Харьковский национальный медицинский университет 1 , Институт общей и неотложной хирургии им. В.Т. Зайцева НАМН Украины 2 , Национальный фармацевтический университет 3 , Харьковская областная клиническая больница 4 , Харьковская медицинская академия последипломного образования 5 , г. Харьков, Украина

Introduction. In recent years, in occupational pathology, much attention is paid to professionally caused diseases, a special place among which is occupied by cardiovascular pathology. Vascular wall stiff ness is considered as an independent cardiovascular risk factor. This makes it important to study the mechanism of development of arterial stiffness, a key component of which is inflammation.The aim of the study was to identify the relationship between immune parameters and vascular wall stiff ness according to volumetric sphygmography in workers exposed to industrial aerosols.Materials and methods. A survey was conducted of 55 men working in conditions of exposure to industrial aerosols, and 32 men who do not have professional contact with industrial pollutants. Serum concentrations of class A and G immunoglobulins, cytokines, tumor necrosis factor α, and C-reactive protein were determined by solid-phase enzyme immunoassay. Assessment of elastic properties of the vascular wall was carried out by volumetric sphygmography.Results. Increased production of anti-inflammatory interleukin–8, immunoglobulin G and C-reactive protein, as well as increased cardiovascular and ankle vascular index on the right and left in the group working under the influence of industrial aerosols was found. Median concentrations of immunoglobulins, interleukins and C-reactive protein were independent of changes in the value of the cardiovascular ankle vascular index. Increased rigidity of the vascular wall was accompanied by an increase in the production of tumor necrosis factor α. Thus, in the group of persons with increased stiff ness, the level of this cytokine was 3 times higher than in the group of persons with normal values of the cardiovascular-ankle vascular index. The relationship between the cardiovascular ankle vascular index and the concentration of tumor necrosis factor α (r=0.61; p=0.009), C-reactive protein (r=0.54; p=0.02) and feedback with the level of anti-infl ammatory interleukin–10 (r=0.36; p=0.04) was revealed.Conclusions. The established significant correlations between cytokines (tumor necrosis factor α, interleukin–10), C-reactive protein and individual indicators of volumetric sphygmography (cardio-ankle vascular index) indicate the pathogenetic role of cytokines and acute phase proteins in the violation of elastic properties of the vascular bed in workers under the influence of industrial aerosols.

Introduction. Currently, the concept of early vascular aging, manifested by an increase in the stiffness of the vascular wall, is gaining popularity. As a method of diagnosis of this syndrome, volumetric sphygmography is increasingly used to determine the cardiovascular ankle vascular index and estimated age. In addition to studying the impact of traditional cardiovascular risk factors on the development of vascular rigidity, a promising direction is the search for additional factors that reduce the elasticity of the vascular wall.The aim of the study was to assess the effect of industrial aerosol on the development of early vascular aging syndrome in metallurgical workers.Materials and methods. 155 men working at the metallurgical enterprise were examined. The main group included 95 people working in conditions of exposure to industrial aerosol. The comparison group included 60 workers not exposed to industrial aerosol. All subjects underwent periodic medical examination, assessment of blood lipid spectrum, smoking status and experience, study of elastic properties of the vascular wall by volumetric sphygmography.Results. The study showed that in persons working under the influence of industrial aerosol, the cardiovascular ankle vascular index was significantly higher than in the comparison group (7.13 [6.3; 8] and 6.75 [6.1;7.13], respectively, p=0.006). The estimated age remained comparable with the chronological age of the two groups, but was significantly higher in the main group (42 [29;49] years and 37.1 [29;44] years, respectively, p=0.014). An increase in the cardiovascular-ankle vascular index relative to the age norm was revealed in 33.6% of the surveyed main group, which is twice higher than this indicator of the comparison group (16.6%). According to the calculated vascular age, early vascular aging was detected in 28.4% of the main group and in 13.3% of the comparison group. Signifi cantdiff erences appear when working in hazardous conditions for more than 10 years in the age category from 35 to 45 years.Conclusions. The obtained results indicate a high prevalence of early vascular aging in persons working under the influence of industrial aerosol.

The article discusses problems of early diagnosis and, accordingly, treatment of hepatorenal syndrome (HRS) in case of obstructive jaundice of blastomatous origin. The results of a comprehensive examination of 37 patients with blastomatous obstructive jaundice (OJ) with clinical and laboratory signs of HRS were analyzed. Patients were evaluated for clinical and biochemical parameters of blood and urine, blood electrolytes, indicators of the blood coagulation system according to unified methods. The main work is devoted to the determination of the biomarker of renal tubular damage, neutrophil-gelatinase-associated lipocaine (s-NGAL) as a marker and indicator of HRS severity, careful and detailed analysis, monitoring of levels (s-NGAL) and other bioactive substances as an indicator of treatment efficacy. Introduction of active ultrasound as a replacement for contrast computer tomography to reduce the load on precompromised kidneys. It has been proven that the level of renal tubular damage, neutrophil-gelatinase-associated lipocaine s-NGAL is an early marker of renal damage whose function is to reduce the severity of damage to the proximal tubules of the kidneys, normalize damaged tissue by participating in apoptosis, increase survival of damaged restoration of damaged epithelium, stimulation of differentiation and structural reorganization of renal epithelial cells. The fact that s-NGAL was not significantly reduced in the stage of recovery of diuresis, confirms the presence of patients with blastomatous MF severe and persistent toxic tubulointerstitial disorders. Based on this determination of the biomarker (s-NGAL) in the serum of patients with blastomatous mechanical jaundice and performing in them at primary ultrasound color Doppler mapping and pulsed wave Doppler imaging of the kidneys with the calculation of the resistance index may serve as early signs of damage.