L'activité des enzymes du système antioxydant dans le cerveau des rats, intoxiqués avec du fluorure de sodium en doses subtoxiques

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BACKGROUND: Family physicians (FPs) play an important role in the prevention of cardiovascular disease (CVD). AIM: This study aims to assess the determinants of FPs’ knowledge and application of cardiovascular preventive management guidelines at primary health-care setting in Ukraine. MATERIALS AND METHODS: We performed a cross-sectional study conducted among the 226 FPs in Kharkiv Region, Ukraine. A self-administrated questionnaire was administered, exploring demographic, job characteristics, knowledge of CVD prevention guidelines, and application of CVD guidelines’ questions about the essential items related to diagnosis and management of CVD according to the international/local guidelines. RESULTS: The results show a very low level of knowledge of guidelines among FPs with 85.8% scoring below the acceptable knowledge level. The guidelines were applied below the acceptable level with 51.3% scoring below the cutoff point. The results indicate that both average scores were below the minimum acceptable level. Lack of knowledge of the CVD preventive care was considered the biggest barrier (62.8%). Lack of counseling skills was the second major barrier (37.9%). Subjectivity of the questions was considered to be the third barrier (32.6%). Lack of counseling skills was the second major barrier (37.9%). Subjectivity of the questions was considered to be the third barrier (32.6%). CONCLUSIONS: Recognizing the low level of knowledge and application of guidelines among primary care providers and working toward minimizing this problem can be through education, training, and monitoring of the application. This can potentially improve CVD preventive management among patients.

The aim of the workconduct a literature review to study the most important and complex aspects in the diagnosis and treatment of gastroesophageal reflux disease that are encountered in the practice of a family doctor. Results. Gastroesophageal reflux disease is becoming an increasingly important disease for the young and ablebodied population, which gives it not only a medical, but also an economic aspect. This is one of the most common pathologies in the practice of not only a therapist, family doctor and gastroenterologist, butdue to the presence of extraesophageal manifestationsin a wider range of medical specialties. Since gastroesophageal reflux disease has many "masks", this leads to delayed diagnosis and treatment. This disease does not have a "gold standard" in routine diagnostics, and the presence of its refractory forms leads to treatment failures and complications. With a comorbid course of gastroesophageal reflux disease, both diagnosis and treatment require an integrated approach. Conclusions. Gastroesophageal reflux disease remains one of the most common diseases in the practice of a family doctor. Despite the extensive study of this pathology, it continues to remain difficult in terms of diagnosis and treatment, which is associated with the presence of extraesophageal manifestations, comorbid and refractory course. This requires an additional study of pathogenetic mechanisms and the development of therapeutic and diagnostic measures on the basis of this

BACKGROUND: Adipokines have been associated with atherosclerotic heart disease, which has plenty of common risk factors with chronic kidney disease (CKD), but their association with CKD has not been well characterized. AIM: We investigated the association between the serum visfatin level and CKD. METHODS: The serum visfatin levels in 101 CKD patients and 101 controls were compared. CKD was defined as estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2 or presence of albuminuria (≥30 mg/24 h). RESULTS: After adjustment for established CKD risk factors, the median (interquartile range) of the serum visfatin was 3.65 ng/ml (2.31–4.59) in patients with CKD and 1.66 ng/ml (0.90–2.45) in controls without CKD (p < 0.0001 for group difference). Serum visfatin was significantly and inversely correlated with eGFR (r = –0.79, p < 0.0001) and positively correlated with urine albumin (r = 0.71, p < 0.0001) in the study participants. There was a strong dose-response and the significant relationship between serum visfatin level and CKD severity, assessed by GFR and albuminuria, regardless of established risk factors for CKD, including hypertension, diabetes, and cardiovascular disease. CONCLUSION: Our results show that circulating visfatin is associated with the risk and severity of CKD. These results suggest that longitudinal studies and clinical trials should be conducted to investigate if adipocytokines play a role in the development and progression of CKD independent of body mass index or waist circumference. These important findings may advance our further understanding of CKD risk factors.