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Документ Androgen state and erectile function in men with chronic distress(Health of Man, 2024-03-29) Savchenko, R. B.; Sarychev, L. P.; Maksimenko, O. O.; Sarychev, Ya. V.; Suprunenko, S. M.; Strashko, Ye. Yu.; Pustovoyt, H. L.; Tenytska Ye. D.; Савченко, Роман Борисович; Саричев, Леонід Петрович; Максименко, Оксана Олександрівна; Саричев, Ярослав Володимирович; Супруненко, Сергій Миколайович; Страшко, Євген Юрійович; Пустовойт, Ганна Леонідівна; Теницька, Єлизавета ДмитрівнаThe objective: to study the state of androgen supply and erectile function in men with chronic distress. Materials and methods. We examined 30 internally replaced males (Average age, M±σ=50.50±3.83) with manifestations of chronic distress (Group I) and 20 practically healthy males (Group II), (Average age, M±σ=51.95±4.60). All men underwent general clinical examination, body mass index evaluation, assessment of depression according to Hospital Anxiety and Depression Scale (HADS), assessment of symptoms of androgen deficiency according to the Aging Males’ Symptoms (AMS). Severity of erectile dysfunction was evaluated according to the International Index of Erectile Function scale (IIEF). The following parameters were determined in blood serum: luteinizing hormone (LH), follicle-stimulating hormone (FSH), total testosterone (TT), free testosterone (TF), estradiol (E), cortisol (K). Results. According to the HADS scores in group I men, the average anxiety domain score was 12.03±1.50 points, the average depression domain score was 13.93±1.49, and the total score was 26.0±2.64 points. In patients of group II, the average anxiety domain score was 2.20±0.88 points, the average depression domain score was 2.60±1.00, and the overall score was 4.80±1.40 points. The comparison of the total score of group I and the total score of group II is statistically significant (p<0.05). According to the AMS, in men of group I, androgen deficiency was more expressed comparing to the control group (45.93±3.30 and 13.30±2.04 points, respectively, p<0.001). Analysis of the IIEF-15 questionnaire revealed a decrease in all indicators of erectile function in men of group I comparing to group II. A study of the hormonal state showed a decrease in the level of TT in men of group I compared to the indicators of group II: 9.30±2.84 and 15.27±0.96 ng/ml, respectively (p<0.001). The average TF levels in group I were reduced comparing to group II and reached 10.23±1.38 and 17.39±1.03 pg/ml, respectively (p<0.001). The levels of LH and FSH in men of group I were within normal age-related fluctuations and did not differ statistically significantly from similar levels of group II. The average E level in men with chronic distress was significantly increased comparing to the control group and reached up to 0.25±0.05 versus 0.11±0.03 nmol/l, respectively (p<0.001). The average C level in men with chronic distress was significantly increased comparing the control group and reached up to 13.33±2.19 versus 6.72±1.33 μg/dL, respectively (p<0.001). Conclusions. 1. The survey results indicate that chronic distress is a factor that worsens sexual function in men. In addition to erectile dysfunction, as evidenced by a decrease in the corresponding IIEF integrative indicator 15 «erectile function», the survey found a decrease in both the frequency of occurrence and the degree of sexual desire, a deterioration in orgasmic sensations in the form of a decrease in the frequency of ejaculation and orgasms.2. Cortisol is an important hormone that forms protective reaction in stressful situations, but loses its positive properties during chronic distress. A prolonged increase in cortisol levels can lead to a pathological condition accompanied by an increase in BMI, depression, anxiety, decreased testosterone levels and ED.3. A decrease in testosterone levels in chronic distress and visceral obesity in men is not accompanied by a compensatory increase in LH and FSH levels. This can be explained by increased aromatization of testosterone in visceral adipose tissue and a decrease in the pituitary gland’s response to the development of androgen deficiency as a result of combined damage to the central and peripheral parts of the regulation of testosterone synthesis.Документ Microscopic Polyangiitis is a “Masquerade Ball” in Modern Realities: A Literature Review(Open Access Journal of Urology & Nephrology, 2023-12-28) Yarmola, T. I.; Gutsalenko, O. O.; Tkachenko, L. A.; Katerenchuk, I. P.; Kostrikova, U. A.; Pustovoyt, H. L.; Talash, V. V.; Tsyganenko, I. V.; Ярмола, Тетяна Іванівна; Гуцаленко, Ольга Олексіївна; Ткаченко, Лідія Афанасіївна; Катеренчук, Іван Петрович; Кострікова, Юлія Анатоліївна; Пустовойт, Ганна Леонідівна; Талаш, Вікторія Володимирівна; Циганенко, Ірина ВолодимирівнаMicroscopic polyangiitis (MPA) is an important new medical problem, as it shows increasing incidence and prevalence in the population, especially after the outbreak of coronavirus disease 2019 (COVID-19). MPA is a multisystemic destructive disease with a wide spectrum of heterogeneous clinical manifestations depending on the affected organs. The polymorphism of nonspecific clinical signs and the variability of the clinical picture, which differs from patient to patient, can cause a diagnostic delay and establish the correct diagnosis only in the late stages of the disease. That is why many patients consult and receive treatment from different doctors before verifying the diagnosis. In the review article, an analysis of literary sources was made, which highlighted classic renal and/or pulmonary symptoms, skin, gastrointestinal, neurological and cardiovascular manifestations of MPA. It is important to note that the clinical manifestations of MPA can be very different from the usual recognized patterns and manifest as unusual manifestations of the disease with a hidden or atypical course, and therefore received the figurative name “the Great Masquerades”. So MPA can often hide under the “mask” of other diseases, including COVID-19 itself, which significantly complicates its early diagnosis and treatment. That is why doctors should be better informed about the different variants of the clinical course of MPA and approaches to diagnosis, which will help eliminate delays in diagnosis. After all, the rapid diagnosis of MPA is important for the initiation of adequate immunosuppressive therapy, which can both save lives, preserve organs from damage, and improve the quality of life.Документ Relationship between indicators of depression, quality of life, compliance and blood pressure in patients undergoing renal replacement therapy(Полтавський державний медичний університет, 2023) Rustamian, S. T.; Katerenchuk, I. P.; Yarmola, T. I.; Pustovoyt, H. L.; Tkachenko, L. A.; Ovcharenko, L. K.; Рустамян, Сатєнік Тігранівна; Катеренчук, Іван Петрович; Ярмола, Тетяна Іванівна; Пустовойт, Ганна Леонідівна; Ткаченко, Лідія Афанасіївна; Овчаренко, Людмила КостянтинівнаThis article presents the results of the relationship between blood pressure indicators and anxiety and depression, indicators of quality of life, compliance to treatment in patients undergoing renal replacement therapy. It was found that in patients undergoing dialysis therapy without accompanying diabetes, there is a direct correlation between blood pressure and the level of anxiety and depression in patients without and with diabetes. Similar changes are observed in patients undergoing peritoneal dialysis. In patients on programmed and peritoneal dialysis with and without concomitant diabetes there is a pronounced inverse correlation between the value of systolic blood pressure and components of quality of life and compliance. Dialysis patients are exposed to a number of components that significantly increase cardiovascular risk, and the elimination of which can significantly improve the effectiveness of therapy in dialysis patients and reduce the degree of cardiovascular risk. These factors include anxiety and depression, quality of life, and compliance to treatment. They are organically interconnected and significantly affect the leading cardiovascular risk factors and, first of all, arterial hypertension.Документ Андрогенно-естрогенний баланс та ліпідний обмін у чоловіків з цукровим діабетом 2 типу(Вищий державний навчальний заклад України «Українська медична стоматологічна академія», 2016) Пустовойт, Ганна Леонідівна; Пустовойт, Анна Леонидовна; Pustovoyt, H. L.Резюме. У роботі узагальнені дані літератури та особисті спостереження відносно вивчення андрогенно- естрогенного балансу та ліпідного обміну у чоловіків окремих вікових груп, хворих на цукровий діабет 2 типу у поєднанні з артеріальною гіпертензією.; Резюме. В работе обобщены данные литературы и личные наблюдения относительно изучения андрогенно-эстрогенного баланса и липидного обмена у мужчин отдельных возрастных групп, больных сахарным диабетом 2 типа в сочетании с артериальной гипертензией.; Abstract. The study of aging has an important place in modern medicine, as it is associated with an increase in life expectancy and, consequently, the number of aging people. The criterion of age-related changes of the population is life expectancy, which is calculated for each definite country. Life expectancy in Ukraine ranks 143 place in the world, mortality occupies first place. The main sex hormone, which determines gender identity and various aspects of the male body is testosterone. As it known, the main precursor for testosterone is cholesterol, and on earlier stages is glucose. The aim of study was to evaluate the androgen-estrogen balance and lipid metabolism in men of different age groups, patients with type 2 diabetes combined with hypertension. The study involved 88 men aged 45 to 76 years. All patients were divided into two groups according to age. Fifty study participants had a history of type 2 diabetes combined with hypertension and entered the main group of the appropriate age. The control group included 38 men who did not have the above-mentioned diseases. First group (I) consisted of 42 middle-aged men (45-59 years). Second group (II) included 46 males aged 60 years or more. According to a study design in patients of first age group suffering from type 2 diabetes combined with hypertension moderate hypertriglyceridemia was revealed, whereas in second age group, the levels were much higher. Atherogenic ratio was significantly higher (p<0.05) in patients of second age group compared with persons of the first age group. According to our records in patients with type 2 diabetes combined with hypertension significantly worsening lipid metabolism was observed, which can lead to progressing of atherosclerosis and development of severe complications such as coronary heart disease, myocardial infarction, stroke, obliterating arterial disease. During the study the decrease of total testosterone in patients with type 2 diabetes II age group was determined. Free testosterone level was almost twice reduced according to the main subgroups of the elder patients. At the same time estradiol levels were increased in both age groups of patients with type 2 diabetes complicated with hypertension. One reason for the decrease of total and free testosterone levels in diabetic patients is deterioration of blood supply as a result of testicular tissue angiopathy. Therefore, the treatment of age-related androgen deficiency in patients with type 2 diabetes must include drugs that improve microcirculation. In order to reduce cardiovascular risk normalization of lipid metabolism in the above-mentioned category of patients is required, which will also have a positive effect on testicular tissue and androgenic status of patients.