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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.

Introduction. The complexity of the interaction between type 2 diabetes mellitus (T2DM), comorbidities, and emerging complications requires a clinical approach that manages risk while maintaining indicated therapeutic goals. The objective of the study was to analyse the frequency and effectiveness of mono- and combined glucose-lowering therapy in T2DM patients with obesity and chronic pancreatitis (CP). Material and methods. The retrospective study analysed 579 medical records of T2DM patients, who were divided in the following groups: group 1- patients with normal body weight and without CP (n=67); group 2 – patients with normal body weight and with CP (n=32); group 3- overweight patients without CP (n=126); group 4 – overweight patients with CP (n=33); group 5 – obese patients without CP (n=262); group 6 – obese patients with CP (n=59). When evaluating the effectiveness of the received therapy, the target value of HbA1c less than 7% was considered. Results. Most of the patients with T2DM+CP and T2DM with normal body weight received combined therapy. The presence of CP significantly influences the choice of treatment for T2DM, particularly, 81.5% of patients with T2DM and CP were prescribed combined therapy. There was no significant difference between serum glucose and HbA1c levels in patients with only T2DM and comorbid T2DM+CP+overweight/obesity regarding monotherapy vs combined glucose-lowering therapy. However, glucose and HbA1c levels in patients with only T2DM on monotherapy were significantly lower, respectively, by 41.72% and 25.64% vs patients with comorbid CP and overweight/obesity, who were also prescribed monotherapy. Conclusion. The presence of CP significantly influences the choice of treatment for T2DM, while overweight/obesity is not a criterion for choosing mono- or combined glucose-lowering therapy. The use of metformin as monotherapy and the use of combined therapy in most of patients with only T2DM and comorbid T2DM do not achieve the target levels of glucose and HbA1c.

Type 2 diabetes mellitus (T2DM) patient outcomes, treatment options, and corresponding healthcare expenses are affected by the presence of different comorbidities.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.We analyzed 541 medical records of T2DM patients.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.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.

Gonorrhea is the second most common sexually transmitted infection spreading worldwide and a serious public health problem. How�ever, 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.

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.

The aim of the work. To analyze the prevalence of nosocomial pneumonias (NP) in surgical and therapeutic departments and determine the nurses’ knowledge on the problem of preventing hospital pneumonia. Materials and Methods. In order to determine the nurses’ level of knowledge on the problems of preventing nosocomial pneumonia, a questionnaire was developed and applied, which included 20 questions with answers. Results and Discussion. The prevalence of hospital pneumonia in the departments of the therapeutic and surgical profiles is high. The incidence of NP in the surgical department is predominant in males, among the risk factors in which tobacco smoking prevails. In females with NP, the main etiological factors include poor nutrition and obesity. Comparing the level of nurses’ knowledge in therapeutic and surgical departments it was found that nurses of surgical department have shown better knowledge of NP identifying and epidemiology. Nursing stuff of both profiles has poor knowledge about pathogens of NP. The most problematic for nurses of both departments is the issue of preventing NP in case of various surgical interventions during preoperative period. Conclusions. The results of the surveys with this questionnaire can be used to focus educational programs on NP prevention.

Objective: According to WHO, about 30 % of people in the world are overweight that allows to characterize this disease as a new non-infection “epidemic” of the XXI century. More than 500 million people in the world are overweight and 250 million are obese. There is a clear tendency to increasing of alimentary obesity among people with different age, sex and nationality. The aim of the study is to investigate the thiol-disulfide homeostasis in liver tissue, adipose tissue and erythrocytes in the pathogenesis of experimental alimentary obesity.Materials and methods: 60 males, non-liner, white rats around 3 months of age with alimentary obesity were examined during the study. Experimental obesity was modeled by administering of sodium glutamate to the feed mixture in a ratio of 0.6:100.0 and adding high-calorie diet. The glutathione redox-system activity in erythrocytes, liver and adipose tissue were analyzed by the level of reduced glutathione (GSH), oxidized glutathione (GSSG), glutathione reductase (GR) and glutathione peroxidase (GP) activity.Results and Discussion: The data indicate a decrease in GSH level within 14 days of the experiment in all investigated tissues. The same trend was observed in animals on 28th day of the experiment: GSH index decreased in blood, adipose tissue and liver (P

Background: The growth of the world population and the need to increase food production led to the widespread use of food additives. One of such additives is carrageenan. Potentially negative health effects of carrageenans prompt us to question safety of their widespread use. Aims and Objectives: In this study, we defined the effect of carrageenan (E407) consumption on the main markers of endogenous intoxication in rats. Materials and Methods: Experimental studies were conducted on 72 non-linear, female, white rats weighing 150-180 g. The experimental animals had free access to 0.5% carrageenan solution in drinking water. Control group of animals received pure water. Syndrome of endogenous intoxication was evaluated using measurements of low, medium, and high molecular weight substances in blood plasma, red blood cell suspension, and urine. Results: Our results indicate shift of the markers of intoxication syndrome toward mainly catabolic substances. The results obtained after 1 week of the experiment correspond with phase of partial compensation, characterized by increased concentrations of low and middle molecular weight substances in red blood cells and plasma. After 2 weeks and up to 1 month of the experiment, the predominantly catabolic markers of endogenous intoxication continue to increase in erythrocytes and plasma, indicating a shift to the phase of partial decompensation to systems and organs of detoxification. Conclusion: The consumption of carrageenan with drinking water in concentration of 0.5% was associated with the development of excessive levels of low and middle molecular weight substances with reduced ability of kidneys to excrete toxic products.