Aim. To estimate the severity of endothelial dysfunction and effects of nitric oxide, thiol status and cystatin on the progression of chronic heart failure and chronic heart failure in type 2 diabetes mellitus. Methods. 80 patients (men and women) with chronic heart failure were included. All patients were divided into two groups: the first group 39 patients with chronic heart failure, the second 41 people with chronic heart failure and type 2 diabetes mellitus. The control group consists of 20 healthy donors. To obtain statistically significant differences with the control group the minimum sample size for observations was determined based on the target variance of a small sample (n=10). The lipid profile and carbohydrate metabolism, endothelin-1, cystatin, nitric oxide were evaluated. Statistical processing was performed using Microsoft Office Excel and IBM SPSS Statistics 20 software. Results. Changes in lipid metabolism were found in both groups, while an increase in carbohydrate metabolism was observed in patients with chronic heart failure with type 2 diabetes mellitus. Under conditions of oxidative stress in patients with chronic heart failure, a decrease in the content of thiol status and an increase in the amount of nitric oxide in the blood serum were recorded. The endothelin-1 level was elevated, particularly in the second group, which indicates a more serious endothelial dysfunction with increased glucose content in patients with chronic heart failure. Conclusion. The level of cystatin C as an atherogenic risk factor was equally increased in the studied patients, possibly it affected by the rate of disease progression; feasible to use these markers to detect the progression of chronic heart failure in the early stages.
The systematic monitoring of COVID-19 pandemic’s ethical content, carried out over the past two years, serves to develop a multi-professional discussion on one of the most relevant platforms - the journal "Infection and Immunity". Two previous articles consistently presented the moral context of historically established regulatory and epidemiological paradigms and the analysis of readiness/or unwillingness to follow them in the real conditions of the epidemic crisis. The modern moral cross-section of the pandemic, characterized by a state of global loss: values of social unity, trust and solidarity; leaves virtually no doubt about the dominant role of ethics as a criterion for resolving conflicts of interest. The point of the highest moral tension was vaccination prevention at all levels of its advancement into an effective resource for containing the COVID-19. According to the author's personal and professional responsibility, based on long-term scientific research of vaccination’s ethics, embodied in the books "Ethics of Infectious Pathology" (2014) [73] and "Ethics of vaccination (criterion of scientific and humanitarian breakthrough" (2018) [72], determined our interest in writing this work. In the "third ethical commentary" presented to the readers, two ideologically related tasks are set. First, consider the ethically verified canon of vaccine prevention on a specific example of the COVID-19 pandemic. Secondly, to expand the scope in the discussion of the ethics role by connecting the vaccination in the context of a regional cluster, namely, the CIS member states. This opportunity took place thanks to long-term cooperation on the creation of an ethical evaluation system within the framework of the WHO project "Forum of Ethics Committees in the Commonwealth of Independent States (FECCIS)" [74] and the practice of developing model laws in the field of social policy and human rights of the IPA CIS. The perspective focus of this work is the need for an innovative approach to the development of management decisions by enlarging the interdisciplinary range and expanding the areas of responsibility of social and bioethical meaning in the protection of public health in epidemic crisis.
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