Wiadomosci lekarskie最新文献

Objective: Aim: To determine the peculiarities of the course of pregnancy and childbirth in mothers whose children suf f er from abnormal uterine bleeding during puberty.

Patients and methods: Materials and Methods: The study involved examination of 95 girls aged 10 to 18, who were divided into clinical groups: clinical group I (main (MG)) - 65 girls with abnormal uterine bleeding during puberty, clinical group II (control (CG)) - 30 somatically healthy girls, who came to clinic for a medical checkup.

Results: Results: Assessment of histories on the condition of mothers during pregnancy and childbirth in the MG showed existing gestational disorders. Thus, in MG, mothers were 17 times more likely to suf f er from extragenital disorders, 15-20 times more likely to suf f er from colds, 10 times more likely to suf f er from toxicosis in the fi rst half of pregnancy and preeclampsia, and 8 times more often to have placental dysfunction. Childbirths of mothers of MG girls were characterized by a pathological course: premature discharge of amniotic fl uid, weakness of labor, preeclampsia during childbirth, fetal distress. In MG, operative deliveries were resorted to 13 times more often. In addition, birth trauma occurred in 15.38% of newborns, asphyxia at birth in 41.53%, and hypoxic-ischemic brain damage in 23.07%.

Conclusion: Conclusions: During the analysis of history data, peculiarities of the course of pregnancy and childbirth in mothers whose children suf f er from abnormal uterine bleeding during puberty were revealed. The mothers of these girls have a complicated course of pregnancy and childbirth. Pathological effects on the fetus in the ante- and intranatal periods create the basis for the development of pathological puberty, which can manifest itself in the form of abnormal uterine bleeding.

Objective: Aim: To identify appropriate methods for determining the content of radioactive and non-radioactive pulmotoxic xenobiotics in the ambient air of NPP equipment to ensure its reliability, radiation and environmental safety, as well as to reduce the risks of occupational pathologies for workers and protect people's health.

Patients and methods: Materials and Methods: Analytical methods of analysis of modern methods of determining the content of radioactive and non-radioactive pulmonary toxic xenobiotics in the ambient air of NPP equipment.

Conclusion: Conclusions: a) during operation of NPP equipment, pulmotoxic xenobiotics enter the surrounding air, which can then enter the human respiratory system in the form of radioactive or non-radioactive substances; b) signif i cant methods of determining the content of pulmotoxic xenobiotics in the air are: gas chroma-tography; gas chromatography-mass spectrometry; liquid scintillation; photometric, ionometric, polarographic, titrometric, turbidimetric, atomic absorption, radiometric and γ-spectrometric measurements; c) radioactive pulmonotoxic xenobiotics cause radiation pathologies in the respiratory organs as a result of internal radioactive irradiation of the body; d) the effects of non-radioactive pulmotoxic xenobiotics are accompanied by irritation and inf l ammatory processes in the respiratory organs, as well as toxic swelling of the lungs; е) there is a connection between the presence of pulmotoxic xenobiotics in the air and the course of human respiratory diseases as a result of breathing such air.

Objective: Aim: Determining the characteristics of urinary stone composition in inhabitants of an industrially advanced region afflicted with oxalate and urate urolithiasis.

Patients and methods: Materials and Methods: A comparative analysis of the morphology of 246 kidney stones from residents of one of heavily industrialized region of Ukraine, was conducted. Petrographic examination of the calculi was performed through microscopic analysis. The qualitative composition of the calculi was investigated using X-ray structural analysis of fragments and dust remnants of the stones, which were formed during the preparation of thin sections.

Results: Results: A distinctive characteristic of all mineral components is their varying microblock structure and the presence of organic material inclusions. The inclusion of an organic component reduces the strength of the crystalline layers. Urolith resembles a brittle-hollow environment, which in certain cases allows for the selection of the most effective methods of their destruction (lithotripsy).

Conclusion: Conclusions: A common feature among all mineral components is their diverse microblock structure and the presence of organic inclusions, which diversify the strength characteristics of uroliths. The prior determination of these characteristics allows for the selection of the most ef f ective method for destructive treatment (lithotripsy). The combination of data on the ontogenesis of uroliths, their mineral composition, and the state of the electrolyte balance in the body of a patient with urolithiasis will allow choosing an individually effective method of metaphylaxis of the disease.

Eccrine acrospiroma is a rare benign tumor of the skin arising from the epithelial cells of eccrine sweat ducts. The clinical picture is characterized by its variability, so a detailed morphological study of the operative material is necessary to establish a diagnosis. Differential diagnosis must be carried out with hemangioma, melanoma, infected sebaceous cyst, metastatic skin lesion, and other tumors from elements of the sweat gland. In the article the authors presented the clinical and morphological analysis of own case from practice of large eccrine acrospiroma on the back surface of the left thigh which was diagnosed in a 56-year-old man.

Objective: Aim: To assess the impact of multidisciplinary simulation training on the educational outcomes of medical students in the emergency care of adults and newborns and implement changes in the curriculum to master simulation scenarios more.

Patients and methods: Materials and Methods: To assess the differences in learning outcomes between medical students who study the same curriculum without simulation interventions and those who undergo multidisciplinary emergency care simulation training. A quasi-experimental approach was used to assign students to the Intervention Group or the Control Group.

Results: Results: According to individual criteria, the lowest scores in both groups were obtained for the stages that required the greatest accuracy and correct technique. After the appropriate cycle of initiation, the results in both groups improved significantly, but the results of students from the first group were significantly higher than those of students from the second group. Despite the absence of a significant difference in the average overall score for the skills, students in the first group significantly improved the accuracy and correctness of the criteria that assess the technical aspects of performance, while students in the second group mainly improved the quality of the descriptive and communicative parts of the practical skill.

Conclusion: Conclusions: We believe that reallocating curricular time to additional hours dedicated to simulation scenarios will better prepare aspiring healthcare professionals for the demanding and dynamic nature of their career, as we continue to increase our understanding of the potential of simulation-based education.

Objective: Aim: The study is intended to consider acute pancreatitis from the point of view of its etiological structure, as well as demographic description, features of the clinical course, distribution of morphological forms, severity and consequences of the disease in different etiological variants.

Patients and methods: Materials and Methods: The work was based on a retrospective analysis of the medical records of 677 patients with acute pancreatitis who underwent inpatient treatment from 2017 to 2022 in an emergency hospital and a tertiary regional hospital in Vinnytsia, Ukraine.

Results: Results: The etiological structure of the general sample was as follows: the alimentary factors - 37,5% of cases, biliary - 18,6%, alcohol - 14,0% and postoperative - 7,8%, respectively. The oldest patients were observed in the group with biliary AP (age [median, interquartile range] 61 [46-72] years), the youngest - in the group with alcoholic AP (age [median, interquartile range] 40 [35-47] years). Men significantly predominated in the groups with alimentary and alcoholic AP. A significant predominance of women was observed in the group with biliary AP (62,7% vs. 37,3%, p=0,0003). The highest mortality was in the alcoholic AP group (22,1%), also here was a significantly lower rate of inpatient bed days (6,0). Edematous AP was dominant in all etiological variants. While infected necrotic pancreatitis was significantly more often found in patients with alcoholic genesis (7,4%).

Conclusion: Conclusions: The etiologic variations of acute pancreatitis differ by demographic and clinical indicators and require more detailed study to understand its prognosis, management, and development of effective prevention and treatment strategies.

Objective: Aim: To evaluate the ultrasound criteria for venous thromboembolic complications in patients with thrombosis of varicose veins of the tributaries of the great saphenous vein (GSV).

Patients and methods: Materials and Methods: The results of ultrasound examination of 52 patients with thrombosis of varicose veins of the tributaries of GSV were analyzed. The indicators of venous hemodynamics were compared with the control group (CG) (n=32).

Results: Results: Varicose transformation of GSV and failure of its valvular apparatus were detected in 44 (84.6%) patients, in 8 (15.4%) patients the superficial venous highway was intact. Vertical reflux was diagnosed in varicose ectasia of GSV: local reflux in 14 (31.8%), widespread reflux in 14 (31.8%), and total reflux in 16 (36.4%) patients. The diameter of GSV in tributary varicothrombophlebitis was 8.9±0.27 mm (p<0.05 vs. CG) and 11.2±0.25 mm (p<0.05 vs. CG) in the horizontal and vertical positions, respectively. The proximal and distal borders of thrombosis exceeded the clinical ones by 15.26±1.21 cm (p<0.05) and 7.94±1.32 cm (p<0.05), respectively. The spread of tributary thrombophlebitis to the superficial venous highway was detected in 14 (26.9%) patients, among whom 12 (85.7%) patients had unfixed apices of thrombotic masses.

Conclusion: Conclusions: The results obtained convincingly demonstrate the need for early ultrasound examination of patients with tributary thrombophlebitis, which allows to identify the real limits of the thrombotic process, timely diagnose the transition of the thrombotic process to superficial and deep venous lines, effectively predict the risk of venous thromboembolic complications and choose the optimal surgical tactics.

Objective: Aim: To conduct a structural analysis of cardiological signs of adaptation to stressogenic cognitive loads by identifying factor features of correlations between heart rate variability (HRV) and coping-testing data indicators.

Patients and methods: Materials and Methods: 43 people aged 19.7±1.8 years (23 boys and 20 girls) were monitored for their HRV. Methods included DC-06000 portable ECG recorder, 3X series "badge" type (single channel) and COPE Test. The study process includes four stages.

Results: Results: As a result of further factor correlation analysis, it was revealed that Factor 1 "HRV Stress Indicators" has a negative correlation (p<0.05) of "moderate" strength ρs= -0.363 with Factor 2 "Strategies to avoid problems and stresses" and a positive correlation of "weak" strength ρs=0.167 with Factor 3 "Psychoemotional Indicators". If two factors correlate with each other, it indicates they are related and can interact, which is important for adequate interpretation of the results of factor analysis.

Conclusion: Conclusions: Structural analysis of the complex of cardiological signs of adaptivity to stressogenic cognitive loads and coping-testing data revealed the existence of three correlated factors: Factor 1 "HRV Stress Scores", Factor 2 "Strategies to avoid problems and stress", Factor 3 "Psychoemotional indicators". The revealed negative correlation of Factors 1 and 2 may indicate that in case the impact of Factor 2 "Strategies to avoid problems and stress" increases, the intensity of Factor 1 "HRV Stress Scores" (i.e., stress signs according to the indicators of heart rate variability) may decrease.

Objective: Aim: To conduct a comprehensive analysis of the oral health status of this vulnerable population in order to collect objective data that will contribute to the development of effective strategies for maintaining and improving oral health in wartime conditions.

Patients and methods: Material and Methods: This epidemiological study was carried out within the initial 6 months of the full-scale invasion of the country. The oral health indices of 1050 internally displaced children, aged 3 to 17 years, seeking dental care at the Municipal Children Dental Clinic in Poltava, were analyzed.

Results: Results: The total sample comprised 620 children aged 6-11 years (mean = 8.5, SD = 0.76), with a gender distribution of 52% boys and 48% girls. The participants were divided into three age groups: Group I (6-7 years), Group II (8-9 years), and Group III (10-11 years). The average prevalence of dental caries, as measured by the dmft + DMFT index, was 76.5%, with prevalence increasing with age. Specifically, the prevalence of dental caries based on the dmft index was lower in children of Group III (66.6%) compared to Group I (79.49%).

Conclusion: Conclusions: The analysis of the oral status among internally displaced children aged 6-11 years revealed higher dental caries prevalence and intensity compared to local children. Notably, children aged 6-7 years showed a high rate of caries in temporary teeth.

Gastroesophageal Reflux Disease (GERD) is a commonly occurring condition that can significantly impact quality of life. Often considered a lifestyle disease. Traditional treatment methods focus on pharmacotherapy, lifestyle modifications, and in extreme cases, surgical interventions. This article discusses current and novel approaches to managing gastroesophageal reflux disease. The foundation of this work was medical articles and research gathered from the PubMed database. Keywords such as "esophageal reflux treatment", "new technologies in GERD treatment", "innovative reflux treatment methods", were used to facilitate the literature search. In managing gastroesophageal reflux disease, the application of appropriate pharmacological therapy and lifestyle changes for the patient remains key. However, new technologies and treatment methods, such as advanced endoscopic repair procedures, innovative medications, and personalized approaches, are gaining importance. These new strategies can significantly improve patients' quality of life, reduce symptoms, and minimize the need for surgical interventions.