 mg) and UDCA (250 mg) made it possible to stop the manifestations of a typical reflux syndrome in patients with a form of GERD refractory to proton pump inhibitors, reflux gastritis, and diarrheal syndrome associated with an excess of bile acids, improve lipid profile parameters. It has been shown that the administration of GA (35 mg) and UDCA (250 mg) can improve the parameters of the intestinal microbiome and lipid metabolism, which can be used in the treatment of patients with atherogenic dyslipidemia. At the same time, patients with comorbid pathology, including NAFLD, GERD, reflux esophagitis, hologenic diarrhea, and dyslipidemia require long-term maintenance therapy with GA (35 mg) and UDCA (250 mg).
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Dytiatkovskyi, V. O. "Genotype-associated clinical markers of atopic phenotype development in children." UKRAINIAN JOURNAL OF PERINATOLOGY AND PEDIATRICS, no. 1(93) (March 28, 2023): 45–50. http://dx.doi.org/10.15574/pp.2023.93.45.
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Atopic march (AM) occurs as the linear progression of atopic disorders (AtD) from atopic dermatitis (AD) phenotype to its combinations with other AtD: allergic rhinitis/rhinoconjunctivitis (AR/ARC) and bronchial asthma (BA). Thymic stromal lymphopoietin (TSLP) plays an important role in AtD pathogenesis. Single nucleotide variant (SNV) rs11466749 of the TSLP gene during the last decades showed the controversial roles of A/A, A/G and G/G genotypes in occurrence of the mono- and polyorgan AM phenotypes in children. Purpose - to determine the associations and risks of AM phenotypes with homozygous or heterozygous SNV rs11466749 genotypes of the TSLP gene in children. Materials and methods. The study involved 398 children aged 3 to 18 years old: 293 children in the main group and 105 - in the control group. Patients of the main group suffered from AtD in 6 different AM phenotypes: «AD», «AR\ARC», «BA», «AD+AR/ARC», «BA+AR/ARC», «AD+AR/ARC+BA»; patients of the control group suffered from gastrointestinal pathology. Patients of all cohorts were genotyped for genotype variants A/A, A/G and G/G rs11466749 TSLP by the polymerase chain reaction in real time. Pearson’ contingency coefficient (rb), Pearson test (ꭕ2), Fisher’s exact test, odds ratio (OR) with a 95% confidence interval (95% CI) were used for statistical processing of the obtained results. Results at p≤0.05 were considered statistically significant. Results. The homozygous A/A rs11466749 TSLP genotype was significantly most frequent in phenotypes with mono- or oligoorgan affection «AR/ARC» and polyorgan affection «BA+AR/ARC» and «AD+AR/ARC+BA»: 66,2%, 65.3% and 76.9% respectively (p<0.05). Heterozygous genotype A/G rs11466749 TSLP was the second most significant and frequent: «AR/ARC» - 31.0% (p<0.05), «BA+AR/ARC» - 31.9% (p=0.05-0.1) and «AD+AR/ARC+BA» - 11.5% (p<0.05). Genotype A/A rs11466749 TSLP was significantly associated and increased the development risks of the 3 specified AM phenotypes: «AR/ARC» - rb=0.156, OR=1.92 (95% CI: 1.03-3.58, p<0.05); «BA+AR/ARC» - rb=0.147, OR=1.84 (95% CI: 1.0-3.42, p<0.05); «AD+AR/ARC+BA» - rb=0.212, OR=3.27 (95% CI: 1.22-8.80, p<0.05). Genotype A/G rs11466749 TSLP was reliably associated and had a protective effect on the development of bespoke AM phenotypes: «AR/ARC» - rb=0.148, OR=0.53 (95% CI: 0.28-1.0, p<0.05); «BA+AR/ARC2 - rb=0.138, OR=0.55 (95% CI: 0.30-1.04, p=0.05-0.1); «AD+AR/ARC+BA» - rb=0.280, OR=0.15 (95% CI: 0.04-0.55, p<0.05). Conclusions. The homozygous genotype A/A SNV rs11466749 of TSLP gene significantly increases the risk of developing AM phenotypes «AR/ARC», «BA+AR/ARC» and «AD+AR/ARC+BA», and the heterozygous genotype A/G SNV rs11466749 of TSLP gene possesses a significantly protective effect on their development in children. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the author.
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Ahmed, Helal, Mahmud Chowdhury, and Lira Saha. "“Rehospitalization Prognostic Factors In Patients with Heart Failure”." International Journal of Medical Science and Clinical Invention 8, no. 10 (2021): 5676–82. http://dx.doi.org/10.18535/ijmsci/v8i10.01.
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Introduction: The prognosis of chronic heart failure (CHF) is determined by the complex relationship of neurohormonal, mechanical and polyorgan pathological changes emerging in the course and progression of the disease.
 Objective: To assess the risk and rate of rehospitalisation due to decompensation of chronic heart failure (CHF) in relation to certain biologic, clinical and instrumental characteristics.
 Material and Methods: This study conducted in the Department of Cardiology, Community Based Medical College & Hospital, Bangladesh. Prospective study on 228 consecutive CHF patients. The follow-up period was 12 to 24 months. The primary endpoint was rehospitalization due to HF decompensation. The risk values were calculated using the Cox regression models. 
 Results: Median survival time was 8 months. The total number of rehospitalizations was 86 (37.7%). Rehospitalization risk values were insignificantly lower in women (HR 0.7, 95% CI 0.4-1.1, р >0.05) and higher in older age groups (HR 1.4 95% CI 0.8-2.2, р>0.05). Univariate regression analysis showed a higher rehospitalization risk in patients with survived myocardial infarction, clinical signs of CHF, high functional class and pulmonary pressure. Multivariate regression analyses revealed the leading role of functional class on rehospitalization risk. 
 Conclusion: rehospitalization rates due to decompensation of CHF are high. Age and gender are insignificant predictors for rehospitalization in our study. Functional class is the prognostic factor with an independent effect on rehospitalization risk over the defined follow-up period among the examined group of patients.
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Aliiev, R. B., A. S. Shapovalova, and S. I. Abuwatfa. "Contemporary Concepts of the Role of Pro-inflammatory Cytokines in COVID-19-Induced Pneumonia in the Context of Metabolic Disorders (Review)." Tuberculosis, Lung Diseases, HIV Infection, no. 3 (September 17, 2024): 85–91. http://dx.doi.org/10.30978/tb2024-3-86.
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Objective — to analyse and summarise literary sources regarding contemporary concepts of the significance of pro-inflammatory cytokines in pneumonia caused by COVID-19 amidst metabolic disorders. Materials and methods. An analytical and bibliosemantic approach was utilised in the study. Google Scholar and PubMed databases were employed for the search using keywords such as «pro-inflammatory cytokines», «COVID-19», «pneumonia», «insulin resistance», «type 2 diabetes mellitus» and «metabolic disorders». Results and discussion. Diabetes mellitus and hyperglycemia are among the major comorbidities in patients with COVID-19, leading to unfavorable outcomes. Diabetes is a chronic condition affecting millions worldwide. By 2030, it is projected to become a leading cause of non-communicable mortality. Hyperglycemia in COVID-19, irrespective of insulin resistance or a history of diabetes, heralds an unfavorable prognosis. Patients with type 2 diabetes mellitus exhibit elevated inflammation levels associated with obesity, insulin resistance and comorbidities such as hypertension, obesity, cardiovascular diseases and dyslipidemia. Chronic inflammation with enhanced inflammatory response to infection and viral load escalation leads to a potent systemic immune response — the «cytokine storm», closely associated with increased severity of COVID-19. There is increasing evidence that COVID-19-induced respiratory failure may be attributed to defective immune response characterised by rapid proliferation and hyperactivation of T cells, macrophages, natural killer cells and hyperproduction of chemical mediators, including pro-inflammatory cytokines, leading to increased vascular permeability and multiorgan failure. Conclusions. In our view, COVID-19 induces polyorgan distress, creating an imbalance between cellular and cytokine immune systems, resulting in hyperinflammatory cytokine storm affecting systemic homeostasis. The presence of COVID-19 in patients with diabetes mellitus, who already have immune dysregulation, exacerbates their overall condition.
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Baychorov, Enver Khuseynovich, Nikolay Sergeyevich Gandzha, Shamil Rashidovich Salpagarov, and Shakhban Ibragimovich Guseynov. "CHANGES IN THE DYNAMICS OF THE FUNCTIONAL ACTIVITY OF BLOOD GRANULOCYTES IN PATIENTS WITH PANCREATIC NECROSIS." Journal of Experimental and Clinical Surgery 13, no. 1 (2020): 18–23. http://dx.doi.org/10.18499/2070-478x-2020-13-1-18-23.
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The purpose of research. Predicting risk of infection of acute destructive pancreatitis.
 Material and Methods. The dynamics of functional activity of granulocytes in 27 (58,7%) patients with sterile and 19 (41,3%) patients with infected pancreatic necrosis. An objective assessment of the severity of their condition carried out by performed using of the scale of the integrated assessment APPACHE-II. The exclusion criterion from the study was the revealing of accompanying acute and chronic diseases.
 Results.Scale APPACHE-II can be used mainly for screening assessment of the degree of polyorgan insufficiency, as well as predicting the development of infected pancreatic necrosis forms, but, unfortunately, only in the later stages of development of pathological process. Dynamics of changes in the functional activity of leukocytes in patients with pancreatic necrosis can be used as an additional test, which characterizes the moment of transition of sterile pancreatic necrosis to infected, and, consequently, in deciding on the timing of terms and nature of performance of operational allowance.
 Conclusions. 1. In patients with sterile pancreatic necrosis (SPN) after a moderate decrease in the activity of myeloperoxidase (MPO), the content of the cation proteins (CP) in the first three days in subsequent periods of observation, on the background of complex conservative therapy, noted, compared with the established "Normal" gradual increase or stabilization at close to the indicators of the functional activity of neutrophils. The activity of KF and alkaline phosphatase from patients with SPN, after the increase in performance in the first 11 days, then gradually declines, reaching the normal level. 2. Patients with infected pancreatic necrosis(IPN) sharply, starting with 11 days of the study, by 35-40%, reduce the activity of MPO and the content of CB and Acid Phosphatase activity and Alkaline Phosphatase, on the contrary, it had progressively pronounced growth after 11 days by 35-40%.
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Yakubtsevich, R. E., D. N. Rakashevich, A. A. Balla, I. N. Neuhen, P. P. Pratasevich, and К. М. Dorokhin. "A CLINICAL CASE OF A SEVERE COVID-19 INFECTION WITH POLYORGAN DYSFUNCTION IN A PATIENT WITH STAGE 5 CHRONIC KIDNEY DISEASE IN THE BACKGROUND OF A FUNCTIONING RENAL TRANSPLANT." Journal of the Grodno State Medical University 19, no. 6 (2021): 961–65. http://dx.doi.org/10.25298/2221-8785-2021-19-6-691-695.
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Abstract. In most cases, COVID-19 is asymptomatic or mild and not life-threatening, but there is a category of patients for whom the infection poses a serious threat – organ transplant recipients. The severity of the disease in such patients is due to the need for immunosuppressive therapy, due to the high risk of developing infectious complications due to prolonged immunosuppression and a pronounced comorbid background. In the given clinical case, the experience of diagnosis and successful treatment of a patient with COVID-19 infection is presented complicated by multiple organ dysfunction and, as a consequence, renal transplant dysfunction in a 36-year-old patient with stage 5 chronic kidney disease who was hospitalized at the Grodno University Hospital.
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Timoshenko, O. P., O. S. Snopenko, D. V. Kibkalo, M. I. Korenev, and Yu V. Maslak. "Diagnostic value of "cuticular index" measuring in dogs with liver and kidney pathology." Veterinary science, technologies of animal husbandry and nature management, no. 8 (2021): 78–84. http://dx.doi.org/10.31890/vttp.2021.08.11.
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Сondition of hair reflects changes in metabolism in animals and humans in relatively long period of time. Thus, the study of hair of domestic dogs with different variants of pathology, in particular nephropathy and polyorgan pathology of liver and kidney is relevant and appropriate in terms of differential diagnosis and establishment of little-known links in the pathogenesis of diseases of these organs. The aim of this study was to establish the diagnostic meaning of «cuticular index» of sick dogs. The object of the study was 60 dogs with confirmed diagnoses. The animals were examined by general clinical methods (temperature, pulse, and respiratory rate were determined) and blood was taken from the jugular vein for biochemical research. Hair samples were obtained and the «cuticular index» was determined. Examination of the cuticle was performed using prints on a colorless varnish, which was applied to a glass slide, pressing the hair to the varnish layer. Then, when the varnish hardened, the hair was removed by the edge from the peripheral end. The impression was studied under a microscope (in. x 400) and set the value of «cuticular index» in the root zone, in the thickest part of the hair shaft, expressed in μm2. Based on the results obtained during clinical and laboratory studies, we have formed groups of sick dogs, which became the basis for studying the dynamics of the «cuticular index» (CI). It was found that in different variants of nephropathy and in the development of hepatic-renal and renal-hepatic syndromes in dogs, significant structural changes occur in the liver and kidney, which correspond to violations of metabolic processes determined by the results of clinical microscopic and biochemical blood tests, as well as changes in the area of the outer surface of the cells of hair cuticle, which we have defined as the «cuticular index». The method of determining the «cuticular index» can be used in differential diagnosis of kidney and liver pathology in combination with clinical, instrumental and laboratory studies, as well as for dispensary examination of animals. The article provides examples of various variants of pathology with the definition of «cuticular index»
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Kukina, I. V., O. P. Zelya, and L. S. Karan. "LABORATORY DIAGNOSTIC OF HUMAN BABESIOSIS." Russian Clinical Laboratory Diagnostics 64, no. 9 (2019): 560–64. http://dx.doi.org/10.18821/0869-2084-2019-64-9-560-564.
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Human babesiosis caused by parasitic protozoan Babesia spp. is sporadic zoonotic vector-borne infection. The course of babesiosis and prognosis depend on the type of pathogen and on the patient’s immunological status. Significance this disease is a severe, often fatal course with immunocompromissed patients resembling complicated falciparum malaria. In Europe to date, more than 50 cases of confirmed human babesiosis have been reported in most cases caused by Babesia divergens. Possible there are unrecognized cases. Pathogen is an obligate intraerythrocyte parasite of vertebrate animals. The organism is transmitted from animal to man through bite of Ixodidae tick. Asexual reproduction of the parasite occurs in a vertebrate host. The pathogenesis of babesiosis is caused by the destruction of host cells. Intensive haemolysis of red blood cells leads to the development of haemolytic anemia, haematuria, jaundice, and polyorgan failure may develop. The clinical manifestations of the disease are nonspecific. Detection of intraerythrocyte parasites in blood smears stained Gimsa-Romanovsky confirms the proposed diagnosis. Blood smears and some laboratory signs from fatal cases were analyzed in the Reference-centre of E. I. Martsinovskiĭ Institute. Original microphotographs B. divergens are shown. The main morphological forms of the parasite are shown. In addition to the well-known tetrades of parasites «Maltese Cross», for the first time, the parasites dividing into 6 interconnected trophozoites - “sextet” - were found. Originally, the invasion of Babesia in a normoblast is shown. An unusually high multiple invasion (14 parasites) of erythrocytes is noted. Because the patients, initially, were incorrectly diagnosed with malaria, the differential diagnosis of Babesia with Plasmodium is described step-by-step. It is important, since the treatment with antimalarial drugs is ineffective. Deviation laboratory signs are discussed. Complex morphological characteristics allowed us to speciated the parasites as B. divergens. DNA was detected in the sample with specific primers Bab di hsp70F/Bab di hsp70R and the probe Bab di hsp70P. The sequence demonstrated 99-100% and 98% similarity to the 18S rRNA gene fragment of B. divergence and Babesia venatorum, respectively. Molecular biological and serological methods of laboratory diagnosis of babesiosis are considered.
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Agayev, R. M., A. A. Mamadov, F. S. Idrisov, E. A. Iskandarov, and E. A. Aliyeva. "The changes of parameters of the systemic inflammatory answer syndrome on early stages of complicated acute pancreatitis." Klinicheskaia khirurgiia 88, no. 9-10 (2021): 11–15. http://dx.doi.org/10.26779/2522-1396.2021.9-10.11.
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Objective. To determine a prognostic validity of parameters of the systemic inflammatory answer syndrome for early diagnosis of an acute pancreatitis severity and prognostication of the pathological processes exacerbation.
 Materials and methods. The treatment results in 71 patients, suffering an acute pancreatitis, were analyzed. An acute pancreatitis in a light form was diagnosed in 39 patients (Group I), and in a severe one-in 32 patients (GroupII). In the patients while hospitalization and in consequent two days an absolute quantity of leucocytes, relative quantity of immature granulocytes and value of neutrophil-lymphocytic ratio, concentration of C-reactive protein were investigated. ROC-curve was applied while doing calculation of the «cut-off» point for neutrophil-lymphocytic ratio and studied a three-week survival, using Kaplan-Meyer method.
 Results. In the Group II patients the leucocytes quantity was trustworthily more - (15.4 ± 2.3) × 109/l, than in patients of Group I - (12.7 ± 1.2) × 109/l. Relative quantity of neutrophils and immature granulocytes was high in Group II, but absolute quantity of lymphocytes in these patients was lower, than in the patients of Group I. In accordance to the neutrophil-lymphocytic ratio in the admittance day the Group II differed from Group I statistically significant - 12.6 ± 1.4 and 9.78 ± 1.3 accordingly. In Group I during consequent two days this marker have lowered, аnd in Group II demonstrated further raising (p < 0.05). Optimal point of «cut-off» for neutrophil-lymphocytic ratio was determined as 10.5. The three-week survival of patients with the neutrophil-lymphocytic ratio value 10.5 has constituted 95,9%. In the values of neutrophil-lymphocytic ratio more than 10.5 a survival have lowered down to 79.2%,and mortality have been raised up to 21/8%. Relative quantity of immature granulocytes in Group I have constituted (0.39 ± 0.21)%, and in Group II - (1.7 ± 0.51)%. Doing analysis of square under the ROC-curve the threshold meaning for immature granulocytes was determined as 0.81%. In the admittance day the Groups did not differ for index of C-reactive protein. But, on the second day the C-reactive protein concentration have been enhanced by 55.3% in Group II and was significantly higher, than in Group I. Multifactorial analysis have shown, that diabetes mellitus constitutes independent predictor of risk for the septic complications occurrence. Negative impact of hepatic adipose dystrophy on occurrence and progress of polyorgan insufficiency in patients with pancreonecrosis were revealed as well.
 Conclusion.There was proved, that studying of values of neutrophil-lymphocytic ratio permits to prognosticate the survival indices in patients, suffering an acute pancreatitis of early stage. The level of C-reactive protein on the second day after admittance takes effect of prognostic significance and must be applied as a marker for the further clinical signs prognostication. In controversial cases theneutrophil-lymphocyticratioand relative quantity of immature granulocytes helps to determine the prognosis. Using simple analysis of peripheral blood it is possible to prognosticate theclinical signs of an acute pancreatitis on early stages of the disease. Theparameters of the systemic inflammatory answer syndrome owe important significance in determination of the pathological changes severity.
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Мазаник, А. В., Н. Ю. Блахов, О. А. Чуманевич, К. Л. Банщикова, Д. И. Пацай, and А. П. Трухан. "Early Surgical Treatment of Severe Acute Pancreatitis of Biliary Etiology." Хирургия. Восточная Европа 12, no. 4 (2023): 417–31. http://dx.doi.org/10.34883/pi.2023.12.4.032.
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Введение. Оптимальные сроки лапароскопической холецистэктомии при тяжелом остром панкреатите билиарной этиологии на сегодняшний день не определены. Цель. Обосновать клиническую целесообразность активной хирургической тактики в лечении тяжелого острого панкреатита билиарной этиологии, безопасность и эффективность ранней лапароскопической холецистэктомии при данной патологии. Материалы и методы. Представлены результаты лечения 66 пациентов с тяжелым (APACHE II ≥8 баллов) острым панкреатитом билиарной этиологии в период с 1 января 2012 г. по 31 декабря 2021 г. В период до 2017 г. начальное лечение проводили в объеме многокомпонентной интенсивной терапии с выполнением инвазивных вмешательств по показаниям (группа сравнения № 1 – 20 пациентов). С 2017 г. в качестве этапа комплексного лечения применяли лапароскопическую холецистэктомию с дренированием холедоха по Холстеду (основная группа № 1 – 46 пациентов). В 17 случаях (группа сравнения № 2) операцию выполняли в период текущей госпитализации после купирования острого воспалительного процесса и нормализации функционального состояния пациента (отсроченная лапароскопическая холецистэктомия), в 27 случаях (основная группа № 2) операцию выполняли в сроки не позднее 72 ч. от начала заболевания (ранняя лапароскопическая холецистэктомия). Результаты. Включение в комплексное лечение тяжелого острого панкреатита билиарной этиологии ранней (не позднее 72 ч. от начала заболевания) лапароскопической холецистэктомии с дренированием холедоха по Холстеду способствовало более благоприятному течению заболевания за счет существенного уменьшения частоты развития системных и местных осложнений (и их сочетаний) (p=0,006), стойкой органной/полиорганной недостаточности (p=0,042) и нуждаемости в инвазивных пособиях (p=0,008), что привело к значимому сокращению продолжительности госпитализации в отделении анестезиологии и реанимации (p=0,038), общей продолжительности госпитализации среди выписанных пациентов (p=0,040), уровня летальности (p=0,003) и частоты развития рецидивов острого панкреатита билиарной этиологии (p<0,001). Выполнение ранней и отсроченной лапароскопической холецистэктомии с дренированием холедоха по Холстеду по основным операционным характеристикам (частота интра- и послеоперационных осложнений, конверсии в открытую холецистэктомию, продолжительность операции, нуждаемость в послеоперационной эндоскопической папиллосфинктеротомии) значимо не различаются. Заключение. Эффективность комплексного лечения острого панкреатита билиарной этиологии с выполнением ранней (не позднее 72 ч. от начала заболевания) лапароскопической холецистэктомии с дренированием холедоха по Холстеду (96,3%) значимо (p=0,046) превосходит аналогичный показатель при консервативном ведении этой категории пациентов (43,6%), что обосновывает клиническую целесообразность активной хирургической тактики в лечении тяжелого острого панкреатита билиарной этиологии. Выполнение лапароскопической холецистэктомии с дренированием холедоха по Холстеду в ранние сроки тяжелого острого панкреатита билиарной этиологии (не позднее 72 ч. от начала заболевания) не приводит к увеличению сложности операции и послеоперационного ведения пациентов, что свидетельствует о ее безопасности. Introduction. The optimal terms of laparoscopic cholecystectomy in severe acute pancreatitis of biliary etiology have not been determined to date. Purpose. To substantiate clinical expediency of active surgical tactics in treatment of severe acute pancreatitis of biliary etiology, safety and effectiveness of early laparoscopic cholecystectomy in this pathology. Materials and methods. The results of treatment of 66 patients with severe (APACHE II ≥8 points) acute pancreatitis of biliary etiology in the period from January 1, 2012 to December 31, 2021 are presented. In the period up to 2017, the initial treatment was performed in the scope of multicomponent intensive therapy with invasive interventions when indicated (comparison group № 1 – 20 patients). Since 2017, laparoscopic cholecystectomy with Halstead choledochal drainage was used as a stage of complex treatment (main group № 1 – 46 patients). In 17 cases (comparison group № 2) the operation was performed during the current hospitalization after resolution of the acute inflammatory process and normalization of the patient’s functional state (delayed laparoscopic cholecystectomy), in 27 cases (main group № 2) the operation was performed within 72 hours from the onset of the disease (early laparoscopic cholecystectomy). Results. Inclusion of early (not later than 72 hours from the beginning of the disease) laparoscopic cholecystectomy with Halstead choledochal drainage into the complex treatment of severe acute pancreatitis of biliary etiology promoted more favorable course of the disease due to the significant decrease in the frequency of systemic and local complications (and their combinations) (p=0.006), persistent organ/polyorgan failure (p=0.042) and the need for invasive interventions (p=0.008), which led to a significant reduction in the duration of hospitalization in the anesthesiology and intensive care unit (p=0.038), the total duration of hospitalization among discharged patients (p=0.040), mortality rate (p=0.003) and frequency of recurrence of acute pancreatitis of biliary etiology (p<0.001). Early and delayed laparoscopic cholecystectomy with Halsted choledochal drainage according to the main operational characteristics (incidence of intra- and postoperative complications, conversion to open cholecystectomy, duration of operation, need for postoperative endoscopic papillosphincterotomy) are not significantly different. Conclusion. The efficacy of complex treatment of acute pancreatitis of biliary etiology with early (not later than 72 hours from the onset of the disease) laparoscopic cholecystectomy with Halstead choledochal drainage (96.3%) is significantly (p=0.046) exceeds the similar index at conservative management of this category of patients (43.6%) that substantiates clinical expediency of active surgical tactics in treatment of severe acute pancreatitis of biliary etiology. Laparoscopic cholecystectomy with Halstead choledochal drainage in early terms of severe acute pancreatitis of biliary etiology (not later than 72 hours from the onset of the disease) does not lead to an increase in the complexity of the operation and postoperative management of patients, which indicates to its safety.
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Hodovanets, Y., and A. Frunza. "PREDICTIVE FACTORS AND CLINICAL AND PARACLINICAL FEATURES OF URINARY TRACT DYSFUNCTION IN PRETERM INFANTS." Neonatology, surgery and perinatal medicine 8, no. 4(50) (2023): 40–48. http://dx.doi.org/10.24061/2413-4260.xiii.4.50.2023.5.
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Acute kidney injury is a multifactorial clinical pathological syndrome that falls within the critical conditions of the early neonatal period and independently associates with high rates of morbidity and mortality. The frequency of acute kidney injury in critically ill preterm infants varies signifi cantly, ranging from 25 % to 77 % according to diff erent studies. Numerous scientifi c investigations describe an inversely proportional correlation between gestational age and birth weight. Of particular importance in terms of pathophysiology is the understanding of the concept of ‘functional acute kidney injury,’ clinically characterized by a reduction in glomerular fi ltration rate in the absence of markers of tubular damage. Consequently, it represents potentially reversible changes in renal function, sensitive to both the duration and depth of the alterations, which precede the development of injury.Aim of the study: To conduct an analysis of clinical characteristics, risk factors, and results of paraclinical examinationsin preterm infants with gestational ages of 25-31 and 32-33 weeks, who exhibited signs of severe functional disturbances in the urinary system during the early neonatal period as part of complex perinatal pathology.Materials and Methods: A comprehensive clinical and paraclinical examination was conducted on 93 preterm infants with severe perinatal pathology. Group I comprised 30 infants with gestational ages of 25-31 weeks, while Group II consisted of 32 infants with gestational ages of 32-33 weeks. Group III included 31 conditionally healthy preterm infants with gestational ages of 34-36 weeks. Verifi cation of the diagnosis of renal dysfunction was performed according to the recommended international classifi cation ‘Kidney Disease: Improving Global Outcomes’ with the modifi cation by J. G. Jetton and D. J. Askenazi (2015). The degree of severity of polyorgan defi ciency in perinatal pathology in newborns was assessed using the Neonatal Multiple Organ Dysfunction Score. The eff ectiveness of therapeutic interventions was evaluated using the Neonatal Therapeutic Intervention Scoring scale. The severity of the newborns’ condition during observation was assessed using the Score for Neonatal Acute Physiology scale. The research was conducted in accordance with the fundamental principles of Good Clinical Practice (GCP, 1996), the Council of Europe Convention on Human Rights and Biomedicine (April 4, 1997), the Helsinki Declaration of the World Medical Association on Ethical Principles for Medical Research Involving Human Subjects (1964-2008), as well as the Ministry of Health of Ukraine Order No. 690 dated September 23, 2009 (amended by the Ministry of Health of Ukraine Order No. 523 dated July 12, 2012).Statistical analysis of the obtained research results was performed using the software packages «Statistica 10» (StatSoft Inc.,USA, 2010) and MedCalc Software (Version 16.1), with calculations including the odds ratio excess coeffi cient (Chi-squared),odds ratio (OR), and 95 % confi dence interval (CI). Statistically signifi cant diff erences between groups were considered ata signifi cance level of p < 0.005. The dissertation work was conducted within the scientifi c focus of the Department of Pediatrics, Neonatology, and Perinatal Medicine at Bukovinian State Medical University. The research themes included: a research project on ‘Improvement of Prognostic, Diagnostic, and Therapeutic Approaches to Perinatal Pathology in Newborns and Infants, Optimization of Followup and Rehabilitation Schemes’ (State registration number 0115U002768, duration from 01.2015 to 12.2019); and a research project on ‘Chronobiological and Adaptive Aspects, as well as Features of Vegetative Regulation in Pathological Conditions in Children of Diff erent Age Groups’ (State registration number 0122U002245, duration from 01.2020 to 12.2024). Research Results: The obtained results demonstrated statistically signifi cant associations between the severity of perinatal pathology in preterm infants and the depth of dysfunction in the urinary system, as well as a complex set of factors complicating the course of pregnancy and childbirth in mothers, thereby infl uencing the postnatal adaptation of the child. Among the reasons for complicated pregnancies, notable factors included anemia, cardiovascular and urinary system pathology, TORCH infections, isthmocervical insuffi ciency, disturbances in fetal- placental blood fl ow, the threat of spontaneous abortion, and premature labor. Anomalies such as abnormal fetal presentation, fetal distress, premature rupture of membranes, and urgent cesarean section were more likely tooccur in women in this group. The course of perinatal pathology in newborns with gestational ages less than 33 weeks at birth was predominantly severe, with some children diagnosed with multiple organ dysfunction syndrome, one manifestation of which was acute kidney injury. Changes in the indicators of general and biochemical blood analysis in newborns refl ected low compensatory reserves of the neonatal organism in the context of experienced hypoxia and morpho- functional immaturity associated with premature birth.Conclusions: The formation of renal dysfunction in preterm infants in the early neonatal period has a complex polyetiological nature associated with a set of adverse factors during pregnancy and childbirth in mothers. Critically ill newborns represent a primary and challenging pediatric cohort in which this pathological syndrome is linked to high neonatal mortality rates and the development of functional and chronic pathology of the urinary system in later years, justifying the need for in-depth scientifi c research to consolidate perspectives on providing medical care to preterm infants.
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Ivashchuk, L. Yu, and I. B. Pizhitsky. "CHARACTERISTIC FEATURES OF MULTIPLE ORGAN FAILURE IN CASES OF PERITONEAL SEPSIS." International Journal of Medicine and Medical Research, no. 2 (December 29, 2017). http://dx.doi.org/10.11603/ijmmr.2413-6077.2017.2.7917.
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Background. The study of hystomorphology of liver and small intestine in experimental peritonitis is presented. Due to this information the criterion of pathogenetic moment transition SIRS for peritoneal sepsis was determined.Objective. The aim of the research was to study the morphology of terminal part of small intestine and liver in cases of experimental peritonitis.Methods. For histological and electron microscope study the biopsy of liver, small intestine were taken; the samples were stabilized in a neutral formalin, dried in alcohol of increasing concentration and placed in paraffin. Paraffin sections were painted with hematoxylin and eosin and studied under the light-optical microscope.Results. Apoptosis caused damage to enterocytes and hepatocytes of first bacterial translocation. Mechanism of vasodilatation effect of NO and its effect on apoptosis were determined. Septic shock was accompaniment of two main levels of body cells damage: apoptosis and membranes destruction. Peritoneal sepsis is a grave condition caused by progressive peritonitis and polyorgan insufficiency syndrome. The phases of peritonealis sepsis pathogenesis were defined.Conclusions. The presented morphological criteria prove the initiation of apoptosis within 24 hours after the development of peritonitis in enterocytes and hepatocytes.
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Bogacheva, T. E., O. A. Gromova, I. Yu Torshin, et al. "Study of the effect of human placenta hydrolysate in a new model of metabolic-associated fatty liver disease with iron overload." FARMAKOEKONOMIKA. Modern Pharmacoeconomics and Pharmacoepidemiology, December 20, 2024. https://doi.org/10.17749/2070-4909/farmakoekonomika.2024.274.
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Background. The combination of metabolic-associated fatty liver disease (МAFLD) with iron overload occurs in approximately 1/3 of patients and is extremely difficult to treat. In addition to the fact that no specific treatments have been developed for this МAFLD form, there are also few experimental models on which such agents could be tested.Objective: to create a model of MAFLD and to study the effectiveness of using human placenta hydrolyzate (HPH) in experiment.Material and methods. In experiment, the rats were divided into three groups: Group 1 on a normal diet and drinking water, in Groups 2 and 3, a model of liver iron overload was reproduced by intraperitoneal administration of iron sulfate for 12 days under conditions of adding saturated fats (palm oil) and fructose to the diet. On the Day 13 of the study, blood was collected from animals in Groups 1 and 2 for biochemical testing and autopsy material (liver, kidneys, brain, heart) for histopathological examination. In Group 3, rats were administered standardized HPH in a therapeutic dose intramuscularly for 4 weeks. On Day 41, blood and autopsy material were collected. The model was used to test the effectiveness of using standardized HPH and to characterize complex changes in biomarkers of liver function, kidney function, hematopoiesis, inflammation, and thrombus formation that occur during the model reproduction.Results. HPH injections were shown to be an effective treatment for iron overload МAFLD. Specifically, after reproducing the model on Day 41, levels of ferritin (intact: 201±45 μg/l; model: 254±12 μg/l; p<0.0001), aspartate aminotransferase (AST) (intact: 114.9±27.3 U/l; model: 301,3±30,3 U/l; р<0.000001), alanine aminotransferase (ALT) (intact: 22.8±3.2 U/l; model: 58.7±5.5 U/l; p<0.00014), leukocytes (intact: 4.6±1.3×109 cells/l; model: 6.9±0.8×109 cells/l; p<0.01), platelets (intact: 509.7±121.6×109 cells/l; model: 820.2±50.5×109 cells/l; p<0.01) increased reliably. Total protein levels (intact: 46.2±2 4.6 g/l; model: 45.5±5.8 g/l; p=0.002), serum creatinine (intact: 35.7±1.2 μmol/l; model: 23.3±1.4 μmol/l; p<0.00001) and glomerular filtration rate (GFR) (intact: 169±5 ml/min/1.73 m2; model: 154.1±7.1 ml/min/1.73 m2; p=0.04) decreased. HPH administration resulted in normalization of the listed indicators of polyorgan pathology on Day 41: reliable reduction of ferritin (141±24 μg/l; p<0.001), AST (166.7±51.3 U/l; p=0.00±77), ALT (36,4±7,2 U/L; p=0.00001), leukocytes (4.5±2.7×109 cells/l; p=0.039), platelets (639.0±92.3×109 cells/l; p=0.00157) and reliable elevation of total protein (55,9±3,8 g/l; p=0.0014), normalization of creatinine (27.7±1.5 μmol/l; p=0.0002), and GFR (169.8±6.2 ml/min/1.73 m2; p=0.0011). Histological analysis revealed that HPH promoted hepatic iron excretion while preventing renal, brain, and myocardial damage in the proposed iron-overload model of МAFLD.Conclusion. The administration of standardized HPH is effective and safe in the therapy of experimental iron overload МAFLD and prevents polyorgan pathology.
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Panati, Dinesh, Yethiraju Madarapu, Bharathi Sibbala, Swetha Puthalapattu, and Sujana Devi Gandla. "The cross-sectional study of assessment of cognitive status in patients with poor glycemic control and good glycemic control of diabetes mellitus." Archives of Mental Health, February 7, 2025. https://doi.org/10.4103/amh.amh_220_24.
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Abstract Context: Microvascular and macrovascular complications of diabetes are well-known but the cognitive dysfunction is least known which can show major impact on the quality of life of diabetic patients. Aims: This study aims to assess the cognitive status among type 2 diabetes mellitus patients. Methodology: This is a cross-sectional study conducted from November 2023 to July 2024 after obtaining ethical committee approval. The sample of the study comprised of 90 persons, 30 persons were controls, 30 cases with good glycemic control, and 30 cases with poor glycemic control based on glycosylated hemoglobin (HbA1c) done within 3 months of the study. The Mini-Mental State Examination (MMSE), Trail Making Test-A (TMT-A), and Brief Cognitive Rating Scale (BCRS) were used to assess the cognitive impairment. Results: The prevalence of cognitive impairment among type 2 diabetes mellitus patients was 50%, 53.3%, and 56.6% according to TMT-A, BCRS, and MMSE, respectively. All the assessment methods have shown a significant difference in levels of cognition among diabetic cases than controls, and the impairment is more in cases with poor glycemic index. The cognitive decline was found to have a significant association with duration of illness (P < 0.0001), HbA1c (P < 0.0001), and number of medications (P < 0.0001) used by the diabetic patients. Conclusions: This study concludes that half of the proportion of diabetic patients are having impairment in various cognitive domains. Global functioning and self-care of the diabetic patients are affected more than the persons without diabetes. Hence, type 2 diabetes mellitus patients with HbA1c > 7, increased duration of illness, and polyoral hypoglycemic medication need to be screened for cognitive impairment.
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Narzullaev, Sh.Sh. "OPTIMIZATION OF SURGICAL TREATMENT TACTICS ACUTE GANGRENO-NECROTIC PARAPROCTITIS." October 12, 2023. https://doi.org/10.5281/zenodo.8436612.
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<strong>Abstract</strong>: The article presents the results of treatment of 242 patients who underwent surgery in the multidisciplinary clinic of Samarkand State Medical University in 2015-2022, among them 23 (9.5%) patients were infected with the necrotic form of the disease. Acute paroproctitis of aerobic etiology was observed in 219 (90.5%) patients. The average age of the patients was 63.1±4.9. All patients underwent clinical examination, rectal examination, rectomanoscopy, transabdominal and transrectal ultrasound examination, computed tomography, and bacteriological examination of wound secretions. All patients underwent urgent surgical operations. The results of the examination showed that timely radical surgery, antibacterial and detoxification therapy led to the recovery of the patients.