No abstract

Dynamic examination of athletes is of great interest for sports medicine specialists, as it allows measuring changes in athletes’ functional state in parallel with increasing athletic performance in a one-year training cycle. The aim of the work is to assess dynamic changes in parameters of heart rate variability, central hemodynamics and physical performance in short-distance swimmers during preparatory and competitive periods of the training process. Materials and methods. The swimmers (n = 94) qualified from the second-class sport qualification to Master of Sports of International Class were examined during the preparatory and competitive periods of the training process. Short ECG recordings of 5 minutes were used for the heart rate variability (HRV) analysis according to the International Standard. Results. In the preparatory period, the autonomic equilibrium index had a mean value of 3.104 ± 0.494 1/s2, and in the competitive period – 2.459 ± 0.248 1/s2 (P = 0.295). The initial distribution of athletes depending on the value of autonomic tone, according to the classification proposed by R. M. Bayevskiy, had the following ratio in the preparatory period: 75.0 % / 20.0 % / 5.0 %, vagotonic, normotonic and sympathotonic individuals, respectively, statistically significantly indicating the prevalence of athletes with vagotonia over normotonic individuals (P = 0.0005). In the competitive period, this ratio was 60.0 % / 40.0 % / 0 %. The central hemodynamic indices showed a downward trend as evidenced by a decrease in the cardiac index from 2.954 ± 0.126·l·min-1·m-2 to 2.862 ± 0.088 l‧min-1‧m-2 (Р = 0.510), although these values matched to the eukinetic circulatory type (CT) during both training periods. However, the ratio of hypokinetic, eukinetic and hyperkinetic CT in the preparatory period was 45.0 % / 45.0 % / 10 0 %, and in competitive period – 45.0 % / 55.0 % / 0 %, respectively. The mean value of physical working capacity (PWC170/kg) in the preparatory period was 15.54 ± 0.66 kgm·min-1·kg-1, and in the competitive period it was 18.09 ± 0.53 kgm·min-1·kg-1, making an increase of 16.41 % (Р = 0.0001). The functional state index (FSI) increased significantly by 25.08 % from 5.558 ± 0.322 r. u. to 6.952 ± 0.272 r. u. (Р = 0.00001). The correlation analysis during the preparatory period showed a significant positive correlation between Mo and PWC170/kg (r = 0.46, P = 0.040), ARI and CI (r = 0.50, P = 0.026), IARP and CI (r = 0.53, P = 0.017), stress-index and SI (r = 0.52, P = 0.019) and negative – between Mo and CI (r = -0.56, P = 0.009). In the competitive period, the general tendency of correlation interaction was remained, as evidenced by revealed positive relationships between Mo and FSI (r = 0.53, P = 0.017), ARI and SI (r = 0.51, P = 0.020). Conclusions. Short-distance swimmers in the competitive period had significantly higher level of physical working capacity (by 16.4 %), the functional state index (by 25.1 %), as well as parasympathetic tone of ANS in comparison with the preparatory period. The above-mentioned hemodynamic changes and autonomic balance indicators were associated with the increase in athletic performance: 4 (20 %) swimmers qualified for the title of Master of Sports of Ukraine, 2 (10 %) swimmers – for Candidate Master of Sports, and 2 (10 %) swimmers – for first-class sport qualification.

Studies on endothelial dysfunction and its relationship with adaptive disorders in highly skilled athletes are few in number and mainly carried out in cyclic kinds of sports due to larger volumes and higher intensities of training loads associated with endurance performance gain. Stress and sex hormones and growth hormone play an important role in the regulation of endothelial function, but factors, which can stimulate negative vascular changes, remain a matter of debate. It is also unclear, whether changes in the vascular system depend on the type, mode or intensity of physical activity. The aim of the work was to perform a comparative assessment of endothelial function and to study the role of some hormones in its regulation in highly qualified athletes in the process of adaptation to various training loads. Material and methods. After signing a written informed consent, the study involved 104 athletes (80 men and 24 women) qualifying from the First-Class athletes to Masters of Sports of International Class (MSIC): 63 – athletes, who mainly trained endurance performance (triathletes, swimmers, long-distance runners, rowers), 31 – strength performance (weightlifters, powerlifters, kettlebell lifters), 10 – speed performance (sprinters). The mean age of the examined athletes was 21.75 ± 3.32 years. Among them, there were Masters of Sports of International Class (MSIC) – 2 athletes, Masters of Sports (MS) – 25, Candidates Master of Sports (CMS) – 48, First-Class athletes – 29. Plasma levels of endothelin-1, 6-keto-PG, erythropoietin, growth hormone, testosterone, free testosterone were determined by enzyme-linked immunoassay on a Seac ELISA-Reader Sirio S (Seac Radim Company, Italy). Results. There was no statistically significant difference in endothelin-1 levels between the endurance and strength athletes, but the strength-trained athletes showed a tendency towards endothelin-1 level predominance (0.77 ± 0.04 fmol/ml vs. 0.72 ± 0.06 fmol/ml; P = 0.176) and 2 times (P = 0.017) higher levels of 6-keto-PG. The endothelin-1 and 6-keto-PG levels did not differ significantly between the endurance and speed athletes. The strength-trained athletes exhibited 5.2 % (P = 0.016) higher endothelin-1 levels than speed-trained athletes. However, these athletes did not differ statistically in the 6-keto-PG (292.30 ± 70.38 pg/ml against 106.92 ± 74.44 pg/ml; P = 0.834) level. A positive correlation was found between the levels of erythropoietin and 6-keto-PG in the endurance-trained (r = 0.57; P = 0.00001) and strength-trained (r = 0.46; P = 0.013) athletes. Analysis of testosterone and free testosterone levels did not reveal statistically significant differences between endurance-, strength- or speed-trained athletes. At the same time, there was a trend towards higher levels of testosterone and free testosterone in the strength-trained athletes as compared to those in the endurance- or speed-trained athletes. The strength athletes showed a positive correlation (r = 0.46; P = 0.013) between the levels of free testosterone and endothelin-1. The highest level of somatotropic hormone was in the speed-trained athletes (11.74 ± 3.13 mIU/l), 2 times less - in the endurance-trained athletes (5.69 ± 1.19 mIU/l), and the lowest one – in the strength-trained athletes (2.66 ± 1.32 mIU/l). A positive correlation between the growth hormone and erythropoietin levels (r = 0.29; P = 0.038) was revealed in the endurance athletes. Conclusions. The endurance and speed athletes did not differ in the levels of endothelin-1, 6-keto-PG, erythropoietin, and testosterone. The strength-trained athletes showed signs of endothelial dysfunction: higher endothelin-1 levels with significantly reduced growth hormone and a tendency of increase in the serum testosterone level, as well as a compensatory increase in 6-keto-PG to maintain the balance between vasoconstrictors and vasodilators.

Запорізький державний медичний університет, УкраїнаЗатяжний перебіг позалікарняної пневмонії спостерігається майже у 30 % хворих та асоціюється зі збільшенням усклад-нень, тривалості перебування у стаціонарі, витрат на лікування, смертності.Мета роботи -з'ясувати предиктори затяжного перебігу позалікарняної пневмонії.Матеріали та методи. У рандомізованому контрольованому проспективному відкритому дослідженні взяли участь 100 хворих на позалікарняну пневмонію 3 групи. Середній вік хворих -43,63 ± 14,58 року, чоловіків -59 %. Хворі були поділені на дві групи залежно від характеру перебігу пневмонії: затяжний (понад 21 день) перебіг захворювання мали 15 хворих, решта осіб (n = 85) одужали протягом 3 тижнів. У першу добу госпіталізації всім хворим виконали загально-клінічне та рентгенологічне обстеження, лабораторні дослідження, імунограму, АДФ-індуковану агрегацію тромбоцитів, досліджен-ня функції зовнішнього дихання, трансторакальну ехокардіографію, розрахована швидкість клубочкової фільтрації за формулою Кокрофт-Голта.Результати. Хворі на позалікарняну пневмонію 3 групи з затяжним перебігом становили 15 % від загальної кількості пацієнтів, яких залучили до нашого дослідження, та мали на 65 % більшу тривалість стаціонарного лікування. За даними логістичної регресії, предикторами затяжного перебігу позалікарняної пневмонії є цукор крові натще, швидкість клубочкової фільтрації за Кокрофт-Голтом, час АДФ-індукованої агрегації тромбоцитів, індекс ваги тіла, ЧСС, швидкість кровотоку в легеневій артерії, резервний об'єм вдиху. Незалежними факторами ризику затяжного перебігу позалікарняної пневмонії є такі вихідні показники: вміст цукру крові менший ніж 4,8 ммоль/л, швидкість клубочкової фільтрації менша за 82 мл/хв, індекс ваги тіла менший за 23,12 кг/м 2 , час АДФ-індукованої агрегації тромбоцитів понад 370 с. Цель работы -выяснить предикторы затяжного течения внебольничной пневмонии.Материалы и методы. В рандомизированном контролируемом проспективном открытом исследовании принимало участие 100 больных внегоспитальной пневмонией 3 группы. Средний возраст больных -43,63 ± 14,58 года, мужчин -59 %. Больные были разделены на две группы в зависимости от характера течения пневмонии: затяжное (более 21 дня) течение заболевания было у 15 больных, остальные (n = 85) выздоровели в течение 3 недель. В первые сутки госпитализации всем больным выполнено общеклиническое и рентгенологическое обследование, лабораторные ис-следования, иммунограмма, АДФ-индуцированная агрегация тромбоцитов, исследование функции внешнего дыхания, трансторакальная эхокардиография, рассчитана скорость клубочковой фильтрации по формуле Кокрофт-Голта.Результаты. Больные внегоспитальной пневмонией 3 группы с затяжным течением составили 15 % от общего количе-ства привлечённых к нашему исследованию пациентов и имели на 65 % большую продолжительность стационарного лечения. По данным логистической регрессии, предикторами затяжного течения внегоспитальной пневмонии является сахар в крови натощак, скорость клубочковой фильтрации по Кокрофт-Голту, время АДФ-индуцир...

No abstract