Inter Collegas

Liraglutide as a means of modifying cardiometabolic risk in patients with arterial hypertension and concomitant obesity

I.P. Dunaieva — Tue, 01 Apr 2025 00:00:00 +0300

In press

Background. Arterial Hypertension (AH), in combination with OBesity (OB), significantly increases cardiometabolic risk, leading to the development of cardiovascular events, chronic kidney disease, and metabolic disorders. In such patients, the effectiveness of standard antihypertensive therapy may be insufficient, which requires the use of drugs with pleiotropic action.

Aim. To assess the effectiveness of liraglutide, Glucagon-Like Peptide-1 Receptors Agonist (GLP-1RA), as a component of combination therapy in patients with AH and OB, with the determination of its effect on cardiometabolic status, functional state of the kidneys, heart and neurohumoral regulation.

Materials and Methods. The study involved 62 patients with AH and OB who received liraglutide at a dose of up to 3.0 mg/day for 12 months. The dynamics of anthropometric, biochemical, hormonal, hemodynamic, and echocardiographic parameters were assessed. Statistical processing was performed using the Statistica 13.0 package (StatSoft Inc., USA).

Results. During the treatment, a significant decrease in systolic and diastolic blood pressure, body mass index, insulin levels, leptin, Cardiotrophin-1 (CTF-1), N-terminal propeptide of brain natriuretic hormone (NT-proBNP), as well as an improvement in the lipid profile were observed. According to echocardiography, regression of myocardial hypertrophy and improved systolic and diastolic function of the left ventricle was recorded. Positive but insignificant dynamics of functional renal parameters were noted.

Conclusions. Liraglutide demonstrates a pronounced multicomponent efficacy in patients with hypertension and obesity, reducing leptin resistance and improving neuroendocrine regulation and metabolic and hemodynamic profile. Our findings suggest that it can be used in complex therapy to modify cardiometabolic risk.

Keywords: leptin, GLP-1RA, N-terminal propeptide of brain natriuretic hormone, cardiohemodynamics.

Statistical characteristics of groups of elderly patients with gonarthrosis against the background of overweight or obesity

V.V. Hryhoruk, D.A. Davidenko — Tue, 01 Apr 2025 00:00:00 +0300

In press

Background. The aging of the population, the prevalence of gonarthrosis, and the the epidemic of overweight highlight the relevance of the study.

Aim. To determine the effectiveness of the treatment algorithm for persons of older age groups with gonarthrosis of the II–III degree and functional insufficiency of the I–II degree, excessive body weight in the conditions of martial law by means of statistical processing of the obtained results.

Materials and Methods. The study continued during 2022–2025 in the polyclinic of the Municipal Non-Profit Enterprise of the Kharkiv Regional Council "Regional Clinical Hospital". 100 older patients with gonarthrosis of II–III degree and functional insufficiency of I–II degree, and overweight, who were divided into three groups according to treatment tactics, were examined. Group I and Group II patients received oral chondroprotectors and used articulated orthoses. After 3 months, patients of Group I were injected with hyaluronic acid intra-articularly during a follow-up examination. Patients in all groups received topical and oral non-steroidal anti-inflammatory drugs. All patients signed a consent to participate in the study. Statistical processing of the Lequesne index and Western Ontario & McMaster Universities Osteoarthritis index was carried out using SPSS 27 (IBM, USA).

Results and Conclusions. According to the Kolmogorov-Smirnov criterion, the normal distribution of the studied indicators was confirmed. Combined treatment of patients of Group I (orthoses, chondroprotectors and hyaluronic acid) proved to be statistically and clinically effective in older patients with gonarthrosis of II–III degree and functional insufficiency of I–II degree against the background of overweight. Group II patients needed further optimization of treatment, and Group III – active intervention. The results obtained were similar to some foreign and domestic studies.

Keywords: degenerative-dystrophic diseases, body mass index, Lequen index, Western Ontario & McMaster Universities Osteoarthritis index.

Role of nursing interventions in preventing postoperative complications

A.A. Huk, G.V. Yeryomenko — Tue, 01 Apr 2025 00:00:00 +0300

In press

Background. Postoperative complications refer to pathological conditions that deviate from the normal course of the postoperative period and are not a consequence of the progression of the underlying disease.

Aim. To analyze the number of nursing interventions in the postoperative period aimed at preventing complications, as well as to evaluate the results of a patient survey regarding the nurse's role in postoperative care.

Materials & Methods. This study is based on an analysis of the number of nursing interventions performed in the postoperative period. A total of 2,913 patients underwent surgical interventions on abdominal organs for conditions such as cholelithiasis, appendicitis, acute intestinal obstruction, hernia, acute pancreatitis, and perforated gastric or duodenal ulcers. The survey included 65 patients from the surgical department. Its purpose was to assess the role of nurses in caring for patients after abdominal surgery (35 (53.8%) men and 30 (46.2%) women).

Results. One hundred percent of nurses fulfill doctors' prescriptions, 96.9% prepare patients for diagnostic and treatment procedures, and 95.4% assist with personal hygiene. Additionally, 96.9% of patients expressed satisfaction with the work of nurses. In the future, the focus will be on identifying the main types of postoperative complications and their causes, as well as formulating measures aimed at preventing such complications

Conclusions. It was found that nurses play an very important role in providing care to patients after abdominal surgery. The nurse is the closest assistant to the doctor, and the success of treatment often depends on her. Correct and timely implementation of medical prescriptions, as well as a compassionate attitude towards the patient, create conditions for a speedy recovery. In the future, the focus will be on identifying the main types of postoperative complications and their causes, as well as formulating measures aimed at preventing such complications.

Keywords: nurse, abdominal surgery, postoperative care.

Importance of infection control in increasing patient safety and preventing infections during healthcare (literature review)

K.O. Krasovska, N.I. Globina — Tue, 01 Apr 2025 00:00:00 +0300

In press

Background. Today, the topic of combating Healthcare-Associated Infections (HAIs) is becoming increasingly relevant. The World Health Organization has developed the concept of Infection Prevention and Control (IPC), which is a key component of quality control and patient safety in hospitals.

Aim. To analyze modern methods of infection prevention and the role of healthcare workers in the effective implementation of infection control measures, according to the data of modern literature sources.

Materials and Methods. We analyzed the literature on prevention of hospital-acquired infections, as well as the importance of infection control in improving patient safety, the role of medical staff in the provision of medical care. The search for scientific information was carried out using the scientific databases Scopus, PubMed, Web of Science, Google Scholar.

Results & Conclusions. Hospital-acquired infections are a serious public health problem associated with increased patient morbidity and mortality, as well as an economic burden on healthcare systems. Approximately 10% of hospitalized patients in high-income countries are affected by HAIs. Infection control is defined as a set of effective organizational, preventive and anti-epidemic measures aimed at preventing the occurrence and spread of healthcare-associated infections. Healthcare workers play an important role in the effective implementation of infection control measures. The use of Personal Protective Equipment (PPE), hand hygiene, environmental cleaning, screening and isolation, sterilization and disinfection, surveillance and reporting, vaccination and the introduction of innovative technologies in hospital infection control are important elements of the prevention and control of HAIs. Hospital infection control is essential to protect patients, healthcare workers and the wider community from HAIs. These measures are important to protect patients, healthcare workers and all society.

Keywords: hand hygiene, healthcare-associated infections, infection prevention.

The role of the nurse in the cervical screening procedure in women of reproductive age

K.V. Lutsenko, E.O. Bolokadze — Tue, 01 Apr 2025 00:00:00 +0300

In press

The implementation of systematic cervical screening programs significantly reduces the incidence and mortality of cervical cancer, which is proven by the experience of countries with developed screening systems. This short scientific report highlights the role of a nurse in the process of cervical screening in women of reproductive age as a key link in the system of early detection of cervical cancer. Attention is focused on the importance of nursing intervention not only at the stage of biomaterial collection, but also in the process of informing, counseling, psychological support of patients, keeping records and monitoring repeated screening. Modern approaches to screening are analyzed, in particular, Papanicolaou test, human papillomavirus testing, co-testing, as well as the organizational component of nursing work. It is emphasized that timely detection of precancerous conditions is possible provided that the nurse's work is professionally performed, quality standards are observed and the female population is regularly covered by preventive programs. Thus, nurses perform key functions in the implementation of cervical screening programs, providing organizational support, information and educational work with the population, direct screening procedures and further monitoring of patients. Expanding the powers of nurses and developing their competencies in the field of cervical screening allows solving the problem of staff shortage, increasing the availability of preventive services and ensuring timely detection of precancerous changes in the cervix. Improving the training of nurses and standardizing their activities in the field of cervical screening creates the basis for full use of the potential of paramedical personnel in the prevention of cervical cancer. The implementation of a structured approach to organizing the work of nurses during cervical screening will ensure an increase in the overall effectiveness of screening programs and an expansion of coverage of target population groups.

Keywords: prevention, cervical cancer, Papanicolaou test, human papillomavirus, women's health.

Dynamics of cardiovascular diseases among Kharkiv residents during the war in 2022 and 2023

N. Pryima, T. Bezditko — Tue, 01 Apr 2025 00:00:00 +0300

In press

Background. The full-scale invasion in Ukraine has become a serious challenge for the healthcare system, in particular for the diagnosis, treatment and prevention of cardiovascular diseases.

Aim. To investigate the peculiarities of the prevalence of cardiovascular disease in Kharkiv residents in wartime, in 2022 and 2023.

Materials and Methods. The study used medical-statistical and comparative methods. Data from the Center for Medical Statistics of the Public Health Center of the Ministry of Health of Ukraine on cardiovascular pathology were analyzed. The comparison was based on absolute rates of morbidity due to the lack of reliable data on the number of the existing population during the war.

Results and Conclusions. The number of registered cases of hypertension increased from 192,919 to 211,214 cases from 2022 and 2023, which corresponds to an absolute increase of 18,295 cases (9.5%). Angina pectoris demonstrated an increase in the number of reported cases from 46,844 in 2022 to 54,850 in 2023, which is an increase of 8,006 cases (17.1%). The analysis of the prevalence of acute myocardial infarction also showed a negative trend. In 2022, 977 cases were registered, while in 2023 there were already 1,176 cases, which is an increase of 199 cases (20.4%). The prevalence of strokes also shows an upward trend – in 2022; 1,630 cases were reported, and in 2023; 1,857 cases were reported, an increase of 227 cases (13.9%). We attribute the increase in the number of cases of cardiovascular diseases to the influence of stress factors, changes in lifestyle, worsening access to medical care, worsening socio-economic living conditions of the population in war-affected regions, insufficient physical activity, sleep disorders (apnea). In addition, an important factor could be the restriction of preventive measures and medical examinations due to wartime conditions, which led to untimely detection and treatment of pathologies in the early stages.

Keywords: martial law, hypertension, angina pectoris, acute myocardial infarction, strokes.

Vasyl Yakovych Danylevskyi's lecture on a doctor at work, his worldview, responsibility and professional freedom (1921): Annotated translation

Wed, 28 May 2025 00:00:00 +0300

In press

A physician must possess certain qualities of intellect and character, certain natural qualities, firm principles and bitter life experience in order to choose the right paths of work and behavior. In an era of social and political upheavals, the number of weak-willed people with antisocial behavior increases. A physician as a practicing psychologist often has to act both in public life and in his daily work with a patient. No less important is the physician's work in the field of hygiene and prevention. An enlightened mind is the basis of social happiness. To restore the disturbed balance of spirit, there is a need for intellectual or artistic pleasure. For a practicing physician, it is necessary to form a general scientific worldview in order not to scatter and fragment knowledge. The deontological attitude of a physician includes many complex and delicate issues, in addition to the physical, moral and mental side. The most difficult problems that a physician faces are the patient's attitude to death, issues of eugenics, abortion, euthanasia. A physician has to bear responsibility not only for his actions, but also for his words. But only doctors can judge a doctor not only from a professional point of view, but also from a moral and social point of view. For the future of medical activity, the solution to the question is of great importance: will it remain a free profession or will it turn entirely into a mandatory service occupation. The progress of medicine cannot be separated from the general course of cultural development of society. A doctor stands above all political, social, economic trends, for he deals with a person without distinction of tribes, dialects, conditions. We are so accustomed to the everyday actions of a doctor that we stop noticing and appreciating his outstanding merits, selfless help to the wounded and sick. Go boldly on the path of serving truth, justice and goodness, fulfill the covenants of humanist doctors and in the consciousness of the rightness of your cause you will draw strength for your difficult and responsible work.

Keywords: deontology, education, personality, society, medical art.