Insulin receptor substrate-1 gene polymorphism and lipid panel data in type 2 diabetic patients with comorbid obesity and/or essential hypertension.

Objective. The hallmarks of type 2 diabetes mellitus (T2DM) are insulin resistance (IR) and insulin receptor substrate (IRS) proteins essential for the insulin signaling. IRS-1 gene has not only been shown to be associated with T2DM, but also has indicated that it may significantly correlate with diabetic complications, such as coronary heart disease and obesity. The aim of this study was to evaluate changes of the lipid panel data in T2DM patients with comorbid obesity and/or essential hypertension in connection with the IRS-1 (rs2943640) polymorphism. Methods. The study involved 33 T2DM patients and 10 healthy individuals. The IRS-1 (rs2943640) polymorphism was genotyped using a TaqMan real-time polymerase chain reaction method. Blood serum lipid panel data were determined with commercially available kits using a Cobas 6000 analyzer. Results. Analysis of the serum lipid panel data depending on the presence of the C/A alleles of IRS-1 (rs2943640) polymorphism in T2DM patients, regardless of the presence/absence of comorbidities, showed significantly lower level of high-density lipoprotein cholesterol (HDL-C) and significantly higher level of non-HDL-C in the carriers of C allele vs. carriers of A allele. In T2DM patients with comorbid obesity and essential hypertension, proatherogenic lipid changes were found in both C and A alleles carriers. Analysis of the effect of IRS-1 (rs2943640) genotypes on serum lipid panel data in T2DM patients, regardless of the presence/absence of comorbidities, showed that the CC genotype carriers had more pronounced pro-atherogenic changes vs. carriers of СА and АА genotypes. In the comorbid course of T2DM (both in combination with obesity and obesity and essential hypertension), pro-atherogenic changes were found in the carriers of the CA genotype of IRS-1 (rs2943640) polymorphism. Conclusions. The presence of the C allele of IRS-1 (rs2943640) polymorphism in both homo-zygous and heterozygous states indicates increased risk of pro-atherogenic changes in T2DM patients with comorbid obesity and/or essential hypertension.

Prediction factors for the risk of diffuse non-toxic goiter development in type 2 diabetic patients.

Type 2 diabetes mellitus (T2DM) patient outcomes, treatment options, and corresponding healthcare expenses are affected by the presence of different comorbidities. AIM: The aim of this work was to develop an algorithm for predicting the risk of diffuse non-toxic goitre development in patients with T2DM according to a mathematical model obtained by regression analysis, for the timely implementation of appropriate preventive measures among T2DM patients. MATERIALS AND METHODS: We analyzed 541 medical records of T2DM patients. RESULTS: It was found the following risk factors influencing the occurrence of diffuse non-toxic goitre in patients with T2DM: age, gender, body mass index (BMI), glycosylated hemoglobin (HbA1c), homeostasis model assessment for insulin resistance (HOMA-IR), thyroid stimulating hormone (TSH), free thyroxine (fT4). Prognostic model of the risk of diffuse non-toxic goitre development in T2DM patients was built using multiple regression analysis. In order to stratify the risk of diffuse nontoxic goitre development in T2DM patients, the following criteria were proposed: no risk at RCG ≤ 5.0; low risk at 5.1≤ RCG ≤12,9; high risk at RCG ≥13.0.; where RCG - risk coefficient for the diffuse non-toxic goiter development in T2DM patients. CONCLUSIONS: Therefore, the developed algorithm and mathematical model for predicting the development of diffuse non-toxic goitre in T2DM patients are highly informative and allow to determine in advance the contingent of patients with a high probability of diffuse non-toxic goitre risk based both on routine laboratory data, such as HbA1c, HOMA-IR, TSH, fT4 levels and such factors as age, gender, and BMI.

The Clinico-Epidemiological Profile of Patients with Gonorrhoea and Challenges in the Management of Neisseria gonorrhoeae Infection in an STI clinic, Ternopil, Ukraine (2013-2018).

Gonorrhea is the second most common sexually transmitted infection spreading worldwide and a serious public health problem. However, further data are required to improve the management of gonorrhea. Our aim was to review the features of gonococcal infection and characterize the challenges of its management. A retrospective descriptive study of the medical records of 136 adult patients with gonorrhea that visited Ternopil Regional Sexually Transmitted Infections Clinic (Ukraine) in 2013-2018 was performed. The male-to-female ratio was 6.6:1. Homosexually-acquired gonorrhoea was 3.7%. Also, most patients acquired gonorrhea in Ukraine (98.4%). The mean infectious period lasted 2-16 days, including the incubation period of 1-9 days and the period from the onset of symptoms to the first visit of the clinic of 1-7 days. The probability of N. gonorrhoeae transmission within the frame of the epidemiologic sexual chain was 1:2.4. Concurrent T. vaginalis (39.7%) and C. trachomatis (2.2%) were detected. HIV and syphilis screening rates were 1.6% and 0.7%, respectively. The examining rate of sexual partners was 11%, testing extragenital specimens - 0.7%, screening coverage for HIV - 46.3%, compliance with follow-up visits - 41.9%. Part of patients (16.2%) received monotherapy with clarithromycin, doxycycline, benzylpenicillin, azithromycin, or ofloxacin. The management of N. gonorrhoeae infections was compromised by a low rate of examining sexual partners, females and testing extragenital specimens, screening for HIV, compliance to follow-up visits, access to nucleic acid amplification tests, and receiving questionable or even obsolete antimicrobial treatment. Therefore, more accurate and comprehensive management of gonorrhea is urgently needed in Ukraine.

THE EFFECTS OF L-ORNITINE AND L-ARGININE ON THE PROCESSES OF LIPID PEROXIDATION IN THE FUNCTIONAL LAYERS OF KIDNEYS ON THE BACKGROUND OF ACUTE TOXIC HEPATITIS.

OBJECTIVE: The aim is to evaluate the effects of L-arginine and L-ornithine on the processes of lipid peroxidation in homogenates of renal cortex, renal medulla and renal papilla under conditions of acute toxic hepatitis. PATIENTS AND METHODS: Materials and methods: The study was performed on 40 outbred white male rats with experimental hepatitis, caused by carbon tetrachloride. The animals were divided into five groups: control group (the rats were simulated carbon tetrachloride poisoning and its correction by administering of olive oil and normal saline in equivalent doses), acute carbon tetrachloride hepatitis (single intraperitoneal injection of 50% carbon tetrachloride oil solution at the dose of 2 mlxkg-1 of body weight and simulation of treatment by administration of normal saline in equivalent doses), acute carbon tetrachloride hepatitis + L-ornithine (1000 mgxkg-1), acute carbon tetrachloride hepatitis + L-arginine (500 mgxkg-1) and acute carbon tetrachloride hepatitis + combination of substances. RESULTS: Results: On the background of acute carbon tetrachloride intoxication it was observed the development of renal failure in experimental animals, manifested by activation of lipid peroxidation processes in homogenates of renal cortex, renal medulla and renal papilla. The administration of L-ornithine and L-arginine demonstrates positive impact on renal function and hepato-renal syndrome by stabilization of cell membranes and regeneration of functional capacity of injured renal cells. CONCLUSION: Conclusions: The results of our study confirm both the presence of unidirectional effects and absence of toxic influences of L-ornithine and L-arginine on renal cells under the conditions of acute carbon tetrachloride intoxication, which are the most important requirements for modern drugs for the treatment of hepato-renal syndrome.