S-AMLODIPINE AS A MODERN EFFECTIVE ANTIHYPERTENSIVE AND AN ANTIANGINAL AGENT.

OBJECTIVE: The aim: Study of the clinical and hemodynamic effects of S-amlodipine in patients with arterial hypertension associated with coronary artery disease, in individuals with preserved LV systolic function. PATIENTS AND METHODS: Materials and methods: The study includes 51 patients with arterial hypertension associated with coronary artery disease, who were treated with S-amlodipine. RESULTS: Results: This study shows the high clinical effectiveness of the use of S-amlodipine in patients with arterial hypertension associated with coronary artery disease. We reveal that treatment of hypertensive patients with coronary artery disease with S-amlodipine leads to improvement of LV diastolic dysfunction, bringing it closer to normal values. CONCLUSION: Conclusions: Clinical effectiveness was associated with positive changes in hemodynamics, and was expressed in the normalization of the left ventricle diastolic function parameters, about which indirectly indicates decreasing of end-diastolic pressure.

PREDICTING PROGRESSION TYPE 2 DIABETES MELLITUS: A 3-YEAR FOLLOW-UP STUDY EXAMINING RISK FACTORS FOR TYPE 2 DIABETES IN PATIENTS WITH PREDIABETES.

OBJECTIVE: Aim: To study the risk factors in patients with prediabetes that can lead to the progression of impaired glucose tolerance in the form of type 2 diabetes mellitus. PATIENTS AND METHODS: Materials and methods: The selection of patients for this study was carried out on an outpatient basis at the Department of Therapy and Family Medicine, Uzhhorod National University. Patients with prediabetes were identified based on the American Diabetes Association criteria. Informed consent was obtained from all patients before the start of the study. Patients were randomly assigned to one of two groups: Group 1 (n=37) that received typical treatment according to the recommendations of the American Diabetes Association and the control Group 2 (n=42). At the 3rd year of the study, we determined the body mass index, glucose levels and glycated hemoglobin levels of the patients, also their medical documentation was analyzed and patients were interviewed about concomitant diseases. RESULTS: Results: Analyzing the 3-year follow-up of patients with prediabetes, cases of type 2 diabetes mellitus were detected in both groups, but there is no statistically significant difference when comparing the indicators between the groups (p>0.05). CONCLUSION: Conclusions: In our study, we analyzed the risk factors in patients with prediabetes that can lead to type 2 diabetes. During a 3-year follow-up, we identified cases of type 2 diabetes mellitus.

EFFECT OF INTERMITTENT FASTING ON CARBOHYDRATE, LIPID AND ULTRASONOGRAPHIC PARAMETERS IN PATIENTS WITH NON-ALCOHOLIC FATTY LIVER DISEASE AND PREDIABETES.

OBJECTIVE: The aim: To study intermittent fasting (IF) treatment in patients with non-alcoholic fatty liver disease (NAFLD) and prediabetes. PATIENTS AND METHODS: Materials and methods: Patients with NAFLD (n=95) were examined. The patients were divided into 2 groups: Group 1 - NAFLD with obesity, Group 2 - NAFLD and prediabetes. All patients in both groups had Body mass index (BMI) within the 2nd degree of obesity range (30.0 kg/m2 to 34.5 kg/m2). RESULTS: Results: The effect of IF on anthropometric parameters, carbohydrate and lipid levels in patients with NAFLD with obesity and NAFLD with prediabetes, 6 and 12 months after treatment is shown. CONCLUSION: Conclusions: Intermittent fasting has a statistically significant effect on anthropometric parameters in NAFLD with obesity and NAFLD with prediabetes. Metformin administration after intermittent fasting in 12 months showed a statistically significant improvement in lipid and carbohydrate profiles.

ASSESSMENT OF COLON MICROBIOCENOSIS DISORDERS IN PATIENTS WITH CHRONIC HEPATITIS C.

OBJECTIVE: The aim: To investigate the peculiarities of colon microbiocenosis disorders in patients with chronic hepatitis C. PATIENTS AND METHODS: Materials and methods: 142 patients with CHC were under observation, determination of the degree of liver fibrosis (FibroMax), bacteriological examination of stools and pancreatic elastase was performed. RESULTS: Results: It was found that 59.2% of patients with CHC had gut dysbiosis (DB), of which 61.9% had increased body weight. Intestinal microbiocenosis disorders were manifested by constipation in 57.1% of patients, diarrhea in 31% of patients, and alternating constipation and diarrhea in 11.9% of patients. Bacteriologically, gut dysbiosis was character¬ized by suppression of the growth of normal microflora: Escherichia coli in 47.6%, bifidobacteria in 61.9%, lactobacilli in 53.6%, complete absence of bifidobacteria in 20.2% of cases. In patients with CHC combined with DB deep stages of liver fibrosis (F2-3 and F3-4) are registered 3.6 times more often compared to patients without intestinal dysbiosis (53.6% versus 24.1% and 11.9% versus 3.4%). The degree of gut DB increased in proportion to the stage of liver fibrosis (p<0.05). 32.1% of patients with CHC with dysbiosis were diagnosed with exocrine insufficiency of the pancreas. CONCLUSION: Conclusions: Gut dysbiosis occurs more often in CHC patients with increased body weight and is characterized by constipation in 59.2% of patients. Intestinal microbiocenosis is characterized by suppression of the growth of normal microflora. In 32.1% of CHC patients with intestinal dysbiosis, according to the results of the pancreatic elastase-1 test, pancreatic exocrine insufficiency of various degrees was found.

COVID-19 AND PRIMARY CARE: POSSIBILITIES FOR INCREASING POSITIVE OUTCOMES.

OBJECTIVE: The aim: Determine the most common non-communicable diseases which are associated with an increased rate of moderate and severe COVID-19 infection. Identify the best tools for diagnosing COVID-19 and predicting the deterioration of the disease. PATIENTS AND METHODS: Materials and methods: Publications were processed and analyzed according to the keywords of the topic of work "COVID-19", "non-communicable disease", "obesity", "hypertension", "Comorbidities", "frailty", "diabetes", "chronic obstructive pulmonary disease", "cardio-vascular diseases", "liver diseases", "diagnostic tools", "outcomes" in the databases of PubMed, MEDLINE, Web of Science. CONCLUSION: Conclusions: As a result of the analysis, we found that patients with concomitant obesity, diabetes mellitus, COPD, CVD and liver diseases have an increased the risk of severe forms and death from COVID-19.

ASSESSMENT OF CARDIOVASCULAR RISK IN PATIENTS WITH TYPE 2 DIABETES MELLITUS AND ASSOCIATED OBESITY AND WAYS OF ITS CORRECTION.

OBJECTIVE: The aim: To analyze and calculate CVR in patients with T2DM and concomitant obesity. PATIENTS AND METHODS: Materials and methods: The selection of patients was carried out based on the Uzhhorod District Clinical Hospital, in the period from November 2016 to January 2020. All patients were divided into 3 groups: 1 (n=93) with T2DM and concomitant obesity, 2 (n=87) with T2DM, 3 (n=39) with obesity. The treatment period lasted 1 year and included dosed exercise for at least 30 minutes per day and dietary recommendations. Patients in groups 1 and 2 received metformin 850 mg twice daily in combination with dapagliflozin 10 mg once daily. CVR was determined at the time of enrollment and after 1 year of treatment using: American College of Cardiology / American Heart Association Guideline on the Assessment of Cardiovascular Risk (2013) (ASCVD Risk) and Framingham Risk Score (FRS). RESULTS: Results: The data obtained as a result of the study revealed the highest CVR in patients of group 1, in contrast to group 2 and 3 (p<0.05). After 1 year of complex treatment, CVR indicators were statistically significantly reduced in all experimental groups (p<0.05). CONCLUSION: Conclusions: Determining CVR parameters and exposure to them within 10 years can remove unwanted cardiovascular complications.

NON-ALCOHOLIC FATTY LIVER DISEASE IN THE CONTEXT OF ALTERED GUT MICROBIOTA.

OBJECTIVE: The aim: To analyze the relationship between non-alcoholic fatty liver disease and changes in the gut microbiota. PATIENTS AND METHODS: Materials and methods: The publications of domestic and foreign editions in the databases of the United European Gastroenterology (UEG) Journal, PubMed, MEDLINE, Web of Science were processed and analyzed. CONCLUSION: Conclusions: In recent years, non-alcoholic fatty liver disease was placed among the important diseases in gastroenterology. During this time, more and more data appear on the link between changes in the human intestinal microbiome and the development of metabolic diseases, including NAFLD. Contemporary research has indeed found evidence of such a relationship. Thus, some strains of microorganisms have been identified in more detail, which directly or indirectly affect the development or course of the above-mentioned disease. For a better understanding of the strategies for the treatment of pathologies, it is necessary to delve into the study of etiological factors, therefore, NAFLC cannot be considered a pathology that has been sufficiently studied. Indeed, recent data indicate that the development and severity of the course of the disease are not always associated with the physiological processes already known to us.

Comparison of the effect of dapagliflozin on contrast to standard therapy of the patients with type 2 diabetes mellitus and concomitant obesity, their effect on laboratory and anthropometric parameters.

OBJECTIVE: The aim: Evaluate clinical and laboratory parameters of the patients with type 2 diabetes mellitus and concomitant obesity after a course of dapagliflozin treatment and compare with a standard treatment regimen. PATIENTS AND METHODS: Materials and methods: Conducted a comprehensive clinical laboratory examination and measurement of the anthropometric parameters of the patients with type 2 diabetes mellitus and concomitant obesity, with subsequent statistical calculations. RESULTS: Results: The data obtained at different stages of the study revealed a statistically significant effect of glucose treatment and glycosylated hemoglobin (HbA1c). Since the 6th month of dapagliflozin treatment, we have shown a tendency to lose weight compared to baseline in this group of patients and controls. CONCLUSION: Conclusions: Type 2 diabetes mellitus and obesity significantly increase the risk of developing a number of complications. Complex control and effects on clinical laboratory and anthropometric parameters can statistically significantly influence the development of the complications, and in this context, dapaglifloflozin showed statistically better results than standard metformin monotherapy.