[FUNCTIONAL PARAMETERS OF BLOOD CIRCULATION IN FIRST THREE MONTHS AFTER RADIOFREQUENCY ABLATION OF ATRIAL FIBRILLATION AND FLUTTER].

The purpose of the study was to evaluate functional parameters of blood circulation in first 3 months after radiofrequency ablation of atrial fibrillation and atrial flutter. The study included 113 patients aged 59.3±10.1 years, after radiofrequency ablation (RFA) with pulmonary veins isolation (PVI) for atrial fibrillation (AF), RFA of cava-tricuspid isthmus (CTI) for atrial flutter (AFl), or combined RFA PVI and CTI. Presence of arrhythmia recurrence episodes, blood pressure (BP) levels, electrocardiographic and echocardiographic indices were assessed before RFA, in acute postoperative period (3-5 days) and 3 months after RFA in the groups of AF, AFl, and AF/AFl combination. In acute postoperative period, arrhythmia recurrence of was most often recorded in the AF/AFl group, less often in groups of isolated AF and AFl, 3 months later - the frequency of recurrence decreased in all groups, but the largest remained in group of combined AF/AFl. In first 3 months after RFA of AF a decreased heart rate (HR), right atrium (RA) and ventricle (RV) size, an increased QTc interval duration and BP; after RFA of AFl - a decreased HR, end-diastolic volume (EDV) and RA; and after RFA of AF/AFl - a decreased ejection fraction (EF), an increased BP, QTc interval duration, and the end-systolic volume (EDV) were recorded. The results showed that effectiveness of RFA of isolated AF and AFl is higher than RFA of combined AF/AFl in the first 3 months after the procedure. Isolated AF and AFl after RFA were associated with BP and QTc interval duration increase, HR, EDV, RA and RV decrease; combined RFA of AF and AFl - with BP, QTc interval duration and ESV increase and left ventricular EF decrease.

[EFFECT OF VIOLATIONS OF CARBOHYDRATE METABOLISM ON THE LEVELS OF BIOMARKERS OF INFLAMMATION OF P-SELECTIN AND GALECTIN-3 IN PATIENTS WITH STABLE ANGINA].

The aim of the study was to study the effect of carbohydrate metabolism disturbances and other factors on the level of new biomarkers of P-selectin and Galectin-3 inflammation in patients with stable angina. The study included 119 patients with angina with or without diabetes mellitus, as well as patients with type 2 diabetes. Patients included in the study were tested in addition to standard methods to determine the levels of new biomarkers of inflammation of P-selectin, Galectin-3 and hs-CRP. The data obtained showed that the levels of P-selectin and Galectin-3 in patients with stable angina are interrelated, but vary significantly at the individual level, with both biomarkers of inflammation not associated with hs-CRP, which creates the prerequisites for the personalization of therapeutic goals in reducing the systemic inflammatory response. A higher level of P-selectin in a subgroup of patients with stable angina with concomitant diabetes mellitus was revealed in comparison with the subgroup of patients with DM without angina (119.9±30.1 and 79.3±38.2 ng/ml, p<0.05, respectively). P-selectin is linked at the level of glycosylated hemoglobin (correlation coefficient = 0.256, p=0.043) and disorders of carbohydrate metabolism. However, the presence of myocardial ischemia influences the activation of the platelet component of inflammation to a greater extent. Galectin-3 was also linked according to the correlation analysis with violations of carbohydrate metabolism. The levels of P-selectin and Galectin-3 in the plasma of patients with angina pectoris were influenced by sex, age of patients and age at which angina was first diagnosed. However, the greatest effect on P-selectin and Galectin-3 levels was exerted by the degree of coronary atherosclerosis and the severity of angina pectoris according to loading test data.

[RELATIONSHIP BETWEEN INFLAMMATIONAND HEART DYSSYNCHRONY IN PATIENTS WITH CHRONIC HEART FAILURE AND DIABETES MELLITUS TYPE 2].

The study involved 100 patients with chronic heart failure of ischemic origin II-III functional class (NYNA) and diabetes mellitus type 2. The concentration of serum markers of inflammation was determined by enzyme immunoassay. Сardiac dyssynchrony was detected echocardiographic and electrocardiographic methods. The study showed that the presence of cardiac dyssynchrony is accompanied by significant increase concentrations of inflammatory markers (CRP (p=2•10-9), TNF-α (p=4•10-6), IL-1ß (p=0,01596), IL-6 (р=2•10-6) in patients. Аlso revealed statistically significant direct correlations between levels: Ts and CRP (r=0,604; p<0,001) and Ts-SD (r=0,611; p<0,001); TNF-α and Ts (r=0,585; p<0,001) and Ts-SD (r=0,561; p<0,001); IL-1ß with the QRS (r=0,257; p<0,05), Ts (r=0,365; p<0,001), Ts-SD (r=0,350; p<0,001) and IVMD (r=0,272; p<0,05); IL-6 and Ts (r=0,744, p<0,001) and Ts-SD (r=0,744; p<0,001), which implies that the amplification of inflammation contributes to the further progression of myocardial dyssynchrony in patients with chronic heart failure of ischemic origin and type 2 diabetes.

[The effectiveness of empirical antibiotic therapy of pyelonephritis in patients with type 2 diabetes and without depending on the availability of plasmid-mediated resistance genes].

Multi-drug resistance has been increasing in the treatment of urinary tract infections, especially complicated. The prevalence of plasmid-mediated resistance genes among urinary pathogens has nether been studied in Ukraine. So, the aim of our study was to identify the plasmid-mediated resistance genes and to determine their impact on the efficacy of the treatment. A total of 105 adult patients with chronic pyelonephritis were included in the study. Among them, 32 patients were diagnosed with type 2 diabetes mellitus. The diagnosis of pyelonephritis was verified according to the criteria EAU, 2013. Plasmid-mediated resistance genes were determined by polymerase chain reaction (PCR). The prevalence of plasmid-mediated resistance mechanisms among patients with pyelonephritis were 44,4%. ESBLs was the most common isolated genes. Favorable clinical response was seen in 11/31 (35,5%) infected with ESBL-producing organisms compared with 59/74 (79,7%) patients with non-ESBL-producing organisms (p<0,05). In 16% of patients with resistance organisms antimicrobial agent was changed. Antibiotic efficiency was reduced in patients with complicated pyelonephritis due to presence of plasmid-mediated resistance genes. Therefore, prоpеr mаnagеment fоr prescriptiоn of аntibiоtics and also idеntificаtiоn of ESBL-prоducing bаcteria in cоmmunitiеs arе impоrtant fоr prevеntion.

[Prevalence of Types TEM, SHV and CTX-M ßLES Among Pathogens of Chronic Pyelonephritis].

There is lately observed an increase in the resistance of the main pathogens of urologic infection to ß-lactam antibiotics due to production of plasmid-induced ß-lactamases. The aim of the study was to reveal types TEM, SHV and CTX-M plasmid ß-lactamases among uropathogens. Out of 115 isolates, 30 (26.1%) strains produced ß-lactamases. Genes blaTEM and bla CTX-Mwere the most frequent. Most of the isolates were resistant to ampicillin (73.3%), ciprofloxacin (46.7%), levofloxacin (43.3%), gentamicin (40%). The ßLES-producing strains were susceptible to meropenem (96.7%), nitroxolin (83.3%), phosphomycin (70%), amikacin (70%). The presence of the resistance genes in the uropathogens was evident of a high rate of their distribution among them by the plasmids. Detection of the plasmid-induced ß-lactamases is important for the optimal choice of the antibiotic for empirical therapy.