The objective of the work was to determine the possibility of drug correction of endothelial dysfunction, structural changes in peripheral arteries and the synthesis of end products of nitric oxide metabolism by the use of a combination of roflumilast and quercetin in the baseline therapy. In contrast to the baseline, the use of integrated therapy was followed in 6 months by a probable increase in the initial rate by 18.76 % (0.61 ± 0.04) m/s to (0.75 ± 0.04) m/s (t = 2.47; P < 0.05) and a probable decrease in the initial diameter of the brachial artery to (3.69 ± 0.29) mm (t = 2.49; P < 0.05). Patients of the experimental group have shown a significant increase in mean values of EDVD at the end of in-patient treatment and after 6 months of intensive supportive therapy (t = 2.17; Р < 0.05). The appointment of complex therapy after 6 months showed an increase in concentration in the blood of metabolites of NO in 1,3 times to (10.35 ± 1.89) μmol/l (t = 1.00; P > 0.1) at normal (12.05 ± 2.11) μmol/l. In patients of the index group after six months of the background therapy, IMT index has appeared in 1.07 times lower than the input data and has not reached the level of the control group. The IMT index for patients in the experimental group was considerably lower than the index before treatment (t = 0.31; P > 0.1).  Application of complex therapy in patients with severe chronic obstructive pulmonary disease in the exacerbation phase in combination with stable coronary heart disease, stable angina pectoris I–II FK contributes to the restoration of endothelial function, improves structural changes in the peripheral arteries and has a stimulating effect on the synthesis of nitric oxide.

Івано-Франківський національний медичний університет», м. Івано-Франківськ, Україна Резюме Мета роботи -оцінити ступінь ризику розвитку хронічної хвороби нирок: гломерулонефриту з не фро тичним синдромом за антигенами груп крові систем АВ0 і резус (Rh). Матеріали і методи. Обстежено 119 хворих (76 чоловіків і 43 жінки) на хронічну хворобу нирок: первинний гломерулонефрит із нефротичним синдромом. Середній вік пацієнтів складав 39,65±14,16 року. Для верифікації морфологічної форми захворювання хворим проводили пункційну біопсію нирки. Для визначення популяційного розподілу фенотипів систем груп крові АВ0 і Rh проведено опитування 1 428 здорових осіб. Результати дослідженя та їх обговорення. Більшу ймовірність розвитку хронічної хвороби нирок: гломерулонефриту з нефротичним синдромом виявлено для носіїв антигенів 0 Rh +і АВ Rh + .Цікавим виявився той факт, що серед хворих значно рідше, ніж серед здорових, реєстрували носіїв фенотипу 0 Rh -.Це може вказувати на певну резистентність до виникнення цього захворювання в таких людей. У Rh-позитивних жінок визначено більшу схильність до розвитку хронічної хвороби нирок: гломерулонефриту з нефротичним синдромом за наявності груп крові 0 (χ 2 = 6 ,98; р=0,008) та АВ (φ=2,32; р=0,010). Шанс виникнення досліджуваної патології у Rh-позитивних жінок проти Rh-негативних був у 2,19 раза вищим, ніж у чоловіків. Найвищі шанси захворіти були в Rh-позитивних жінок із групами крові АВ і 0 проти В, відповідно в 4,49 раза та 4,34 раза порівняно з чоловіками. Висновки. Найвищий ризик захворіти мають чоловіки з фенотипами А Rh -і В Rh -п роти 0 Rh -;жінки -АВ Rh + ,а також 0 Rh +п роти А Rh +і В Rh + .Резистентними до виникнення захворювання можуть бути особи обох статей із групами крові 0 Rh -і В Rh + .Ключові слова: хронічна хвороба нирок, гломерулонефрит, нефротичний синдром, група крові, система АВ0.Ключевые слова: хроническая болезнь почек, гломерулонефрит, нефротический синдром, группа крови, система АВ0.Aim. The evaluation of the risk of the expansion of chronic kidney disease: glomerulonephritis with nephrotic syndrome by antigens of blood groups of AB0 and Rhesus (Rh) systems. Materials and methods. We examined 119 patients (76 men and 43 women) with chronic kidney disease: primary glomerulonephritis with nephrotic syndrome. The mean age of the patients was 39.65±14.16 years. The patients underwent a puncture biopsy of the kidney to verify the morphological form of the disease. The identify of 1428 healthy individuals was conducted to determine the populational distribution of blood groups phenotypes of AB0 and Rh systems. Results and discussion. The greater probability of the expansion of chronic kidney disease: glomerulonephritis with nephrotic syndrome was observed in carriers of 0 Rh + and AB Rh + antigens. The fact was interesting that carriers of phenotype 0 Rhwere registered much less of ten in patients than in healthy individuals. This may indicate some resistance to the disease in such individuals. Greater predisposition to the expansion of chronic kidney disease: glomer...

The article deals with the biographical data of the Italian doctor Giuseppe Moscati (1880-1927), who was recognized as a saint. Moral and ethical principles that he was guided in life are an example to follow by future doctors.

Background and Aims Lymphocytes play an important role in the development of glomerulonephritis (GN). Their subpopulations are activated under the influence of certain cytokines that act on the activation factors of transcription of these cells, leading to the corresponding regulation of gene expression. However, in addition, in the regulatory processes of lymphocyte functions, epigenetic modifications of the degree of nuclear chromatin compaction are important. The morphological manifestation of the latter may be the state of the optical density of the nuclei and the range of its variability due to the ratio of chromatin condensation/decondensation. The study of the features of potentially reversible changes in chromatin structure in somatic cells becomes actual. One of the convenient objects for studying the epigenetic mechanisms of the genome functioning regulation are interphase nuclei of peripheral blood lymphocytes. Morphodensitometric study permits to establish compensatory changes at the cellular level and to evaluate the functional state of the hereditary apparatus. The aim of the research was to study the morphodensitometric features of genome status of peripheral blood lymphocytes in patients with primary GN. Method We examined 119 patients (76 men and 43 women) with primary GN. The average age of patients was (39.65±14.16) years. The patients underwent a renal biopsy to verify the morphological form of the disease. For comparison, a survey of 30 healthy individuals was conducted. Chromatin of nuclei and its changes were studied using an image analyzer based on the programm Image Tool for Windows (v. 3.0). The advantage of this method is the possibility of a combined assessment of morphometric (area, perimeter), spectrometric (optical and integral density) data with the analysis of the microanatomy of isolated chromatin blocks and the chromatin function at the same time. The study of the morphodensitometric characteristics of peripheral blood lymphocytes is an informative and accessible method for assessing the general state of the function and structure of the hereditary apparatus of the organism. Results The sexual characteristics of the morphometric and optical parameters of lymphocytes nuclei of patients were established. So, in all patients and especially women, a decrease in the perimeter of lymphocytes nuclei was registered in 1.25 and 1.31 times, respectively (p &lt;0.05). The area of these cells nuclei also naturally decreased in 1.22 times in all patients (in 1.08 and 1.34 times in men and women, respectively) compared to the control (p&lt;0.05). A significant decrease in the area of lymphocytes nuclei with an unchanged density of chromatin packing in these nuclei limits the space inside the nucleus for the interaction of individual chromosome loci in this space. Such limitations can be a serious obstacle to the normal functioning of the genome and its repairing processes. Meanwhile, differences in the optical density parameter of lymphocytes nuclei in both groups were defined. The minimum and maximum optical density were higher in the group of patients, and the range of optical density variability showed wider borders of functional heterogeneity of cells compared to the control. Conclusion Comparative analysis of morphodensitometric features of peripheral blood lymphocytes in patients with primary GN detected the changes in the ratio of chromatin condensation/decondensation and normal structure of nuclei, that may indicate functional disorders of the genotype due to exo- and endogenous factors.

The objective of the study was to determine the main causes of osteoporosis in chronic kidney disease, chronic obstructive pulmonary disease, pulmonary sarcoidosis and understand how the disease develops in these conditions. Materials and Methods. To study the mechanisms of developing secondary osteoporosis, a literature review was conducted. Results. Secondary forms of osteoporosis account for approximately 15-20% of reported cases and result mainly from concomitant diseases or from using drugs that have a negative effect on bone tissue. Despite its inert and stable appearance, bone tissue is a metabolically active, continuously renewing system. Throughout life, it continuously undergoes remodeling cycles involving the two main processes: the first one is called bone resorption and involves the breakdown of old bone followed by the destruction and removal of both the mineral substance and the organic matrix from resorption sites; the second one is called new bone formation and involves bone matrix synthesis and its subsequent mineralization. The imbalance between these two processes, the predominance of bone resorption over bone formation, is the key link in the pathogenesis of osteoporosis. Such an imbalance reflects the impairment of the major mechanisms of systemic hormonal and local (cytokine) regulation of cellular activity and occurs in secondary osteoporosis. Conclusions. To date, at the stage of providing medical care to patients with chronic bronchopulmonary diseases and chronic kidney disease, inadequate attention is paid to timely diagnosis and treatment of concomitant osteoporosis. The latter often develops as a secondary condition due to systemic inflammation, severe hypoxia, low physical activity, taking inhaled and systemic glucocorticoids. Its signs are not clinically apparent; hence, it is referred to as the ‘silent epidemic. Since osteoporosis has no pathognomonic symptoms and its clinical presentation is rather vague, in patients with chronic bronchopulmonary diseases and chronic kidney disease, its early diagnosis by determining mineral bone density is recommended to prevent the development of severe complications, including low-energy fractures.