Galectin-3 in Blood Serum and Lymphocytes as a Marker of Myocardial Damage in Patients with Arterial Hypertension and COVID-19.

BACKGROUND: The constant increase of arterial hypertension and the development of pathology at an earlier age are global healthcare problems that cause damage to vital organs and worsen patient prognosis. In recent years, studies have shown that galectin-3 plays a role in the development and progression of arterial hypertension and coronavirus disease (COVID-19). OBJECTIVE: The explanatory research study aimed to analyze the prognostic value of galectin-3 determination in the serum blood and lymphocytes of patients with arterial hypertension and coronavirus disease (COVID-19). METHODS: The patients were divided into two groups: Group 1 consisted of 36 individuals with AH, Group 2 included 35 patients with arterial hypertension and polysegmental COVID-19 pneumonia, and 16 practically healthy individuals were included in the control group. All patients underwent anthropometry, biochemical blood analysis, determination of galectin-3, level in serum and lymphocytes, IL-1ß, IL-6, and echocardiography. RESULTS: The highest level of galectin-3 was found in patients of Group 1, while in patients of Group 2, the concentration of galectin-3 was significantly decreased, mostly due to the treatment of COVID-19, in addition to prolonged antihypertensive therapy. CONCLUSION: The level of galectin-3 in serum and lymphocytes was significantly higher in patients of both groups compared to the control group (p<0.05). Arterial hypertension causes structural changes in the cardiovascular system that are associated with elevated levels of galectin-3 in serum and lymphocytes. It can be used as a marker of myocardial damage in the context of arterial hypertension and COVID-19.

13C-METHACETIN BREATHE TEST IN EARLY DIAGNOSTICS OF NON-ALCOHOLIC FATTY LIVER DISEASE.

OBJECTIVE: The aim: Of the study was to evaluate the early utility changes of the 13C methacetin breath test parameters in patients with NAFLD. PATIENTS AND METHODS: Materials and methods: There were included 50 subjects in the study, among them 35 patients had steatosis and 15 patients had steatohepatitis, including 35 (70.0%) male subjects and 15 (30.0%) female subjects. The control group included 17 apparently healthy volunteers, among them 10 (58.8%) subjects were male and 7 (41.2%) subjects were female. RESULTS: Results: It was determined that metabolism kinetics in case of liver steatosis was significant decreased more than 30% compared to the control group (p = 0.0001) and in case of steatohepatitis that decrease was more than 65% (p = 0.00001) compared with normal values. It resulted in less cumulative dose accumulation in steatosis (p = 0.00001) and steatohepatitis (p = 0.00001). Among the reasons for the decrease in the kinetics of metabolism in steatosis, there were insufficient response of hepatocytes on 10 minutes (<10 dose/h,%) in 40% of cases and reduction of metabolism rate amplitude at 20-40 minutes following methacetin administration. CONCLUSION: Conclusions: The results of 13C-methacetin breath test demonstrate that in patients with NAFLD there is a gradual slowing of metabolism rate in hepatocytes, which leads to a decrease in cumulative dose.

Changes of nitric oxide synthase and hydrogen sulfide in blood lymphocytes in the acute period of polytrauma

Introduction: Polytrauma patients have high risk of shock, septic complications and death during few years of follow-up. In recent years a lot of attention is paid to gaseous transmitters, among which are nitrogen oxide (NO) and hydrogen sulfide (H2S). It is known that the rise of NO and its metabolites levels occurs during the acute period of polytrauma. Nitric oxide and hydrogen sulfide are produced in different cell types, among which are lymphocytes. The aim: To investigate the levels of NO, NOS, iNOS, еNOS, H2S in lymphocytes lysate in patients at the moment of hospitalization and 24 hours after trauma. Materal and methods: We investigated the levels of NO, NO-synthase, inducible NO-synthase, endothelial NO-synthase, H2S in lymphocytes lysate in patients at the moment of hospitalization and 24 hours after trauma. Results: The study included 20 patients with polytrauma who were treated in the intensive care unit (ICU) of the Lviv Emergency Hospital. Tissue injury was associated with an increased production of NO, NOS, iNOS, еNOS during the acute period of polytrauma. At the same time, the level of H2S decreased by the end of the first day of traumatic injury. Conclusions: In acute period of polytrauma, significant increasing of iNOS and eNOS occurs with percentage prevalence of iNOS over eNOS on the background of H2S decreasing.

Influence of risk factors on insulin resistance in patients with overweight and obesity.

OBJECTIVE: Introduction: Obesity is a multifactorial, heterogenic disease, associated with an increased risk of morbidity and mortality due to cardiovascular diseases, diabetes, cancer, chronic liver and kidney diseases. Excessive body weight and obesity are serious medical and social problems, since their incidence is constantly increasing and has reached global epidemic proportions. The aim: Determining the influence of risk factors on insulin resistance level in patients with overweight and obesity. PATIENTS AND METHODS: Materials and methods: The study included 127 patients with overweight and obesity. Anthropometric measurement was performed for determination of the degree and type of obesity by WHO and IDF (2015) criteria. The levels of ALT, AST, uric acid, lipids, glucose, insulin, glycated hemoglobin in the blood were measured. HOMA-IR index was calculated and multiple regression method with inclusion of reliable signs was applied. RESULTS: Results: By multiple regression method, we identified four signs which, in combined action, affect HOMA-IR index: AST, triglycerides, insulin level and atorvastatin dose. Value of determination coefficient indicates that the level of insulin resistance in overweight and obese patients is by 37% explained by the factors included in regressive model. However, we did not investigate the influence of behavioral risk factors and burdened family history of type 2 diabetes mellitus, which significantly affect insulin resistance level. CONCLUSION: Conclusions: We assume that modification of lifestyle and individual approach to pharmacologic correction of dyslipidemia in overweight and obese patients help to avoid the development of insulin resistance, which is a predictor of type 2 diabetes mellitus.

Clinical aspects of gastropathy development in patients with chronic obstructive pulmonary disease.

OBJECTIVE: Introduction: Chronic obstructive pulmonary disease (COPD) is a one of the main reasons of disability and mortality in the world. The essential attention is dedicated to the combination of COPD and erosive/ulcer defects with the haemorrhage risk factor. The aim was to compare gastric acidity and mucoid secretion in patients with chronic obstructive pulmonary disease of gastropathy development. PATIENTS AND METHODS: Materials and methods: 94 patients with gastroduodenal erosive and ulcerous defects combined with COPD were examined. More than 50 % of patients (over 20 pack-years) had a long smoking history. Control group including 20 healthy voluntiers. RESULTS: Results: The mean age of patients was no difference in both groups. In regards to the severity of disease based on FEV1 30,9 % patients had mild obstruction and 69,1 % had moderate obstruction. Measurement of intragastric pH in patients with COPD and gastropathy showed the tendency of decreasing pH from 1,70±0,05 to 1,52±0,04 (р<0,05), while the pepsin level increased from 0,56±0,05 mg/ml to 0,86±0,07 mg/ml (р<0,01). At the same time the level of NANA decreased in cases of ulcerative defects (р<0,05). CONCLUSION: Conclusions: The COPD combination with gastropathy leads to appearance of numerous erosions and ulcers in gastroduodenal zone that can be the reason of bleeding development. Long-term cigarette smoke exposure and high level of H.pylori infectoin are the main cause of gastroduodenal erosive and ulcerative defects in this comorbidities. The presence of erosions and ulcers is accompanied by a significant increase of an acid-peptic factor and a decrease of defense factor.

Nitric oxide and hydrogen sulfide - markers of acute period of polytrauma.

OBJECTIVE: Introduction: Polytrauma or multiple organ damage is connected with shock and organ failure, which in severely injured patients and if untreated quick can lead to death.). The aim: To investigate levels of NO, NOx and H2S in patients with acute trauma period at the time of hospitalization and for 24 hours after trauma. PATIENTS AND METHODS: Materials and method: Etiology of trauma: traffic accident - 78 %, drop from the altitude - 5 %, everyday trauma - 17 %. Blood tests were performed during patient admission and 24 hours after admission. RESULTS: Results: Results of the study in patients with severe polytrauma showed increase of serum NO and its metabolites, but decrease of H2S. Suggest increase of NОx is connected with severity of trauma and can be as indicator of prognosis for severity of injury in polytrauma. So detection of NO and its metabolites and H2S can be use as early markers of detection for severity of polytrauma. CONCLUSION: Conclusions: Intensive care management in acute polytrauma period leads to increase of NO level and its metabolites on the background of H2S decrease. Detection of NO, NOx, H2S and valuation of its balance in acute period of polytrauma can serve as severity indicators and prognosis of these disease. In comparation to general clinical parameters, gasotrasmitters react on changes in homeostasis faster and more sensitive what allows to use them more widely as biomarkers of organ disfunction development in acute polytrauma period.