Coronary artery lesions in Takayasu arteritis.

Introduction: Takayasu arteritis (TAK) is a granulomatous inflammation of vessels of large diameter, mainly affecting the aorta and its proximal branches, which is more common in young women. The incidence of coronary artery disease in TAK is unknown and not sufficiently studied. Material and methods: A literature review was performed for the period 2003 to 2023 using a search of the PubMed and Scopus scientific databases. We used the following key words to search the academic journal databases: "Takayasu arteritis", "coronary angiography", "myocardial revascularization", "coronary artery disease", "angina pectoris", and "myocardial infarction". Results: The analysis of studies showed that coronary artery lesions (CAL) in TAK are not uncommon, being identified particularly in children and young individuals. Pathology of the coronary arteries increases the morbidity and mortality of TAK patients. In TAK, the ostia and proximal segments of the coronary arteries are more frequently affected, presenting as stenosis or occlusion with the development of stable coronary artery disease, unstable coronary artery disease, acute myocardial infarction, and sudden death. The diagnosis of TAK and coronary artery pathology is often complicated due to nonspecific manifestations and frequently the absence of symptoms. The treatment of patients with TAK with CAL is challenging and requires both pharmacological therapy and interventional or surgical methods of myocardial revascularization. Conclusions: Takayasu arteritis is a more prevalent cause of CAL development, especially in young patients, than previously believed, and cardiovascular death due to CAL is not rare. Early diagnosis of TAK with CAL, particularly occlusion or hemodynamically significant stenosis, and the prompt initiation of appropriate treatment prevent dangerous complications, reduce mortality, and improve prognosis.

Multi-purpose transport monitoring of passenger-cargo traffic in Ukraine.

BACKGROUND: The epidemiological and environmental security of states is the most important component for the functioning of the International Transport Corridors (ITC). The growing capacity of passenger and cargo flows increases the risk of the spread of dangerous infectious diseases in the territories of the countries on the route of the ITC. Preventing the introduction of dangerous infections by various vehicles and the activation of local natural foci are the priority in the anti-epidemic provision of the population of Ukraine. MATERIALS AND METHODS: The study of the features of the functioning of border checkpoints (BCPs) for various types of transport in different regions of Ukraine made it possible to create their classification, taking into account the nature of the goods and the intensity of passenger traffic. RESULTS: The functioning of 204 checkpoints in 20 different localities, employing more than 29,000 specialists, was studied. When conducting a retrospective epidemiological analysis of documentation for maritime, aviation, road and rail transport for 2000-2013, non-compliance with sanitary-hygienic and anti-epidemic requirements to prevent the introduction and spread of dangerous infections and their carriers were revealed. The authors scientifically substantiated recommendations on sanitary-hygienic and anti-epidemic support of the BСP. Based on the results of a survey of 112 BCPs (54.9 ± 1.2%), taking into account the degree of epidemiological danger in the areas of their operation, indicators of the presence of rodents, blood-sucking insects and the nature of the goods transported, five epidemic zones were identified. CONCLUSIONS: Inadequate operation of the BCP was expressed in non-compliance with sanitary and anti- -epidemic requirements. Control of the personal property of passengers and luggage was less than 30%. The analysis of the functioning of the BCPs made it possible to unify their work and identify priority areas for improvement.

Warfarin resistance: possibilities to solve this problem. A case report.

Effective prevention of thromboembolism is essential for patients with mechanical prosthetic heart valves. For this group of patients, vitamin K antagonists (VKAs) remain the drug group of choice despite the widespread use of new anticoagulants in other diseases. As a consequence, warfarin resistance remains a serious challenge for physicians. The current report describes a 65-year-old male patient that had a mechanical prosthetic aortic valve implanted due to severe aortic insufficiency after infective endocarditis. Despite consistent increases in his warfarin dose, the level of international normalized ratio (INR) remained very low. The patient was considered to have warfarin resistance. Warfarin was successfully replaced by another VKA, acenocoumarol, which resulted in a stable INR observed over 1 year of follow-up. Achieving the target INR in patients with mechanical prosthetic heart valves using VKAs is the main goal of thromboprophylaxis. Although the genetic changes that cause warfarin resistance are understood, the options to overcome these pharmacogenetic issues remain limited. Based on the success with this current patient, physicians with similar patients with warfarin resistance might wish to consider replacing warfarin with acenocoumarol.

Cardiovascular lesions in giant cell arteritis.

Introduction: Giant cell arteritis (GCA) is a systemic vasculitis that affects large vessels. Cardiovascular complications that develop with GCA have high morbidity and can be fatal. The aim of this work was to discuss epidemiology, clinical picture, etiopathology and risk of development of cardiovascular complications in GCA. Material and methods: A literature review was performed for 2002 to 2021 using PubMed and Medline scientific search databases. The following keywords were used to search academic journal databases: "giant cell arteritis", "heart attack", "cardiovascular system", "aortic aneurysm", "coronary heart disease", "aortic dissection", "myocardium" and "stroke". Articles written in languages, other than English, were excluded. Results: The analysis of studies showed an increased risk of an aneurysm, aortic dissection, coronary heart disease, cerebrovascular events, and peripheral artery disease in patients with GCA. This was not surprising as it has been shown that, cardiovascular complications worsens the prognosis in GCA. According to the results of observations and cited studies the most significant risk of cardiovascular complications was observed in the first year following the diagnosis of GCA. Conclusions: Patients with GCA have an increased risk of cardiovascular disease, but research data/findings are somewhat conflicting, and there is limited information/knowledge on how to treat the patients. Awareness of the risk of cardiovascular disease in GCA is essential, and monitoring these potentially fatal consequences is mandatory in patients with GCA. It is critical to be aware of the danger of cardiovascular illness in GCA patients and to keep track of these potentially deadly outcomes.

Cross-sectional Evaluation of the Sarcopenia Quality of Life (SarQoL) Questionnaire: Translation and Validation of its Psychometric Properties.

BACKGROUND: The SarQoL, a quality-of-life questionnaire specific to sarcopenia, was developed in 2015 and has since been translated into a number of other languages. The main reason to introduce this new Ukrainian version of the questionnaire was to measure sarcopenic individuals' perceptions regarding their positions in life in the context of their culture and value systems. METHODS: The questionnaire was translated using a forward-backward approach with a pre-test. A total of 49 participants were recruited for the validation study. Sarcopenia was diagnosed according to the Ishii test. The validation analyses included discriminative power, internal consistency, floor and ceiling effects, construct validity, and test-retest reliability. We compared the SarQoL questionnaire to the Short-Form 36 and the EuroQoL-5 Dimensions. RESULTS: A total of 28 participants out of 49 were categorized as probably sarcopenic. They had a significantly lower quality of life (overall score 58.43±17.13 vs. 69.89±13.31; p=0.014). The internal consistency was excellent (α=0.898), with none of the domains showing a disproportionate influence on the homogeneity of the questionnaire. Convergent construct validity was also confirmed. The results indicated a near-perfect degree of test-retest reliability. CONCLUSIONS: The first Ukrainian version of the questionnaire is equivalent to the available original English version.