The outcomes of hemorrhagic fever with renal syndrome (HFRS) were analyzed in 55 patients who were under the supervision of a physician – infectious within one year after the disease. This issue has been studied in more detail by the example of Hantaan virus infection in the Far East, the effects of Puumala infection aren’t well understood, vigilance among physicians concerning the formation of chronic kidney disease in patients is lacking. However, it is proved that the peculiarities of the clinical course of HFRS are caused by a specific serotype of the virus. It is revealed that the leading clinical manifestation in patients in early reconvalescence period of HFRS was astheno vegetative syndrome. Long-term prognosis of patients with HFRS, isn’t always favorable, it may be associated with prolonged disorders of the kidneys. Renal pathology includes lumbar – pain, eyelid swelling, dysuric phenomena, polyuria, nycturia, proteinuria, hematuria, cylindruria, reposotory. It is established that the disease is accompanied by a prolonged dysfunction of the nervous system, cardiovascular system, hepato-biliary system, this suggests the possibility of development of chronic pathology of different organs and the need for surveillance of HFRS patients, not only the infectious, but the nephrologist, cardiologist, neurologist.
The author proposes original methodology of defining the meaning of occupational safety and the model designed to adapt learners to occupational safety issues at the consequent stages of professional-oriented secondary school — technical higher school. The proposed model is theoretically and methodologically backed.
Background In contrast to type 2 diabetes mellitus (DM), cardiac and vascular abnormalities in type 1 DM (T1DM) are not well investigated. We aimed to evaluate occurrence of cardiac remodeling, arterial stiffness and blood pressure (BP) phenotypes in T1DM patients. Methods The cross-sectional study consecutively included T1DM patients 18–44 y.o. without known CVD, in whom 24-hour monitoring of peripheral and central BP (ABPM) with BPLab Vasotens, applanation tonometry and conventional and speckle tracking echo were performed. BP phenotypes were determined according to current guidelines, PWV and CBP - according to individual reference values. Presence of systolic dysfunction was defined as global longitudinal strain (GLS) <20%, left ventricular hypertrophy (LVH) as LV myocardial mass index (LVMI) >95/>115 g/m2 for women/men, LV remodeling (LVR) as RWT ≥0.43. P<0.05 was considered significant. Results A total of 125 patients with T1DM (mean age 29,2±7,6 years, 60% male, median duration of DM 6,9 [2; 11] years, HbA1c 9.9 [6; 12] %, mean BMI 23±3 kg/m2, smoking 39%, median GFR 100 [86; 117] ml/min/1.73 m2, GFR <60 ml/min/1.73 m2 – in 8.8%, median albuminuria 19 [8; 24] mg/g (moderate and high albuminuria in 14.6% and 2.2%) were investigated. According to office BP and ABPM hypertension (HTN) was diagnosed in 28% patients (true and masked in 4.8 and 23.2%, respectively) and true normotension in 72%. Isolated nocturnal HTN was observed in 14.4%. Majority of the patients were dippers (51.2%), non-dippers and night-peakers profiles were registered in and 43.2% and 5.6%, respectively. Central SBP and PWV elevation were observed in 17.6% and 57.6% (PWV >10 m/s - only in 2.4%). Cardiac abnormalities were revealed in 72.4% of patients: GLS<20%, LVH, LVR and diastolic dysfunction (DD) in 71.2, 12, 39.2 and 16.8% patients, respectively. Isolated GLS <20% was detected in 30%, combination of GLS<20% with LVH (or LVR) and DD in 47.2%. Patients with vs without HTN were characterized by higher PWV (7.8±1.5 vs 6.9±1.2, p<0.001), LVMI (89.9 [75; 96] vs 71.5 [64; 77] p<0.001), incidence of DD (29.6 vs 12.2%, p=0.03), LVH (28 vs 6%, p=0.002), trend towards higher rate of central SBP increase (32.7% vs 17.4%, p=0.08), lower incidence of LVR (26 vs 44%, p=0.002) and similar GLS (p=0.16). Groups with vs without nocturnal HTN did not differ by PWV, central SBP, GLS and LVMI. PWV increase was associated only with higher LVMI (88.2 [69; 95] vs 77.6 [68; 83], p=0.042). Correlations (p<0.05) with albuminuria were observed for GLS (r=−0.26), DD (r=0.22) and non-dipping state (r=−0.34). GFR correlated (p<0.05) with GLS (r=−0.32) and PWV (r=−0.32). Conclusion Incidence of prognostically unfavourable phenotypes of HTN, cardiac remodeling and arterial stiffness (even in patients without HTN) were relatively high in T1DM population. GLS and non-dipping state correlated with albuminuria, GLS and PWV with GFR
In the framework of different countries' international comparison, the objective of this paper reflects research topic of investigation-the identification of small countries, revealing features of economic development and business growth in economic history context of small economies classification. The object of investigation focuses on West European and Nordic countries' small economies. The hypothesis of the article is that small states under consideration are developing as the business competitive peripheries areas due to the special Scandinavian capitalist model development characterized by high level of social capital. The statistical data base includes Organization of Economic Cooperation and Development indicators, World Bank parameters and Nordic transnational corporation's annual reports. The paper considers the following research questions: (1) the critical overview of the mainstream academicians opinions concerning different-scaled economies, (2) classification of small states and clarification of different groups of the small-scaled countries role in the world and regional economy through historical context, (3) estimates and variants of small countries' social-economic development in accordance with different parameters, (4) consideration of Nordic European countries coming to the business model of the competitive peripheral social-economic development. The main summing up conclusion is that small economies of Nordic Europe are converting nowadays into the experimental laboratory of the European and world economy due to the specific model of their social-oriented economic and business growth, their geopolitical location between developed European integration complex embracing presumably small-scaled states from one side and large-scaled emerging market economy of Asian continent from the other side.
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