Wiadomosci lekarskie最新文献

Objective: Aim: Breast cancer (BC) remains the most common malignant disease among women in Ukraine and worldwide. The indication for neoadjuvant hormone therapy (NAHT) is HR+/HER2- breast cancer of stage II-III. However, there are currently insufficient data on its impact on the IHC biological characteristics of tumors and clinical outcomes.

Patients and methods: Materials and Methods: The study was conducted at the Uzhhorod Treatment and Diagnostic Oncology Center during 2015-2023. At the diagnostic stage, morphological verification and IHC profile were determined based on trephine biopsy material. The study included 28 patients with HR+/HER2- BC, aged from 38 to 75 years old. All patients were prescribed NAHT with the use of aromatase inhibitors for 6.10±2.23 months. The expression levels of ER, PR, Ki-67, category G were assessed before and after NAHT using histological and IHC analyses.

Results: Results: After NAHT, we observed a decrease in Ki-67 levels from 25.31% to 10.25%, ER expression levels from 97% to 84%, and PR expression levels from 87% to 11%. There were changes in category G: G1 was observed in 45.83% of patients, G2 in 54.17%. The staging of BC also decreased. A moderate degree of curative tumor pathomorphosis was achieved in 76.47% of patients, and complete regression (pCR) in 5.88%.

Conclusion: Conclusions: Neoadjuvant hormone therapy demonstrated high efficacy in the treatment of patients with luminal HR+/HER2- BC of stage II-III. In most cases, it was possible to reduce the proliferative activity of the tumor, which was accompanied by a decrease in tumor staging. This made it possible to perform organpreserving surgeries in 60.71%, which confirms the feasibility of using NAHT as an alternative to chemotherapy in certain groups of patients.

Objective: Aim: To classify systemic pathomorphologic changes in severe acute pancreatitis (SAP) and to identify histologic features associated with abdominal compartment syndrome (ACS).

Patients and methods: Materials and Methods: The retrospective cohort examination of 53 patients with SAP, who died due to progressive organ failure. Microscopic specimens of the heart, lungs, liver, kidneys and intestines have been reviewed, divided by the proposed four levels of pathological changes and comparable between the two groups, depending on the presence of AСS (25 and 28 patients).

Results: Results: When comparing in two groups the levels of lesions of each studied organ, according to given levels of change, a statistically significant difference between groups in the level of kidney and intestine lesions (P <0.05, Mann-Whitney U-Test) was obtained. The changes in moderate and severe levels were significantly dominating in the microscopic specimens of the kidneys and intestines of group A compared to group B (p <0.001).

Conclusion: Conclusions: Histopathological changes in the examined organs of patients who died from severe acute pancreatitis complicated by abdominal compartment syndrome were characterized by more pronounced ischemic and inflammatory damage in the kidneys and intestines. The variability of extrapancreatic pathological changes in SAP patients depended on intra-abdominal pressure levels. Monitoring and timely correction of intra-abdominal hypertension aimed at preventing ACS in SAP patients may influence disease progression and treatment outcomes.

Objective: Aim: To present theoretical and practical approaches to the development of digital competence among participants in the medical education environment based on the digitalization of Ukraine's healthcare system.

Patients and methods: Materials and Methods: To achieve the research objective, general scientific theoretical and empirical methods were used, including: bibliosemantic method, system analysis method, conversations and interviews with participants in the educational process, modeling of the process of formation of digital competence.

Results: Results: An analysis of self-assessment and the level of digital competence formation among healthcare representatives helped determine the criteria for updating educational programs on digital competence development as a result, steps were taken to introduce comprehensive training in digital competencies, covering previously unaddressed aspects and enabling healthcare professionals to acquire all necessary competencies. Therefore, we presented a model illustrating the interrelation of competency formation and learning outcomes (LOs) through the lens of qualification characteristics and higher education standards for the specialty, interpreted in the information-educational environment model NMU_DIGITAL.

Conclusion: Conclusions: Medical and pharmaceutical education must adapt to modern standards and tools, regardless of whether they relate to treatment, prevention, rehabilitation, or management activities. Developing digital competence and using digital tools should begin at the earliest stages of professional orientation, be thoroughly studied at the pre-higher and higher education levels, and continue through lifelong professional development.

Objective: Aim: To assess condition of periodontal health and serum levels of interleukin-1β in periodontitis and control groups and determine relationship between serum levels of interleukin-1β and clinical periodontal parameters in periodontitis and control groups.

Patients and methods: Materials and Methods: A sample consists of 80 male participants, ages thirty to sixty. A total of twenty people were separated into four groups: twenty people with stage I, twenty people with stage II, and twenty people with stage III periodontitis. Periodontium of control group was clinically sound, for every subject, clinical periodontal parameter were measured, such as depth of probing pocket, bleeding on probing, clinical attachment level, and plaque index. Following clinical evaluation, five milliliters of venous blood were extracted from each group. Serum samples were frozen at (-20)°C after centrifusion. Level of interleukin-1β in serum was measured using mean of enzyme-linked immune-sorbent assay (ELISA).

Results: Results: Group with stage III periodontitis had highest serum interleukin-1 β levels, which were followed by those in stages II and I. There were notable variations between groups, with control group exhibiting lowest levels of interleukin-1 β group. An increased stage of periodontitis was indicated by a statistical analysis of clinical periodontal parameters, which showed a significant difference in mean of all clinical periodontal parameters. There were non-significant weak positive correlations of interleukin-1β with all clinical measures at all periodontitis groups, with exception of a moderately positive correlation with PLI, BOP, and CAL in stage I periodontitis group.

Conclusion: Conclusions: Serum interleukin-1β could be used to differentiate between periodontitis stages.

Objective: Aim: To study of the data about the results of tracheal cicatricial stenoses treatment with the goal of further improvement of its results on the basis of diagnosis enhancing, identification of factors of prognosis of the disease and by conducting a differential analysis of tactics of surgical treatment with the use of minimally invasive interventions.

Patients and methods: Materials and Methods: We have identified contemporary literature sources on the topic of modern directions of treatment of tracheal cicatricial stenoses and their complications. The studied material has been summarized and represented in the form of literature review in this article.

Conclusion: Conclusions: To increase the quality of treatment of patients with tracheal cicatricial stenoses and their surgical complications an important role is played by objective formation of groups at risk of complications development and prognosis of the disease dynamics. Successful solution of the problem is related mostly to the highly informative diagnostics, reliable determination of severity of disease, as well creation of multidirectional classification of tracheal cicatricial stenoses. These issues may not be considered completely solved, they require further study. All of the above dictates search of new effective methods of treatment of the indicated pathology and proves relevance of the topic. The stated information emphasizes necessity of improvement of surgical tactics of patients with tracheal cicatricial stenoses.

Objective: Aim: To investigate the concentration of natural anticoagulants protein C (PC) and tissue plasminogen activator (t-PA) in patients with rheumatoid arthritis (RA) and to evaluate the effect of their concentration on the course of the disease.

Patients and methods: Materials and Methods: We examined 74 patients with RA. There were 15 men and 59 women and control group consisted of 27 subjects. The average age of the patients was 47.3±1.12 years. Laboratory (PC, t-PA, C-reactive protein, TNF-alpha, von Willebrand factor, and lipid profile) and instrumental (ultrasonography and Doppler) examinations were performed.

Results: Results: PC deficiency was significantly more common among men with RA (26.6%), but did not depend on the age and the duration of the disease (p<0.05). PC deficiency correlates with the degree of activity of the inflammatory process (r = -0.27) and TNF-alpha (r = -0.37). The levels of PC and t-PA were associated with the level of cholesterol (r = -0.25), LDL-C (r = -0.31), and HDL-C (r = 0.31). In patients with PC and t-PA deficiency, significantly higher (by 19% and 12%, respectively) serum levels of Von Willebrand factor were recorded than in patients with normal levels (p<0.05).

Conclusion: Conclusions: The study of PС and t-PA revealed a deficiency of important natural anticoagulants, that helps us to expand the understanding of the mutually aggravating effect of the deficiency of these compounds and changes in known biologically active substances on the course of RA, and to supplement the pathogenetic picture of RA with certain links.

Objective: Aim: To describe antibiotic use in Al-Ramadi hospitals using the Biomérieux VITEK2 compact system.

Patients and methods: Materials and Methods: A lot of different hospitals in Al- Ramadi were visited, checking Patients' illness profile. Information about antibiotics prescription pattern in Al-Ramadi hospitals had been collected from urinary tract infected patients using the Biomérieux VITEK2 compact system.

Results: Results: Out of 67 specimens obtained from Urinary tract infection, fifty-two isolates were E. coli, eight isolates were Klebsiella pneumoniae, four were Burkholderia cepacian, and two were Raoultella spp and only one isolate Acetobacter aceti. The data analysis revealed that females had a higher prevalence of infection than males, with 41(68.30%) and 26(38.80%), respectively.

Conclusion: Conclusions: Resistance rates have shown variations over the years, they have typically remained elevated for antibiotics commonly employed in the empirical management of urinary tract infections. For successful treatment, it will be crucial to adjust therapy based on culture results and to consider resistance rates during empirical treatment.

Pain is subjective unpleasant feeling of varied origin and once it is chronic (lasting more than 6 month) it could be responsible for significantly decreased quality of life. Pivotal role in pain suffering plays both peripheral and central nervous system and at these levels its intensity could be decreased by several pharmacological and non-pharmacological means. Rationale of chronic management of musculoskeletal pain. This article is a review of contemporary bibliography in order to assess pathomechanism and causes of pain to successfully cope with the condition. Of utmost importance in managing pain is proper diagnosis and identification of its sources. Once this condition is met it is easier to apply diagnosis-specific treatments even including surgeries. In various clinical situations especially in chronic aged patients with multiple comorbidities personalized approach is mandatory. Armamentarium then encompasses complex actions with the use of simple counseling, medical treatment, physiotherapy, orthotics and preferably mini-invasive but also major surgical interventions. Proper management of chronic musculoskeletal pain demands detailed analysis of complex clinical situation basing on medical history, examination and combining these data with possible imaging investigations. Often cooperation of several specialists is mandatory.

Objective: Aim: To assess the psychological well-being of children and adolescents, socio demographic distribution data of parents and children and to find out the relationship between psychological well-being of children and adolescents and their socio demographic characteristics.

Patients and methods: Materials and Methods: A descriptive cross- sectional study to assess the psychological well-being of children and adolescents in AI-Nasiriyah schools. The study period was extended (from December 1, 2023 to April 1, 2024). A non- probability (purposive sample) consist of (200) children and adolescents.

Results: Results: Results revealed That children and adolescent in current study have moderate levels of Psychological Well-Being, our study revealed that is significant correlation (between participants' age and Psychological Well-being, difference in psychological wellbeing between history of school fail, difference in psychological Well-being among between mother educational groups and difference in Psychological well-being among father job groups) and no statistically Significant ( between difference psychological well-being and school history, difference in psychological well- being Among socioeconomic status groups, difference in psychological well-being among father level of education Groups and difference in psychological wellbeing among father job groups).

Conclusion: Conclusions: Study provides valuable insights into factors influencing the psychological well- being of children and adolescents, highlighting the complex interaction between age, social status, parental education, and parental occupation. Academic performance and school experiences play a significant role in psychological well-being, especially in cases of academic failure.

Objective: Aim: To study the susceptibility of isolates obtained from the oral cavities of individuals with inflammatory periodontal diseases and maxillofacial pathology to bacteriophages.

Patients and methods: Materials and Methods: Biological specimens were obtained from the Dental Medical Center and University Clinic of O.O. Bogomolets National Medical University and the National Specialized Children's Hospital OKHMATDYT. Biomaterial was collected from the wound surface using a sterile FLmedical transport system (Italy). Clinical isolates used in the studies included Escherichia coli, Klebsiella spp., Pseudomonas spp., and Staphylococcus aureus. We assessed the susceptibility of microorganisms to bacteriophages by administering 0.01 ml of bacteriophage culture to a bacterial culture. A suspension (inoculum) was prepared from a 24-hour culture of microorganisms in sterile saline and then Mueller Hinton agar was inoculated with it. The results were recorded 24 hours post-incubation in a thermostat at 37°C. The study used bacteriophages from the bacterial test cultures Klebsiella pneumoniae DSM30104, Staphylococcus aureus DSM 799, Escherichia coli DSM 1103, and Pseudomonas aeruginosa DSM 50071, provided by NeoProBioCare Ukraine Ltd.

Results: Results: The susceptibility rates of isolates to phages were 40% for Klebsiella spp, 73.3% for S. aureus, 50.0% for E. coli, and 20.0% for Pseudomonas spp. Prior research confirms the effectiveness of bacteriophages in oral diseases. This method may be beneficial in controlling opportunistic microorganisms and maintaining the oral microbiota balance.

Conclusion: Conclusions: The application of bacteriophages for inflammatory oral diseases appears promising and warrants further research. Clinical trials and additional scientific investigations are necessary to confirm its safety and effectiveness.