2024, volume 20

Objective: to assess the presence of cardiometabolic risk factors in women who have suffered arterial or venous thrombosis at a young age. Material and methods. The type of study is a "cross-section" based on a prospective observational study. The main group included 49 women aged 18-44 who had undergone instrumental^ verified arterial or venous thrombosis at least 1 year ago. The median follow-up was 80.3 months [50.1; 96.2] months. The control group included 24 practically healthy female volunteers in the same age range. All patients underwent a comprehensive laboratory examination, bioimpedance measurement and oscillographic sphygmography Results. Women with a history of thrombosis had higher levels of LDL cholesterol (3.4±0.8 vs 2.6±0.6 mmol/L); lipoprotein (a) (90.6±7.4 vs56.9±6.5 mg/dl) and adiponectin (10.4±4.3 vs 8.2±3.6 mcg/ml); lower levels of cholesterol HDL(1.5±0.4 vs 1.8±0.4 mmol/l) (0.049>p>0.001). The incidence of visceral obesity in this group was 76.2% vs 37.5% in the control group (p<0.001). The total number of cardiovascular risk factors in these patients averaged 2.7±0.1 vs 1.4±0.2 in the control group (p=0.0001). In the main group, an increase in the cardio-ankle vascular index was revealed 6.85±0.95 vs 6.20±0.51 (p=0.044) in women without thrombosis. Only in the group with thrombosis patients have a decrease in LPK0.9 and an increase in the CAVI index>8 (18,5 vs 0% in the control; p=0.025). Conclusion. Young women with a history of thrombosis are characterized by a more burdened profile of cardiometabolic risk factors, a higher incidence of visceral obesity and increased vascular wall stiffness compared with women without thrombosis of the same age group.

Objective: clinical characteristics of patients with carbohydrate metabolism disorders (CDM) in the post-COVID period. Material and methods. 72 people with CDM in the post-COVID period were examined. Results. When detailing complaints, the incidence of respiratory symptoms in patients with impaired glucose tolerance (IGT) and diabetes mellitus (DM) was comparable. In both groups, nonspecific (general weakness) and neurological (memory deterioration, sleep disturbances, decreased vital activity) symptoms predominated. The development of NUD in the post-COVID period was facilitated by such risk factors as age >45 years, body mass index >25 kg/m2, family history of type 2 diabetes, hypertension. The most common concomitant diseases were overweight and obesity — in 64 (88.9%) patients, dyslipidemia — in 44 (61.1%), hypertension — in 32 (44.4%). In the group of patients with IGT, the frequency of re-infection with SARS-CoV-2 was higher compared to the group of patients with diabetes, and there was a tendency for the course to become more severe with re-infection. Conclusion. In the post-COVID period, patients with IGT and diabetes are more likely to have nonspecific and neurological complaints, while identified NDEs can aggravate the course of concomitant diseases and lead to re-infection with SARS-CoV-2.

Objective: to determine the potential prognostic value of serum biomarkers in relation to the development of adverse cardiovascular events in patients who have undergone COVID-19. Material and methods. The prospective study involved 114 patients hospitalized with confirmed COVID-19. In addition to standard examinations, blood samples were taken from patients on the day of hospitalization to determine the level of serum cardiovascular biomarkers, including pentaxin-3 (РТХЗ). The patients were monitored for 366 [365; 380] days after discharge from the COVID hospital with registration of major adverse cardiovascular events (MACE) developed in patients. Results. During follow-up, MACE was noted in 19 patients (16.7%), including 2 deaths (1.8%) from cardiovascular causes. The incidence of MACE was higher in patients with higher concentrations of РТХЗ (odds ratio — OR 1.28, 95% confidence interval — Cl 1.13-1.45; p<0,001), interleukin 6 (OR 1.01, 95% Cl 1.0-1.02; p=0.048), D-dimer (OR 2.05, 95% Cl 1.16-3.6; p=0.019), lactate dehydrogenase (OR 1.08, 95% Cl 1.03-1.13; p<0.001), creatine phosphokinase-MB (OR 1.19, 95% Cl 1.02-1.39; p=0.001). The concentration of PTX3>3.1 ng/ml predicted the development of MACE with a sensitivity of 94.0% and a specificity of 82.1% (AUC 0.885; p<0.001). Conclusion. Serum biomarkers, in particular РТХЗ, may be used to predict the development of MACE in the long-term follow-up of patients who have undergone COVID-19.

Lumbar fractures are an urgent medical problem. They are often feature the compression of dural sac and roots followed by neurological deficit. This case study presents the anterior approach surgery as the method of choice for the management of multiple fractures with damage to the A and В columns ensuring optimal decompression of the spinal canal and deformity correction and avoiding multi-stage interventions.

Objective: comparative qualitative expert assessment of the condition of the patient's fundus in severe and advanced stages of proliferative diabetic retinopathy (PDR). Material and methods. An assessment was made of the developed qualitative criteria for the condition of the fundus in patients with the following stages of PDR: severe-high risk 1 (SHRPDR-1, 32 eyes), severe-high risk 2 (SHRPDR-2, 32 eyes) and advanced (APDR, 34 eyes). The developed criteria (preretinal hemorrhage, fibrosis of the posterior hyaloid membrane, vitreous hemorrhage, etc.) were assessed by one ophthalmic surgeon on a point scale: 1 point — initial changes; 2 — weak, but more pronounced (compared to 1 point) changes; 3 — severity of moderate changes; 4 — pronounced changes. Results. The greatest increase in the average score in the group of patients with APDR (compared with SHRPDR-1 and SHRPDR-2) was established according to the following criteria: fibrovascular tissue in the area of the optic nerve head and along the vascular arcades (2 times), fibrosis of the posterior hyaloid membrane (1.5 times), vitreous hemorrhage (1.4 times); for other criteria, the increase in average score varies from 28 to 93%. At the same time, there is only a tendency for the criteria to worsen between SHRPDR-1 and SHRPDR-2 (p>0.05). Conclusion. A significant deterioration of all criteria was established in patients with APDR compared with SHRPDR-1 and SHRPDR-2.

Objective: to assess the level of markers of antioxidant protection in women with infertility of unknown origin in comparison with women who gave birth to at least one living child. Material and methods. A comparative cohort retrospective study was conducted, which included 52 women with infertility of unknown origin and 85 women who do not suffer from infertility. In the course of the work, standard biochemical parameters, antioxidant and peroxidase activity were studied. Results. In women with infertility of unknown origin, the total antioxidant activity is more pronounced (2.21±0.312 and 1.97±0.312 ng/ml; p<0.001), however, a low level of peroxidase activity was found (11.6±3.96 and 13.4±6.67%; p<0.001). Conclusion. In our study, it was found that in women with infertility of unknown origin, the level of total antioxidant capacity of serum is higher than in women who have realized their reproductive function, while peroxidase activity is less pronounced.