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Conclusion: Our researches showed that the Dopplerometria has to be included in complex ultrasonic research at a cancer of a stomach and is one of important methods of monitoring of a condition of surgically significant vessels at a cancer of the stomach, influencing assessment local and general prevalence of tumoral process.
Complex application of a duplex and triplex echography, and also multispiral computer angiography allows to increase diagnostic efficiency of methods of research, to estimate operability of a cancer of a stomach and to plan medical tactics.
References:
1. Chernousov A. F., Chernousov F. A., Selivanova I. M., Fishkova Z. P. Early gastric cancer. Surgery. Journal of the N. I. Pirogov. 2006; 7.
2. Siegel R., Ma J., Zou Z. et al. Cancer statistics. 2014. CA Cancer J Clin. 2014; 64.
3. Sedikh S. A., Mitina L. A., Kazakevich V. I. Opportunities ultrasound in determining the local extern of the tumor in patients with gastric cancer. Medical imaging. 2005; 5.
4. Jemal A., Bray F., Center M. M. et al. Global cancer statistics. CA Cancer J Clin.2011 Mar-Apr; 61 (2).
5. Chen C. Q Wu X. J., Yu Z. et al. Prognosis of patients with gastric cancer and solitary lymph node metastasis. World J Gastroenterol. 2013 Dec 14; 19 (46).
6. Voropayeva L. A., Valeyeva O. V. Possibilities of an ultrasonic angiography at chronic ulcerations of a stomach. Kazan medical Journal. 2011; 2.
7. Lelyuk V. G. Technique of ultrasonic research of vascular system: technology of scanning, standard indicators//Methodical manual. M., 2002.
8. Karmazanovskiy G. G. Spiral computer tomography: bolus contrast strengthening. M.: Vidar-M publishing house, 2005.
9. Chen C. Y., Wu D. C., Kang W. Y. Staging of gastric cancer with 16-channel MCDT. Abdominal imaging 2006; 31.
10. Chen C. Y., Hsu J. S., Wu D. C. et al. Gastric Cancer: Preoperative local staging with 3D multidetector row CT-correlation with surgical and histopathologic results. Radiology 2007; 242 (2).
11. Voropayeva L. A., Diomidova V. N.. The organization and introduction of modern beam technologies in algorithm of diagnostics of a cancer of a stomach//Public health and health care. 2010. № 1.
12. Diomidova V. N., Voropayeva L. A. Use of modern technologies of radiodiagnosis in screening of an ulcerated cancer of a stom-ach//Newsletter of the Chuvash university. 2010. № 3.
Pupelyte Ague,
student of Lithuanian University of Health Sciences
Kleinauskiene Rita, student of Lithuanian University of Health Sciences
Rakickas Julius,
student of Lithuanian University of Health Sciences E-mail: [email protected]
HDL, LDL, age and gender factors impact on cardiovascular disorders
Abstract: The aim of this research is to identify the factors eliciting coronary artery disease (CAD) among Lithuanian citizens, and to find out the influence of age and sex. Cardiovascular (CV) disease like CAD is one of the main factors of adults' death in developed countries. It is important to understand the causes of their origin and influence, in order to reduce mortality and morbidity of cardiovascular diseases.
Keywords: cardiovascular, CAD, HDL, LDL, TG.
Introduction: In scientific researches it has been found that [1] according to the latest World Health Organization data, Coronary heart disease has reached 38.26% of total deaths in Lithuania. [2] In 2012, mortality irom cardiovascular diseases in Lithuania was 775.5 cases of 100 000 population, while in 2013 — already 789.5 to 100,000 ofpop-ulation. The number of deaths from cardiovascular disease is not only higher than the European average, but also it is obviously increasing every year [3]. Coronary artery disease is often caused by atherosclerotic occlusion of the coronary arteries. Atherosclerosis is the buildup of cholesterol and fatty deposits (called plaque) on the inner walls of the arteries that restricts blood flow to the heart [4].
The risk factors for atherosclerosis and CAD are basically the same. These risk factors include high blood cholesterol level, high level of LDL and TG, low level of HDL, hypertension, diabetes, smoking, obesity, and physical inactivity [5]. In some studies, TG levels do not independently predict CAD mortality after adjustment
of other cardiac risk factors, whereas others suggest an independent effect [20]. Also CAD is a fairly common problem associated with aging. The majority of cardiovascular disease cases and deaths occur in the elderly people (>65 years).
The increase in aging population and predominant Western lifestyles, which are also being adopted in developing countries, combines to produce higher population levels of cholesterol and atherogenic dyslipidemia; the result is growing in the incidence of cardiovascular disease and death [7]. According to the University of Maryland Medical Center, 80 to 90 percent of individuals over the age of 30 have some degree of atherosclerosis [8]. Also, menopause is the major risk factor for females with CAD [18]. Menopause is a risk factor for CAD because estrogen withdrawal has a detrimental effect for cardiovascular function and metabolism. The menopause contributes to blood pressure, the increases of sympathetic tone, endothelial dysfunction and vascular inflammation [19].
The evaluation of the World Health Organization — has led the international program MONICA (Monitoring Cardiovascular Disease in). The results has shown that hypercholesterolemia increases the number of men and women deaths from ischemic heart disease [9]. Pioneering epidemiological projects such as the Seven Countries study, and the Framingham Heart studies showed that a raised serum of total cholesterol, high blood pressure (systolic and diastolic) and smoking prove that for women CAD level increases about 10 years later than for men [10]. Moreover, analysis of the Framingham Heart Study and Kaiser Permanente Heart Study cohorts showed significant associations between cholesterol levels and the risk ofCAD mortality of individuals with or without a history of CAD [11; 12; 13]. Studies showed that when cholesterol levels increases by 1 percent, the risk of heart attack increases by 2 percent [14]. The association between elevated serum cholesterol levels, aging and cardiovascular risk was established before several decades [15].
Therefore, early detection and correction of cardiovascular risk factors is necessary to extend the human life span and reduce
Summary of Age Groups
80
70 -
morbidity [16]. Both primary and secondary prevention trials of cholesterol lowering, using HMG-CoA reductase inhibitors, have demonstrated clear benefits for lipid lowering in preventing both cardiovascular morbidity and mortality [15].
The prospective Studies of Collaboration meta-analysis, which brought together 61 mainly European and American cohort studies, concluded that a lower total cholesterol plasma concentration of 1 mmol/L (39 mg/dL) was associated with a lower risk of mortality from CAD (hazard ratio: 0.89, 95% CI: 0.81-0.85) to individuals of both genders from 70 to 89 years of age [17]. Clinical studies have shown that treatment of dyslipidemia reduction CVD risk of 30 percent over 5 years [2, 14].
Results: This section presents analysis results when taking into account different factors. The selected factors are LDL, HDL, TG level, total cholesterol level and CAD level. All results are summarized using statistical visualization technique called probability density distribution diagrams. Diagram summarizes statistical distribution for each group. in Sample Set
J Men J Women
60 -
50
40
30
20 _
Figure 1. Summary of age groups in sample set distribution
From the 1st diagram we can see the summary of our respon- genders in the second group (age 65-75) and in the third group the dents. There are 3 separated age groups. There are mainly men in the domination of woman is seen (more than 75). first group (age less than 65); there is no huge difference between
LDL Level
Men ^J Women
<3 mmol/l <4.1 mmol/l <6 mmol/
Figure 2. LDL level distribution
10
0 L_
>75
0
6 mmol/l
Figure 2 presents LDL level results when it is separated into four groups by sex and LDL level. LDL is short for short-density lipoprotein. It is important that a low LDL level decreases risk of developing coronary disease. Horizontal axis shows LDL level and vertical axis probability between men and women. However,
HDL
0.6
0.5
0.4 0.3 0.2 0.1
0
Figure 3. HDL
Figure 3 presents results for HDL level. HDL is short for high-density lipoprotein. High HDL levels reduce the risk for heart diseases but low levels contrary increase the risk. HDL rates are: for men >1,2 mmol/l; women >1,4 mmol/l. From Figure 3 we can see
TG
0.8 _____
0.7
we can see that for highest results distribution of LDL is <3mmol/l for men and <6mmol/l for women. LDL rates are: <3 mmol/l — normal; <4,1 mmol/l — moderate increased; <6mmol/l — significantly increased; >6 mmol/l — critically increased. LDL shows a strong association with TG, HDL ratio. Level
<1.0 mmol/l
that respondents who have <1.0 mmol/l HDL are mostly men and respondents who have more than 1.0mmol/l are mostly women. In the figure 4 we can see the TG level distribution.
J Men J Women
| Men | Women
15 ro
■Q
g
Ql
Men: >1.2 mmol/l; Women: >1.4 mmol/l
level distribution
Level
0.6
£ = 04
ra .o
0
01
0.3
0.2
0.1
<1.7 mmol/l
<4.5 mmol/l
Figure 4. TG
It is important that respondents who have <1.7 mmol/l TG level are mostly women and respondents who have more than 1.7mmol/l, but less 4,5mmol/l are mostly men. So, in comparison we can say that TG level distribution among different genders is an important indicator and respondents who have more than 1.7mmol/l but less than 4,5mmol/l have increased risk of cardiovascular diseases than those respondents who have <1.7 mmol/l. Patients who have >4,5 mmol/l and <11 mmol/l have significantly increased risk of cardiovascular diseases.
<11 mmol/l
level distribution
>11 mmol/l
From Figure 5 we can see distribution of respondents who were tested by total cholesterol level in their blood. An aspiration of this mark is < 5,2 mmol/l. As a result, it is obvious that the biggest part of all patients who do not have higher marks of total cholesterol is men. In comparison with women who highly risk with cholesterol quantity 4,5mmol/l but less than 6,5 mmol/l and probability is less than 0.6. In other groups where total cholesterol is more than 6,5mmol/l but less than 8mmol/l probability for women is about 0.2.
0
Total Cholesterol Level
0.6
0.5
0.4
= 0.3
0.2
0.1
Men U Women
0.25
= 0.15
o Dl
0.1
Figure 5. Total Cholesterol level distribution CAD Level
j Men Women
1 VA Damage
2 VA Damage 3 VA Damage Small changes (<50%) No changes
Figure 6. CAD
From the figure 6 we can see distribution of CAD level. We decided to group CAD level groups into 5 smaller groups. It can be seen that 1-3 VA damage dominate in men's group. And mostly in women group are no changes or only small ones (less than 50%).
Conclusions
In this paper we evaluated effects of lipid gram's factors for risk of cardiovascular diseases. After analysis of patients we have found that actual correlation coefficient between CAD and LDL is -0.11, which shows a slight negative relationship between mentioned variables: as CAD damage level increases LDL level decreases or vice versa (correlation does not imply causation). However, the relationship is not strong and is based
level distribution
on 238 observations (patients that have both CAD and LDL data available).
After performing one-way-ANOVA test on CAD between men and women, we have found that p-value is equal to 0.035 (significantly different at 95% level) which shows strong evidence that CAD is significantly different between men and women. Also, HDL and LDL are very important marks. If patients have low level of HDL and LDL level is high it is important to change their lifestyle. There are some simple alternatives such as daily exercising, smoking cessation and overweight restriction. The last factor is vital while improving HDL and LDL levels, because absence of obesity reduces risk of heart disease and multiples other health conditions.
References:
1. Ann Intern Med: Cardiovascular risk profile in the TROPHY study: Is low risk hypertension fact or fiction? 2000.
2. Egidija Rinkûnienè, Aleksandras Laucevicius, Zaneta Petrulionienè,Jolita Badarienè. Teorija ir praktika: Lietuvos didelès kardiovaskulinès rizikos pacienta atrankos ir preventing priemoni^ (lithir) programos rezultatai: dislipidemijos paplitimas tarp vidutinio amziaus suaugusi^ lietuvos gyventoj^. 2012 - T.18.
0
<4.5 mmol/l
<6.5 mmol/l
<8 mmol/l
>8 mmol/l
0.3
0.2
0
3. Higienos Institutas: Mirties priezastys 2013. Vilnius, 2014.
4. Munther K. Homoud, MD. Tfuts. Coronary artery disease. New England Medical Center, 2008.
5. Dzau VJ., Antman E.M., Black H.R., Hayes D.L., MansonJ.E., PlutzkyJ. et al. Circulation: The cardiovascular disease continuum validated: clinical evidence of improved patient outcome: Part I: Pathophysiology and clinical trial evidence (Risk factors through stable coronary disease), 2006.
6. Roger V.L., Go A.S., Lloyd-Jones D.M., Benjamin E.J., Berry J.D., Borden W.B. Circulation: Heart disease and stroke statistics -2012 Update: A report from the American Heart Association, 2012.
7. Levi F., Chatenoud L., Bertoccio P., Lucchini F., Negri E., La Vecchia C. Eur J Cardiovasc Prev Rehabil: Mortality from cardiovascular disease in Europe and others areas of the world: an update, 2009.
8. Janelle Martel: Atherosclerosis, 2012.
9. Reklaitiene R, Margeviciene L, Tamosiunas A, et al. Medicina: Cholesterolio koncentracijos pokyciai ir isemines sirdies ligos rizika tarp Kauno 35-64 met^ gyventoj^, 2001.
10. Keil U. Basic Res Cardiol: Coronary artery disease: the role of lipids, hypertension and smoking, 2000.
11. Rubin S.M., Sidney S., Black D.M., Browner W.S., Hulley S.B., Cummings S.R. Ann Intern Med: High blood cholesterol in elderly men and the excess risk for coronary heart disease, 1990.
12. Castelli W.P., Wilson P.W., Levy D., Anderson K. Am J Cardiol: Cardiovascular risk factors in the elderly, 1989.
13. Wong N.D., Wilson P.W., Kannel W.B. An Intern Med: Serum cholesterol as prognostic factor after myocardial infarction: the Framingham Study, 1991.
14. Fisher N. Pazangioji kardiologija, 2007.
15. John C. LaRosa. American Journal of Cardiovascular Drugs: Reduction of Serum LDL-C Levels A Relationship to Clinical Benefits, 2003.
16. Graham I., Atar D., Borch-Johnsen K., Boysen G., Burell G., Cifkova R., Dallongeville J., De Backer G., Ebrahim S., Gjelsvik B. Eur J Cardiovasc Prev Rehabil: European guidelines on cardiovascular disease prevention in clinical practice, 2007.
17. Lewington S., Hitlock G., Clarke R., Sherliker P., Emberson J., Halsey J. Lancet: Blood cholesterol and vascular mortality by age, sex and blood pressure: a metaanalysis of individual data from 61 prospetive studies with 55,000 vascular deaths, 2007.
18. Sunita Suman Bala Sharma, Dinesh Puri, Ram Lagan Tripathi1 and Sridhar Dwivedi. International Journal of Medicine and Medical Sciences: Clinico-biochemical correlation with special reference to oxidized LDL and small dense LDL in Indian women with CAD, 2009.
19. Rosano G.M., Vitale C., Marazzi G., Volterrani M. Climacteric: Menopause and cardiovascular disease: the evidence, 2007.
20. Criqui M.H., Heiss G., Cohn R., Cowan L.D., Suchindran C.M., Bangdiwala S., Kritchevsky S., Jacobs D.R., O'Gray H.K., Davis C.E. Plasma triglyceride level and mortality from coronary heart disease, 1993.
Rajabov Askarjon Hamroqulovich, PhD Head of Congenital and Acquired ENT diseases Department, Republican Specialized Scientific Practical Medical Center of Pediatrics, Republic of Uzbekistan Inoyatova Flora Ilyasovna, professor Head of Hepatology Department, Republican Specialized Scientific Practical Medical Center of Pediatrics, Republic of Uzbekistan Amonov Shavkat Ergashevich, professor Head of ENT, pediatric ENT and dentistry Department, Tashkent Pediatric Medical Institute, Republic of Uzbekistan
E-mail: [email protected]
Clinical course of chronic tonsillitis in children with chronic hepatitis B
Abstract: In the course of our study was investigated the clinical course of chronic tonsillitis in children patients in combination with chronic hepatitis B. There were 120 children patients aged 3 to 18 years under our supervision. Our study showed that chronic tonsillitis with chronic hepatitis B occurs with frequent exacerbations, which contributes to the development of severe forms of chronic hepatitis B and affects the rate of disease progression and the frequency of adverse outcomes.
Keywords: tonsils, chronic tonsillitis, chronic hepatitis.
General medical value of tonsil's pathology caused by that described more than 100 diseases associated or combined with chronic tonsillitis can affect to the function of remote organs and chronic tonsillitis, which also includes liver diseases [4; 7]. systems. Chronic inflammation of tonsils is the direct or indirect Connection of pharyngeal lymphoid ring diseases with abnor-
cause of many pathological states in children, as well, as factor malities of the liver and biliary system is shown in the few research which deteriorates a course of various diseases [3]. Currently, it is works [1; 6]. A number of studies concerning the relationship of
