Objective. To assess hemodynamic parameters in the extra- and intracranial segments of the brachiocephalic arteries (BCA) in patients with metabolic syndrome (MS) using duplex ultrasonography. Materials and Methods. The study included 82 patients, of whom 62 had MS and 20 were practically healthy controls. All patients underwent duplex ultrasonography of the extra- and intracranial segments of the BCA with evaluation of qualitative and quantitative parameters: intima–media complex (CIM) in the bifurcation of the brachiocephalic trunk, in the common carotid arteries (CCA), and in the vertebral arteries (VA), as well as quantitative blood-flow parameters in the CCA, internal carotid arteries (ICA), VA, and middle cerebral arteries (MCA). All patients also underwent biochemical blood testing. Results. Patients with MS demonstrated a statistically significant increase in peripheral resistance indices in the ICA (left ICA pulsatility index (PI), p = 0.05) and in the MCA/ICA resistance index ratio on the left side compared with controls (p = 0.026). No statistically significant differences in linear or volumetric blood-flow velocities were found in the studied arteries. Significant correlations were found between quantitative blood-flow parameters and MS components based on Pearson’s linear correlation coefficients: the end-diastolic velocity in the left ICA correlated with low-density lipoproteins (LDL), total cholesterol (TC), atherogenic index, and both absolute and relative glucose dynamics in the oral glucose tolerance test; PI of the left ICA correlated with the CARO index; PI of the right VA correlated with LDL and TC; the MCA/ICA PI ratio on the left side correlated with LDL, high-density lipoproteins, TC, triglycerides, and the triglyceride–glucose index; as well as with fasting insulin, HOMA-IR index, and CARO index. Pearson correlation coefficients ranged from −0.41 to 0.24 at p < 0.05. Conclusion. Comprehensive ultrasound evaluation of hemodynamics in the extra- and intracranial segments of the BCA in patients with MS allows detection of blood-flow alterations associated with structural remodeling of the vascular wall induced by the negative impact of multiple metabolic factors.
Background. COVID-19, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has profoundly impacted global health since its emergence. Beyond its acute respiratory symptoms, COVID-19 is recognized for its systemic effects, capable of impacting multiple organs and triggering a range of inflammatory and autoimmune responses. One area of growing concern is the potential of COVID-19 to induce or exacerbate systemic autoimmune-mediated diseases. Purpose – to analyze the clinical case of a patient diagnosed for the first time with systemic lupus erythematosus (SLE) following a COVID-19 infection. The study aims to investigate the long-term effects of COVID-19 on the immune system and explore possible challenges in diagnosis and management strategies to prevent or mitigate autoimmune complications in such patients. Materials and Methods. The case history of a 27-year-old woman is presented, including complaints of weakness, fever up to 39°C, joint pain, facial and lip swelling, petechial-papular rashes on the face (nasal wings, forehead, chin), and oral ulcers. Differential diagnosis was conducted, leading to the diagnosis of SLE. The course of the disease and associated complications were subsequently analyzed. Results and discussion. Challenges in diagnosing SLE and its development following COVID-19 infection are described. Conclusions. COVID-19 has demonstrated its ability to affect the body beyond the respiratory system. Its potential role in triggering autoimmune conditions such as SLE underscores the importance of understanding the connection between infectious diseases and autoimmune disorders. The link between COVID-19 and the development or exacerbation of SLE highlights the need for heightened medical vigilance and tailored treatment strategies for vulnerable population groups.
Background. Primary immunodeficiency is a group of more than 550 rare genetic diseases characterized by reduced or absent resistance to infectious agents involving all parts of the immune system. According to the European Association of Immunologists, 70–90% of patients with PID remain undiagnosed. Purpose – to describe the features of the course of primary immunodeficiency in infants. Materials and Methods. The study employed a systematic analysis of medical history data. A review of relevant scientific literature was conducted, followed by systematization and synthesis of information related to the clinical case. Results. Illustrated data of the medical history of a 3-month-old child who was urgently admitted to the pediatric hospital with signs of surgical pathology (Acute obturative intestinal obstruction. Intestinal perforation.) primary were diagnosed. The clinical signs of the disease, the results of histopathological examination, changes in the immunogram, as well as the presence of a multidrug-resistant flora in the abdominal cavity contents, pure effect from combined antibacterial therapy courses and immunoreplacement therapy allowed us to confirm primary immunodeficiency. While being in the hospital, the child underwent five surgical interventions, which had a complicated course. The fatal outcome caused by the progression of multiple organ failure. Conclusions. A clinical case of primary immunodeficiency in an infant demonstrates the peculiarities of the course of the disease and the difficulties of its differential diagnosis. The manifestation of immunodeficiency is associated with surgical pathology. The absence of antibacterial therapy response allowed us to suspect primary immunodeficiency and implement appropriate treatment measures. However, the burdened premorbid background, age, and severity of surgical pathology contributed to the development of multiple organ failure, which was the cause of the childʼs death.
Obesity is the process of fat accumulation, which leads to an increase in body weight. The most common cause of excess weight is overeating, which is supplemented by a lack of physical activity. Today, the results of the study of risk factors for overweight and obesity among young people are extremely important. The study is devoted to the study of risk factors for overweight and obesity among young people. Its purpose is to identify eating habits of young people that contribute to weight gain, as well as to develop measures to improve the quality of life of young people with excess weight and obesity. The task of the study was also to identify and identify risk factors for obesity and overweight among young people and to determine their significance. Sociological and mathematical and statistical methods were used in the work. A questionnaire on the eating habits of young people was developed for the study. As a result of the study, it was established that although 62.5% have information about rational (healthy) nutrition and the caloric composition of products, the majority of respondents (68.5%) do not follow a specific diet (only 17.5% follow a strict diet). 41.5% of young people often skip breakfast, and 37.5% eat food right before going to bed. In 40.0% of surveyed families, the basis for choosing food products is the taste of products, in about a quarter of families (22.5%) – cost, and only 37.5% of families choose food products based on health benefits. The majority of respondents (62.5%) confirmed the fact of having information about rational (healthy) nutrition and the caloric composition of products. As a result of the study, we came to the conclusion that medical workers and medical education institutions should intensify information and explanatory work on the promotion of healthy eating and prevention of overweight and obesity. Keywords: rational nutrition, diet, risk factors, survey.
Topicality. The problem of abuse of psychoactive substances and the search for effective means for its treatment remains an acute topic in modern psychiatry and narcology. To date, cognitive-behavioral therapy when applied to patients with alcohol addiction is one of the most promising methods of treatment. This method of treatment is aimed at preventing and minimizing relapse. The purpose of this work was to study the possibilities of using cognitive-behavioral therapy to achieve remissions in alcohol addiction. Materials and methods: modern literary scientific data were analyzed regarding the issues of indicators of the effectiveness of alcohol addiction treatment, understanding the concept of remission and its prognostic factors, the personality profile of addicted persons, and the direct application of cognitive-behavioral therapy to achieve remissions in alcohol addiction. The results. The analysis of literature data showed that the duration, stability and quality of remissions are important for evaluating the effectiveness of alcohol addiction treatment. When a remission is established, such factors as the duration of anti-alcohol therapy, stress resistance, personality profile of the addict and supportive therapy are of prognostic value. Cognitive-behavioral theory views alcohol addiction as an inadequate way to cope with problems or needs. Cognitive-behavioral therapy for alcohol addiction uses a standard set of methods, educational coping strategies that take into account the identification and specificity of situations when coping is inconsistent, as well as training, modeling, role-playing and behavioral rehearsals. These methods are intended not only to increase the level of cognitive and behavioral coping, but also to facilitate the perception of external influences and improve adaptation in stressful situations. Learning coping skills to overcome their deficit, eliminating factors that can prevent overcoming a breakdown and ensuring their adequate application in practice is a necessary condition for the effective use of cognitive-behavioral therapy. The methods of this type of therapy make it possible to show the patient that social learning plays an important role in the development of rigid thinking and maladaptive behavior and are designed to develop and strengthen self-control. Conclusions. Thus, the analysis of literary sources showed that cognitive-behavioral therapy for addicts is a short-term, structured method of psychotherapy aimed at developing the skills of controlling addictive behavior in patients with alcohol addiction in the conditions of forming and maintaining remission.
