Background: Hypertensive patients with type 2 diabetes mellitus are also at increased risk for diabetes mellitus–specific complications, including nephropathy. Even the smallest degree of albuminuria increases risk for cardiovascular diseases and all-cause death. The common conditions coexisting with type 2 diabetes (e.g., hypertension and dyslipidemia) are clear risk factors for cardiovascular diseases.Methods and materials: The first (I) group consists of 99 obtained patients with type 2 and AH, the second (II) includes 49 practically healthy people. We evaluated such markers of cardiovascular complications as glycated hemoglobin, lipid profile components by biochemical method and albumin excretion rate with the help of enzyme immunoassay.Result: The positive correlation between the level of albumin excretion rate and glycated hemoglobin (r = 0,23, p < 0,001) is confirmed that albuminuria is a main marker of diabetic nephropathy. The positive correlation between albuminuria and low density lipoproteins (r = 0,34, p < 0,001), triglycerides (r = 0,04, p < 0,001) is the definition of the important role of dyslipidemia in diabetic nephropathy.Conclusion: Determination of albumin excretion rate, glycated hemoglobin as markers of nephropathy, lipid profile components is necessary for patients with type 2 diabetes mellitus and arterial hypertension for prevention cardiovascular complications.Bangladesh Journal of Medical Science Vol.17(2) 2018 p.319-322
Social changes, technological re-equipment, intensive formation of urban infrastructure have led to a constant increase in stress factors and an excessive growth of the nervous and psychological population burden. As a result of these processes in economically developed countries, acute diseases are becoming less and less significant, unlike the group of chronic disorders, such as arterial hypertension. Data from the review of the literature and the data we have received indicate that there is an increase in the level of cortisol in the blood in the phase of anxiety, which reduces in the resistance phase. A significant role is played by another hormone - insulin, which plays a key role in the development of the general adaptive syndrome. Through it the body implements numerous counter-defects in relation to the regulatory influence of catecholamines and cortisol. In conditions of prolonged stress, the level of insulin in the blood decreases and diabetes develops. The effect of cortisol and catecholamines in the resistance phase persists. The level of oxidative modification of blood plasma proteins indices depends on the behavior of the individual and changes in his psycho-emotional state, while a prolonged increase in the levels of catecholamines and cortisol in peripheral blood causes the development of psychosomatic pathology. It is proved that under the influence of complex action of risk factors there are significant changes in the psycho-emotional state that cause hypertension. This is confirmed by the presence of the highest level of reactive anxiety in patients with hypertension of the 1st stage on the background of the lowest personal anxiety which is the basis for the occurrence of the disease. With the progression of hypertension there are more profound changes in the personality of the patient, which is accompanied by the accumulation of personal anxiety, which can lead to a depressive state of neurotic genesis, which we observed with its complication. On the basis of a comprehensive study, the effect of stress on the occurrence of a syndrome of psychoemotional stress is shown, which leads to a steady increase in blood pressure - hypertension, and with its subsequent action complicates its course. Bangladesh Journal of Medical Science Vol.19(4) 2020 p.722-729
Our publication is devoted to the evolution of the public health system, its role in public health promotion and determination of the basic notions. According to the definition of the World Health Organization, public health is a science and practice of the diseases prevention, increase in life expectancy and health promotion with the help of the organized actions of the society. Yet in practice, public health formed under difficult conditions. In the article we consider the following questions: stages of public health system formation in the world and in Ukraine; analysis of public health system formation in Ukraine: institutional frameworks and strategic priorities and basic operational public health functions in Ukraine. We propose suggestions on legal procedures state improvement in public health in Ukraine in the context of European integration. Bangladesh Journal of Medical Science Vol.19(3) 2020 p.358-364
Background and aims. The purpose of our study was to determine the features of diabetic nephropathy, to identify the relationship between the level of albumin excretion, urine and lipid profile, genotype variants of the CYP7A1 gene in people with type 2 diabetes and diabetic nephropathy. Material and methods. Patients were divided into three groups. Normoalbinuria was detected in group I, and II - microalbuminuria, and III -macroalbuminuria. Determination of albumin to creatinine ratio was more accurate, although more expensive method. We examined single nucleotide polymorphism -204A> C [rs 3808607] of the promoter region of the CYP7A1 gene. Results. It was established that homozygotes by the major allele with genotype AA had lower values of albuminuria, atherogenic lipoproteins, total cholesterol, triglycerides and higher levels of anti-atherogenic lipoproteins than patients with AС and СС genotypes. Conclusion. The СС genotype was most unfavorable in the prognostic plan, since homozygotes for this minor allele were characterized by higher values of albuminuria, total cholesterol, triglycerides, and lower values of high-density lipoprotein
This paper summarizes the arguments and counterarguments within the scientific discussion on the factors that influence public health service. The main purpose of this research is to determine the expected indicators of pathogenic and sanogenic effects on significant risk factors of pathology among children. For achieving the research goal, the authors substantiated the models of final results for the modification of risk factors. Investigation of antenatal and genealogical factors in healthy and ill children groups was performed using a specially compiled expert assessment card and parents’ interviews. The systemic population modeling methods were applied to develop and substantiate population health management models (early diagnosis and primary prevention). Evaluation of the expected effectiveness of the N-factor program of primary prevention was carried out on a set of genealogical and antenatal factors. Conducted logical analysis of the methodology of quantitative and qualitative determination of health and the gathered experience in that respect were taken into account in developing population models of preventive effects. This study provides the identified priority directions for realizing the regional and population programs to implement them further. The authors presented the example of calculating the expected effectiveness of children’s health management by eliminating the investigated factors. The authors determine the priority directions for realizing the regional and population programs pathology based on the influence on the various elements to improve the public health services system. An example of calculating the expected effectiveness of children’s health management by eliminating these factors is given. The obtained results could be used to further research the issues associated with a prospective assessment of the program’s effectiveness in reducing the impact of antenatal and genealogical factors on children’s health.
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