Pub Date : 2021-06-18DOI: 10.26641/2307-0404.2021.2.234513
I. Shifris, I. Dudar, Е. Krasiuk, А.Yu. Shymova
The aim of the study was to establish the frequency and possible predictors of cardiovascular disease (CVD) in chronic kidney disease (CKD) VD stage patients, treated with hemodialysis, based on results of prospective observation. The prospective observational cohort study included 223 patients with CKD V D stage who were treated with hemodialysis (HD) during 2012-2019. The research was carried out in two stages. At the first stage, main demographic, laboratory and clinical characteristics of patients, including the frequency of CVD, at the time of beginning the study were examined. At the second stage, based on prospective studying of the dynamics of the frequency of CV pathology, an assessment of potential predictors of CVD in CKD V D stage patients treated with HD was made. Patients’ characteristics determined at the beginning of the study were used as possible predictors. The average duration of prospective study was 35.5±17.8 months, cumulative – 579.3 patient-years. For determination of prognostic factors of CVD events, ROC-analysis, univariate and multivariate Cox proportional hazard regression analysis were done. The primary endpoint (newly diagnosed CVDs) was assesses at the end of the study. Statistical processing of the obtained results was performed using the MedCalc Statistical Software, version 19.3. During the study period, a significant increase of all CVD frequency by 80% (р<0.001) was stated, more than twice – of coronary artery disease (CAD; р<0.001) and atrial fibrillation (AF; р=0.0039). The incidence rate of CVD and CAD was 9.8 and 9.15 per 100-patient-years, respectively. The primary endpoint was observed in 92 (41.26%) patients: newly diagnosed CAD – in 53 patients, heart failure – in 12 patients, AF – in 9 patients, acute myocardial infarction – in 8 patients, other heart diseases – in 10 patients. Independent predictors on increased CVD risk in chronic kidney disease VD stage patients treated with hemodialysis are: age over 35 years, use of a central venous catheter as a vascular access during HD initiation, history of nasal MRSA collonization. In the other hand, serum albumin level of more than 36,6 g/l was associated with reduced risk.
本研究的目的是基于前瞻性观察的结果，确定慢性肾脏疾病(CKD) VD期接受血液透析治疗的患者发生心血管疾病(CVD)的频率和可能的预测因素。这项前瞻性观察队列研究包括223名2012-2019年接受血液透析(HD)治疗的CKD V D期患者。这项研究分两个阶段进行。在第一阶段，检查了研究开始时患者的主要人口统计学、实验室和临床特征，包括心血管疾病的发生频率。第二阶段，在前瞻性研究CV病理频率动态的基础上，评估CKD VD期HD患者CVD的潜在预测因素。在研究开始时确定的患者特征被用作可能的预测因子。前瞻性研究的平均持续时间为35.5±17.8个月，累计- 579.3患者年。为确定CVD事件的预后因素，进行roc分析、单因素和多因素Cox比例风险回归分析。在研究结束时评估主要终点(新诊断的心血管疾病)。使用MedCalc统计软件19.3版对所得结果进行统计处理。在研究期间，所有心血管疾病的频率显著增加了80%(<0.001)，超过冠状动脉疾病(CAD;<0.001)和心房颤动(AF;р= 0.0039)。CVD和CAD的发病率分别为9.8和9.15 / 100患者年。在92例(41.26%)患者中观察到主要终点:新诊断的CAD(53例)，心力衰竭(12例)，AF(9例)，急性心肌梗死(8例)，其他心脏病(10例)。接受血液透析治疗的慢性肾脏疾病VD期患者CVD风险增加的独立预测因素有:年龄超过35岁，在HD开始时使用中心静脉导管作为血管通道，鼻腔MRSA定殖史。另一方面，血清白蛋白水平超过36,6 g/l与风险降低相关。
{"title":"Predictors of cardiovascular disease in patients with chronic kidney disease VD stage treated with hemodialysis","authors":"I. Shifris, I. Dudar, Е. Krasiuk, А.Yu. Shymova","doi":"10.26641/2307-0404.2021.2.234513","DOIUrl":"https://doi.org/10.26641/2307-0404.2021.2.234513","url":null,"abstract":"The aim of the study was to establish the frequency and possible predictors of cardiovascular disease (CVD) in chronic kidney disease (CKD) VD stage patients, treated with hemodialysis, based on results of prospective observation. The prospective observational cohort study included 223 patients with CKD V D stage who were treated with hemodialysis (HD) during 2012-2019. The research was carried out in two stages. At the first stage, main demographic, laboratory and clinical characteristics of patients, including the frequency of CVD, at the time of beginning the study were examined. At the second stage, based on prospective studying of the dynamics of the frequency of CV pathology, an assessment of potential predictors of CVD in CKD V D stage patients treated with HD was made. Patients’ characteristics determined at the beginning of the study were used as possible predictors. The average duration of prospective study was 35.5±17.8 months, cumulative – 579.3 patient-years. For determination of prognostic factors of CVD events, ROC-analysis, univariate and multivariate Cox proportional hazard regression analysis were done. The primary endpoint (newly diagnosed CVDs) was assesses at the end of the study. Statistical processing of the obtained results was performed using the MedCalc Statistical Software, version 19.3. During the study period, a significant increase of all CVD frequency by 80% (р<0.001) was stated, more than twice – of coronary artery disease (CAD; р<0.001) and atrial fibrillation (AF; р=0.0039). The incidence rate of CVD and CAD was 9.8 and 9.15 per 100-patient-years, respectively. The primary endpoint was observed in 92 (41.26%) patients: newly diagnosed CAD – in 53 patients, heart failure – in 12 patients, AF – in 9 patients, acute myocardial infarction – in 8 patients, other heart diseases – in 10 patients. Independent predictors on increased CVD risk in chronic kidney disease VD stage patients treated with hemodialysis are: age over 35 years, use of a central venous catheter as a vascular access during HD initiation, history of nasal MRSA collonization. In the other hand, serum albumin level of more than 36,6 g/l was associated with reduced risk.","PeriodicalId":18652,"journal":{"name":"Medicni perspektivi (Medical perspectives)","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87818670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-18DOI: 10.26641/2307-0404.2021.2.234486
S. Shtrygol’, I. Kapelka, M. V. Mishchenko, O. Mishchenko
The participation of arachidonic acid metabolism products – prostaglandins and leukotrienes – in the process of inflammation is a common pathogenetic link of cold injury and epilepsy. Montelukast is widely used for the treatment of bronchial asthma and allergic rhinitis as a leukotriene receptor blocker. However, the mechanism of action of the drug suggests a wider range of its pharmacological properties and the corresponding scope of application. This study is aimed to determine the effectiveness of montelukast as a potential frigoprotective and anticonvulsant drug. Experiments were performed on 73 white mice weighing 20-22 g on models of acute general cooling and pentylenetetrazol convulsions. Frigoprotective properties were studied at a temperature of –18°C, recording the lifetime. Montelukast ("Singular", 2 mg/kg), acetylsalicylic acid ("Aspirin", 50 mg/kg), celecoxib ("Celebrex", 74 mg/kg), diclofenac sodium ("Voltaren", 14 mg/kg) were administered intragastrically as a suspension in a prophylactic mode, 30 minutes before the cold injury. In the study of anticonvulsant activity, montelukast ("Singular", 4 mg/kg) and sodium valproate ("Depakin", 300 mg/kg) were administered intragastrically 30 minutes before stimulating convulsions by subcutaneous administration of pentylenetetrazole (90 mg/kg). The latent period of convulsions, the number of convulsions per 1 animal, % of mice with clonic and tonic paroxysms, the severity of convulsions in points, the duration of the convulsive period, the lifetime of animals and lethality were recorded for an hour. On the model of acute general cooling, montelukast showed a dose-dependent frigoprotective effect at a dose of 2 mg/kg surpassing drugs with proven frigoprotective properties – acetylsalicylic acid and celecoxib. On the model of pentylenetetrazole-induced convulsions, montelukast statistically significantly reduced the integral indicator of anticonvulsant activity – lethality – by 2.57 times. Thus, the experiment proved the significant role of leukotrienes in the pathogenesis of cold injury and epilepsy and justified the feasibility of further study of the frigoprotective and anticonvulsant properties of montelukast – leukotriene receptor blocker a drug as for adjuvant therapy, especially when these pathologies are combined with bronchial asthma and allergic rhinitis.
{"title":"Non-obvious effects of montelukast – leukotriene receptor blocker: frigoprotective and anticonvulsant properties","authors":"S. Shtrygol’, I. Kapelka, M. V. Mishchenko, O. Mishchenko","doi":"10.26641/2307-0404.2021.2.234486","DOIUrl":"https://doi.org/10.26641/2307-0404.2021.2.234486","url":null,"abstract":"The participation of arachidonic acid metabolism products – prostaglandins and leukotrienes – in the process of inflammation is a common pathogenetic link of cold injury and epilepsy. Montelukast is widely used for the treatment of bronchial asthma and allergic rhinitis as a leukotriene receptor blocker. However, the mechanism of action of the drug suggests a wider range of its pharmacological properties and the corresponding scope of application. This study is aimed to determine the effectiveness of montelukast as a potential frigoprotective and anticonvulsant drug. Experiments were performed on 73 white mice weighing 20-22 g on models of acute general cooling and pentylenetetrazol convulsions. Frigoprotective properties were studied at a temperature of –18°C, recording the lifetime. Montelukast (\"Singular\", 2 mg/kg), acetylsalicylic acid (\"Aspirin\", 50 mg/kg), celecoxib (\"Celebrex\", 74 mg/kg), diclofenac sodium (\"Voltaren\", 14 mg/kg) were administered intragastrically as a suspension in a prophylactic mode, 30 minutes before the cold injury. In the study of anticonvulsant activity, montelukast (\"Singular\", 4 mg/kg) and sodium valproate (\"Depakin\", 300 mg/kg) were administered intragastrically 30 minutes before stimulating convulsions by subcutaneous administration of pentylenetetrazole (90 mg/kg). The latent period of convulsions, the number of convulsions per 1 animal, % of mice with clonic and tonic paroxysms, the severity of convulsions in points, the duration of the convulsive period, the lifetime of animals and lethality were recorded for an hour. On the model of acute general cooling, montelukast showed a dose-dependent frigoprotective effect at a dose of 2 mg/kg surpassing drugs with proven frigoprotective properties – acetylsalicylic acid and celecoxib. On the model of pentylenetetrazole-induced convulsions, montelukast statistically significantly reduced the integral indicator of anticonvulsant activity – lethality – by 2.57 times. Thus, the experiment proved the significant role of leukotrienes in the pathogenesis of cold injury and epilepsy and justified the feasibility of further study of the frigoprotective and anticonvulsant properties of montelukast – leukotriene receptor blocker a drug as for adjuvant therapy, especially when these pathologies are combined with bronchial asthma and allergic rhinitis.","PeriodicalId":18652,"journal":{"name":"Medicni perspektivi (Medical perspectives)","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73939939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-18DOI: 10.26641/2307-0404.2021.2.234736
O. E. Khudiakov
Doctor of Medical Science, Professor, Honoured Scientist of Ukraine Sukmansky Oleh Ivanovych(to his 90th birthday)
医学博士、教授、乌克兰荣誉科学家苏克曼斯基·奥列·伊万诺维奇(庆祝他90岁生日)
{"title":"Doctor of Medical Science, Professor, Honoured Scientist of Ukraine Sukmansky Oleh Ivanovych (to his 90th birthday)","authors":"O. E. Khudiakov","doi":"10.26641/2307-0404.2021.2.234736","DOIUrl":"https://doi.org/10.26641/2307-0404.2021.2.234736","url":null,"abstract":"Doctor of Medical Science, Professor, Honoured Scientist of Ukraine Sukmansky Oleh Ivanovych(to his 90th birthday)","PeriodicalId":18652,"journal":{"name":"Medicni perspektivi (Medical perspectives)","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84859454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-18DOI: 10.26641/2307-0404.2021.2.234733
V. Chorna, V. Makhniuk, S. Khliestova, N. Gumeniuk, H. Chaika
The article presents the results of theoretical and experimental studies of the degrees of value-motivational, cognitive, emotional, and behavioral components in health care workers of psychiatric health care facilities concerning their health. The degree of risk and value of the personal hygiene of health care workers is determined. The main components and factors that affect the attitude to personal health are revealed. The awareness of the own emotional and cognitive experiences by the medical staff of psychiatric hospitals regarding the preservation and strengthening of their hygiene is analyzed. According to research on the value-motivational component of the medical staff of psychiatric health care concerning the place of personal health in the hierarchy of values in life, it was found that own health is on the second place – 15.2% males, nursing staff (NS), 15.1% females, are psychiatrists and women NS, 14.8% are men psychiatrists. In case of a deterioration of own health both women (35,6%), and men (35,5%) psychiatrists are engaged in self-treatment, the similar tendency is among NS – women NS – 31,3%, men NS – 31, 5%), in 25.8% of cases female psychiatrists and in 23.1% of men NS do not pay attention to the disease at all, which leads to occupational diseases and chronic diseases. At the same time, occupational diseases among doctors and NS do not exceed 10% of the total number of occupational diseases in Ukraine due to self-medication and early treatment. Therefore, the statistics of occupational diseases of health workers in that field are underestimated compared to the actual ones.
{"title":"Attitude of health care workers in the field of mental health to their health","authors":"V. Chorna, V. Makhniuk, S. Khliestova, N. Gumeniuk, H. Chaika","doi":"10.26641/2307-0404.2021.2.234733","DOIUrl":"https://doi.org/10.26641/2307-0404.2021.2.234733","url":null,"abstract":"The article presents the results of theoretical and experimental studies of the degrees of value-motivational, cognitive, emotional, and behavioral components in health care workers of psychiatric health care facilities concerning their health. The degree of risk and value of the personal hygiene of health care workers is determined. The main components and factors that affect the attitude to personal health are revealed. The awareness of the own emotional and cognitive experiences by the medical staff of psychiatric hospitals regarding the preservation and strengthening of their hygiene is analyzed. According to research on the value-motivational component of the medical staff of psychiatric health care concerning the place of personal health in the hierarchy of values in life, it was found that own health is on the second place – 15.2% males, nursing staff (NS), 15.1% females, are psychiatrists and women NS, 14.8% are men psychiatrists. In case of a deterioration of own health both women (35,6%), and men (35,5%) psychiatrists are engaged in self-treatment, the similar tendency is among NS – women NS – 31,3%, men NS – 31, 5%), in 25.8% of cases female psychiatrists and in 23.1% of men NS do not pay attention to the disease at all, which leads to occupational diseases and chronic diseases. At the same time, occupational diseases among doctors and NS do not exceed 10% of the total number of occupational diseases in Ukraine due to self-medication and early treatment. Therefore, the statistics of occupational diseases of health workers in that field are underestimated compared to the actual ones.","PeriodicalId":18652,"journal":{"name":"Medicni perspektivi (Medical perspectives)","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85125887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-18DOI: 10.26641/2307-0404.2021.2.234521
I. Gladchuk, N. Rozhkovska, N. Kashtalian
The last decades showed the worldwide tendency to finding consensus between diagnostics improvement and constant increase of cost of medical services in conditions of restricted financing. The aim of the article was to analyze the diagnostic value of p16 and Ki-67 biomarkers in diagnostics of precancerous diseases of cervix. Data of 80 patients with cervical dysplasia of varying degree who received excisional treatment were analyzed. It was shown that cytological study has a high sensitivity (79.17%) for the diagnosis of CIN 2-3, but low specificity (53.57%). The p16 immunocytochemical biomarker has a high sensitivity for the diagnosis of CIN 2 (0.92; 95% CI: 0.76-0.98) with good specificity (0.78; 95% CI: 0.67-0.82), for the diagnosis of CIN 3 both sensitivity (0.93; 95% CI: 0.82-0.98) and specificity (0.93; 95% CI: 0.82-0.98) is high. The immunocytochemical biomarker Ki-67 has a high sensitivity for CIN 2 (0.92; 95% CI: 0.65-0.99), but insufficient specificity (0.62; 95% CI: 0.54-0.64), for the diagnosis of CIN 3 the sensitivity is very high (0.96; 95% CI: 0.80-0.99) as well as specificity (0.78; 95% CI: 0.69-0.81). The combined use of p16 and Ki-67 biomarkers can significantly increase the diagnostic accuracy of the diagnosis of high-grade precancerous pathology of cervix and justify timely surgical intervention. Such an approach for the differential diagnosis of severe dysplasia, on the one hand, may contribute to a decrease in the risk of developing cervical cancer, and on the other hand, it will allow to avoid unnecessary operations and preserve reproductive function of women, reduce the economic costs of treatment.
{"title":"The role of immunocytochemical biomarkers in diagnostics of precancerous pathology of cervix","authors":"I. Gladchuk, N. Rozhkovska, N. Kashtalian","doi":"10.26641/2307-0404.2021.2.234521","DOIUrl":"https://doi.org/10.26641/2307-0404.2021.2.234521","url":null,"abstract":"The last decades showed the worldwide tendency to finding consensus between diagnostics improvement and constant increase of cost of medical services in conditions of restricted financing. The aim of the article was to analyze the diagnostic value of p16 and Ki-67 biomarkers in diagnostics of precancerous diseases of cervix. Data of 80 patients with cervical dysplasia of varying degree who received excisional treatment were analyzed. It was shown that cytological study has a high sensitivity (79.17%) for the diagnosis of CIN 2-3, but low specificity (53.57%). The p16 immunocytochemical biomarker has a high sensitivity for the diagnosis of CIN 2 (0.92; 95% CI: 0.76-0.98) with good specificity (0.78; 95% CI: 0.67-0.82), for the diagnosis of CIN 3 both sensitivity (0.93; 95% CI: 0.82-0.98) and specificity (0.93; 95% CI: 0.82-0.98) is high. The immunocytochemical biomarker Ki-67 has a high sensitivity for CIN 2 (0.92; 95% CI: 0.65-0.99), but insufficient specificity (0.62; 95% CI: 0.54-0.64), for the diagnosis of CIN 3 the sensitivity is very high (0.96; 95% CI: 0.80-0.99) as well as specificity (0.78; 95% CI: 0.69-0.81). The combined use of p16 and Ki-67 biomarkers can significantly increase the diagnostic accuracy of the diagnosis of high-grade precancerous pathology of cervix and justify timely surgical intervention. Such an approach for the differential diagnosis of severe dysplasia, on the one hand, may contribute to a decrease in the risk of developing cervical cancer, and on the other hand, it will allow to avoid unnecessary operations and preserve reproductive function of women, reduce the economic costs of treatment.","PeriodicalId":18652,"journal":{"name":"Medicni perspektivi (Medical perspectives)","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91549005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-18DOI: 10.26641/2307-0404.2021.2.234640
M. Melnychuk
Such premalignant conditions of prostate cancer (PC) as prostate intraepithelial neoplasia (PIN) are classified between benign and malignant ones. Contemporary evidence wheather PIN develops malignancy is limited and (LGPIN) data present varied results. Morphological and clinical differencies between high (HGPIN) and low grade PIN specimens in the prostate remain unclear. Aim of the work – to determine clinical significance and progression ability of high grade and low grade prostate intraepithelial neoplasia. The results of examination of 276 patients with PIN (152 patients with high grade PIN and 134 patients with low grade PIN) were assessed comparatively. During a 3 year follow-up repeated prostate biopsies were performed with 6 months interval to detect PC. Initial and repeated multifocal transrectal prostate biopsies from 12 samples were performed under transrectal ultrasonic guidance. There were statistically significant differences in PC detection rates between HGPIN and LGPIN. Patients with HGPIN had malignization rate of 42.1% during a 3-year follow-up that was by 33.9% higher than in LGPIN patients. The spread of HGPIN lesions within prostate gland is a malignization risk factor. The mean malignization term of HGPIN is 18 months and of LGPIN – 30 months. Low and high grade PIN are gradual stages of cancerogenesis. PIN grade determines its clinical significance, while LGPIN has low malignization potential, HGPIN possesses morphological and clinical prostate characteristics similar to adenocarcinima.
{"title":"Clinical significance of high grade and low grade prostate intraepithelial neoplasia","authors":"M. Melnychuk","doi":"10.26641/2307-0404.2021.2.234640","DOIUrl":"https://doi.org/10.26641/2307-0404.2021.2.234640","url":null,"abstract":"Such premalignant conditions of prostate cancer (PC) as prostate intraepithelial neoplasia (PIN) are classified between benign and malignant ones. Contemporary evidence wheather PIN develops malignancy is limited and (LGPIN) data present varied results. Morphological and clinical differencies between high (HGPIN) and low grade PIN specimens in the prostate remain unclear. Aim of the work – to determine clinical significance and progression ability of high grade and low grade prostate intraepithelial neoplasia. The results of examination of 276 patients with PIN (152 patients with high grade PIN and 134 patients with low grade PIN) were assessed comparatively. During a 3 year follow-up repeated prostate biopsies were performed with 6 months interval to detect PC. Initial and repeated multifocal transrectal prostate biopsies from 12 samples were performed under transrectal ultrasonic guidance. There were statistically significant differences in PC detection rates between HGPIN and LGPIN. Patients with HGPIN had malignization rate of 42.1% during a 3-year follow-up that was by 33.9% higher than in LGPIN patients. The spread of HGPIN lesions within prostate gland is a malignization risk factor. The mean malignization term of HGPIN is 18 months and of LGPIN – 30 months. Low and high grade PIN are gradual stages of cancerogenesis. PIN grade determines its clinical significance, while LGPIN has low malignization potential, HGPIN possesses morphological and clinical prostate characteristics similar to adenocarcinima.","PeriodicalId":18652,"journal":{"name":"Medicni perspektivi (Medical perspectives)","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83642459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-18DOI: 10.26641/2307-0404.2021.2.234734
T. Kirieieva, T. Pertseva, N. Kravchenko, B. Basina
Venous thromboembolism (pulmonary embolism (PE) and deep vein thrombosis (DVT)) is the third among all cardiovascular syndromes in the world, second only to heart attack and stroke. Estimation of clinical probability of this condition takes into account many factors, including age. But in case of PE probability in young patient data of scales such as Geneva Score (Revised), Wells' criteria for pulmonary embolism, the PERC rule may be misleading. For this group a new influential factor emerges – thrombophilia. The aim of our work was to demonstrate the approach to identifying whom and when to test for genetic predisposition for thrombosis, based on a clinical case of young male with unprovoked episode of PE. Testing patients for thrombophilia is a good way to develop a personalised approach in case of prescribing long-term anticoagulant treatment. Moreover, patient’s awareness about congenital condition helps to increase complience which is crucial, due to the fact that in case of unprovoked pulmonary embolism another episode can occur in up to 50 % of cases during the next 5 years. In addition, further accumulation and analysis of data on the amount of genetic risk factors for thrombosis will expand our understanding of this issue and in the future will allow us to better diagnose and treat this condition.
{"title":"Genetic testing for thrombophilia in case of unprovoked episode of pulmonary embolism","authors":"T. Kirieieva, T. Pertseva, N. Kravchenko, B. Basina","doi":"10.26641/2307-0404.2021.2.234734","DOIUrl":"https://doi.org/10.26641/2307-0404.2021.2.234734","url":null,"abstract":"Venous thromboembolism (pulmonary embolism (PE) and deep vein thrombosis (DVT)) is the third among all cardiovascular syndromes in the world, second only to heart attack and stroke. Estimation of clinical probability of this condition takes into account many factors, including age. But in case of PE probability in young patient data of scales such as Geneva Score (Revised), Wells' criteria for pulmonary embolism, the PERC rule may be misleading. For this group a new influential factor emerges – thrombophilia. The aim of our work was to demonstrate the approach to identifying whom and when to test for genetic predisposition for thrombosis, based on a clinical case of young male with unprovoked episode of PE. Testing patients for thrombophilia is a good way to develop a personalised approach in case of prescribing long-term anticoagulant treatment. Moreover, patient’s awareness about congenital condition helps to increase complience which is crucial, due to the fact that in case of unprovoked pulmonary embolism another episode can occur in up to 50 % of cases during the next 5 years. In addition, further accumulation and analysis of data on the amount of genetic risk factors for thrombosis will expand our understanding of this issue and in the future will allow us to better diagnose and treat this condition.","PeriodicalId":18652,"journal":{"name":"Medicni perspektivi (Medical perspectives)","volume":"300 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86441653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-18DOI: 10.26641/2307-0404.2021.2.234722
A. Ipatov, N. Sanina, I. Khanyukova
In order to determine the possibility of using a rehabilitation profile to assess the effectiveness of rehabilitation and develop a methodology for quantifying the effectiveness of rehabilitation measures in the short term in inpatients of the State Institution "Ukrainian State Research Institute of Medical and Social Disability of the Ministry of Health of Ukraine" we created a rehabilitation profile of the patient based on the principles of the International Classification of Functioning, Disability and Health (ICF). There were analyzed rehabilitation profiles of 522 patients with therapeutic pathology, musculoskeletal system diseases, and eye diseases. Rehabilitation of patients was comprehensive, with the use of methods of medical, psychological, and physical rehabilitation. The severity of dysfunctions was assessed by a quantitative scale from 0 to 4 points, where "0" – no issues, and "4" – extremely serious issue. The evaluation was performed twice by members of the multidisciplinary team: at the initial examination of the patient and at the discharge from the clinic. The statistical method and the method of expert evaluations were used to process the research results. The licensed software MS Excel for Windows was used. The study found that the proposed method of assessing the effectiveness of short-term rehabilitation is accurate and objective, it considers the initial functional status of the patient and allows to assess the quality and effectiveness of rehabilitation measures at the patient level and at the institution. Its implementation will provide a unified approach to the provision of rehabilitation services and draw conclusions about the effectiveness of rehabilitation activities of the medical institution differentially, considering the type of pathology, leading limitations of life, severity of disorders, age of patients.
为了确定使用康复概况来评估康复效果的可能性，并制定一种方法来量化国家机构"乌克兰卫生部医疗和社会残疾国家研究所"住院病人短期内康复措施的效果，我们根据国际功能分类的原则创建了病人的康复概况。残疾和健康(ICF)。分析了522例治疗性病理、肌肉骨骼系统疾病和眼病患者的康复概况。患者的康复是全面的，采用了医学、心理和身体康复的方法。功能障碍的严重程度通过从0到4分的定量量表进行评估，其中“0”表示没有问题，“4”表示非常严重。多学科小组成员进行了两次评估:在患者的初步检查和出院时。采用统计方法和专家评价方法对研究结果进行处理。使用授权软件MS Excel for Windows。研究发现，所提出的短期康复效果评估方法准确客观，考虑了患者的初始功能状态，可以在患者层面和机构层面对康复措施的质量和效果进行评估。它的实施将为提供康复服务提供统一的方法，并根据病理类型、生命的主要限制、疾病的严重程度和患者的年龄，对医疗机构康复活动的有效性得出不同的结论。
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Pub Date : 2021-06-18DOI: 10.26641/2307-0404.2021.2.234732
I. Aliyeva
The purpose of this study was to determine dynamics of the levels of type I diabetes mellitus (DM) incidence in the regions with its different incidence. Material from the Azerbaijan Republican and Regional Registers of Diabetes Mellitus were used in this study. All cases of newly diagnosed type 1 DM and documented according to the clinical protocol in 2012-2016 were selected. At the first stage of the study, the rates of diabetes were identified in all administrative-territorial entities. Two groups from administrative-territorial entities were formed for further observation: the first group included regions with high (>80) incidence of type 1 DM, the second group included regions with low (<40) incidence of type 1 DM. At the next stages, changes in type 1 DM incidence were studied and a mean chronological incidence over five years (2012-2016) was determined. Morbidity rate in cities and regions of Azerbaijan in 2012 changed within a range from 5.4 to 294.8. The lowest incidence was observed in three districts: 5.4 in Agjabedi, 5.8 in Jalilabad, 6.1 in Masalli. Very high incidence was observed in Shamkir (294.8) and Khachmaz (278.7) districts. Data from Agdash (30.6) and NAR (32.2) were closer to data from the districts with low incidence. Incidence in Shirvan (81.9) and Yexlakh (171.7) districts was high, but lower than in Shamkir and Khachmaz districts. Type 1 DM incidence has significant interregional differences. Interregional differences in type 1 DM incidence do not depend on the age of the population; age-adjusted incidence of type 1 DM is within a range of 5.0-77.4.
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Pub Date : 2021-06-18DOI: 10.26641/2307-0404.2021.2.234498
O. Fedosieieva
During the individual development and exposure to infectious agents of the organism, the structural components of the thyroid gland can change significantly. In modern research, great importance is attached to the study of mechanisms for maintaining morphological homeostasis of the thyroid gland and ideas about its structural and functional restructuring in response to the body's immune system to various infections. The morpho-functional features of the thyroid gland of newborn animals after prenatal action of thyroid-nonspecific antigen (staphylococcal toxoid) have been experimentally established. In antigen-premiumed rats, the timing of folliculogenesis changes, as well as the size, distribution and immunohistochemical expression of antibodies to thyroglobulin, the functional state of thyrocytes and follicles compared to normal. The detected immunohistochemical changes indicate signs of morpho-functional immaturity of the organ with hypoactivity elements.
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