The article presents research data of oxidative stress role in the pathogenesis of anemia in patients with CKD V stage, who receive hemodialysis replacement therapy. Background. Oxidative stress is a part of the pathogenesis of many complications in patients with CKD stage V on replacement therapy with hemodialysis. Anemia syndrome is the most frequent complication of this patient`s population. Aim. The aim of this study was to study indicators of oxidative stress in patients with CKD stage V and anemia on replacement therapy with hemodialysis. Materials and methods. We studied laboratory parameters in 42 hemodialysis patients with CKD V stage. Biochemical methods are used for investigation of lipid peroxidation processes: studied diene conjugates (DC), malondialdehyde (MDA), total lipids and catalase, lipid’s structure of erythrocytes membranes and their osmotic resistance. Results. We found that in dialysis patients anemic syndrome was associated with high activity of oxidative stress. Also increased destruction of red blood cells depends from high activity of oxidative stress. In the blood of the patients concentration of DC was 1,12±0,26 opt.den.units/ mg of lipids (p<0,01), and MDA level 0,35±0,05 opt.den.units/ mg of lipids (p<0,01). Levels of catalase, decreased to 0,029±0,0019 mm/l*sec (p<0,001). Also osmotic resistance of erythrocytes significantly decreased. MDA has inverse correlation relationship with hemoglobin in the blood, with a correlation coefficient r=-0,36. Investigation of erythrocyte membrane lipid structure of patients by TLC showed a significant decrease of phospholipids and monoglycerides of higher fatty acids, and the increase of cholesterol fractions. Conclusions. In patients with chronic kidney disease on dialysis replacement therapy anemic syndrome is associated with high activity of oxidative stress, as there is an inverse relationship between the level of hemoglobin and the content of MDA in blood. As a consequence of oxidative stress changes the lipid composition of erythrocyte membranes of the patient, because some fraction of lipids are substrates for oxidative processes. Impairment of lipid membranes of red blood cells of hemodialysis patients is one of the probably causes of anemia.
Progress in clarifying the etiology, pathogenesis of peptic ulcer disease and the development of new methods of treatment did not lead to a decrease in surgical interventions for urgent and urgent reasons. At the same time, the quality of life of patients is the lowest after gastrectomy. Vagotomy to a lesser extent affects the quality of life, comparable to non-surgical treatment
The article looks at the place and role of Latin in liberal a5rts education as well as at methods and techniques for forming and developing students’ communicative competence through learning the Latin language. The authors provide a detailed review of research done by Russian and foreign philologists and methodologists on implementation of the communicative method in teaching ancient languages. The article presents educational models conducive to developing in students sufficient motivation and ability to understand and appreciate the historical and cultural legacy of the Latin language and its formative influence on the Western European civilization. The authors discuss the effectiveness of implementing the competence approach which involves the formation of competencies related to value orientations, spiritual and moral foundations of human life, and ways of intellectual self-development, and argue that this approach is related to the personality-oriented approach where special emphasis is placed on the socio-cultural component of the communicative competence. Learning Latin would develop students’ ability to tolerate social and cultural differences and foster in them respect and care for historical heritage and cultural traditions. The authors emphasize the importance of knowing Latin idioms, proverbs, and famous quotes and their philosophical meaning, claiming that this, along with appreciation of the ancient cultures and their significance in world history, could serve as an indicator of general cultural competence. While a high level of professional competence is a prerequisite for successful professional activity, in our modern world, along with professional and communicative competencies, social and personal competencies are becoming increasingly relevant, and, among other things, their development is manifested in the ability to build strategies for personal and professional development and training. The authors state that a methodically competent integration of the communicative method with the use of everyday communication situations would lead to increased motivation in learning Latin which is especially important since the volume of independent work presupposed by the curricula increases every year, and a college graduate should have not only professional competencies, but also sufficient skills for organizing her own independent work, necessary for successful self-development.
Internal diseases 398В недрение в клиническую практику новых препаратов инсулина, оптимизация режи-мов дозирования и методов самоконтроля в большинстве случаев позволяют предотвратить развитие осложнений сахарного диабета (СД) и существенно снизить их частоту [11, 13, 14].В то же время увеличение продолжительности жизни больных СД выдвигает на первое место про-блему поздних осложнений, число которых увеличи-вается в зависимости от стажа заболевания. По дан-ным международной диабетической ассоциации, на 2014 год в мире 388 млн людей имеют СД, и прогно-зируется увеличение их количества в 2 раза в течение ближайших 20 лет [12].В основе развития диабетической микроанги-опатии лежит взаимодействия ряда патогенетиче-ских механизмов: изменение эндотелия и базальной мембраны капилляров, гемодинамические и реоло-гические нарушения. Основным патогенетическим фактором развития этих изменений служит глюкозо-токсичность в условиях хронической гипергликемии [5, 8]. Сведения об авторах:Саритхала Виджайа Джавахар, аспирант кафедры госпитальной терапии; тел.: 89887422198; e-mail: jay_sv2006@yahoo.com Корой Павел Владимирович, доктор медицинских наук, профессор; тел.: 89282938068; e-mail: paule75@yandex.ru Ягода Александр Валентинович, доктор медицинских наук, профессор, заведующий кафедрой; тел.: (8652) s. i. georgievsky medical academy of V. i. Vernadsky crimean federal university, simferopol, russiaОбследовано 42 больных СД I типа, 19 мужчин и 23 женщины, которые были разделены на группы с учётом длительности заболевания и компенсации СД. Всем исследуемым выполнялась капилляроскопия сосудов верхних и нижних конечностей.У больных СД I типа со стажем менее 5 лет на нижних конечностях чаще, чем на верхних, выявлялся спазм артериальных и относительная дилатация переходных отделов капилляров. При стаже СД 7 лет и более на-блюдались стойкие нарушения архитектоники капиллярной сети со снижением ее плотности. Декомпенсация СД приводила к редукции капиллярной сети, при этом отмечена обратная взаимосвязь между содержанием гликированного гемоглобина и плотностью капиллярной сети. Ключевые слова: сахарный диабет, капилляроскопия, микроангиопатия, капиллярыThe study involved 42 patients with type I diabetes, 19 men and 23 women. They were divided into groups according to duration of the disease and compensation of diabetes. All studied persons had capillaroscopy of vessels of the upper and lower extremities.In patients with type I diabetes with disease duration less than 5 years arterial capillaries spasm and the relative dilation of transitional parts of capillaries on the lower extremities were revealed more often than on the upper ones. With the duration of DM for 7 years or more, persistent violation of the architectonics of the capillary network with reduce of its density have been observed. Decompensation of diabetes resulted in a reduction of the capillary network, at the same time an inverse relationship between the content of glycated hemoglobin and the density of the capillary network was noted.
Internal diseases 398В недрение в клиническую практику новых препаратов инсулина, оптимизация режи-мов дозирования и методов самоконтроля в большинстве случаев позволяют предотвратить развитие осложнений сахарного диабета (СД) и существенно снизить их частоту [11, 13, 14].В то же время увеличение продолжительности жизни больных СД выдвигает на первое место про-блему поздних осложнений, число которых увеличи-вается в зависимости от стажа заболевания. По дан-ным международной диабетической ассоциации, на 2014 год в мире 388 млн людей имеют СД, и прогно-зируется увеличение их количества в 2 раза в течение ближайших 20 лет [12].В основе развития диабетической микроанги-опатии лежит взаимодействия ряда патогенетиче-ских механизмов: изменение эндотелия и базальной мембраны капилляров, гемодинамические и реоло-гические нарушения. Основным патогенетическим фактором развития этих изменений служит глюкозо-токсичность в условиях хронической гипергликемии [5, 8]. Сведения об авторах:Саритхала Виджайа Джавахар, аспирант кафедры госпитальной терапии; тел.: 89887422198; e-mail: jay_sv2006@yahoo.com Корой Павел Владимирович, доктор медицинских наук, профессор; тел.: 89282938068; e-mail: paule75@yandex.ru Ягода Александр Валентинович, доктор медицинских наук, профессор, заведующий кафедрой; тел.: (8652) s. i. georgievsky medical academy of V. i. Vernadsky crimean federal university, simferopol, russiaОбследовано 42 больных СД I типа, 19 мужчин и 23 женщины, которые были разделены на группы с учётом длительности заболевания и компенсации СД. Всем исследуемым выполнялась капилляроскопия сосудов верхних и нижних конечностей.У больных СД I типа со стажем менее 5 лет на нижних конечностях чаще, чем на верхних, выявлялся спазм артериальных и относительная дилатация переходных отделов капилляров. При стаже СД 7 лет и более на-блюдались стойкие нарушения архитектоники капиллярной сети со снижением ее плотности. Декомпенсация СД приводила к редукции капиллярной сети, при этом отмечена обратная взаимосвязь между содержанием гликированного гемоглобина и плотностью капиллярной сети. Ключевые слова: сахарный диабет, капилляроскопия, микроангиопатия, капиллярыThe study involved 42 patients with type I diabetes, 19 men and 23 women. They were divided into groups according to duration of the disease and compensation of diabetes. All studied persons had capillaroscopy of vessels of the upper and lower extremities.In patients with type I diabetes with disease duration less than 5 years arterial capillaries spasm and the relative dilation of transitional parts of capillaries on the lower extremities were revealed more often than on the upper ones. With the duration of DM for 7 years or more, persistent violation of the architectonics of the capillary network with reduce of its density have been observed. Decompensation of diabetes resulted in a reduction of the capillary network, at the same time an inverse relationship between the content of glycated hemoglobin and the density of the capillary network was noted.
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