Wiadomosci lekarskie最新文献

Objective: Aim: To find out the peculiarities of constitutional and legal status of the subject during biomedical research.

Patients and methods: Materials and methods: A synergistic approach helps predict possible fluctuations and vectors of development, taking into account various social and technical processes of influence on the status of the subject; comprehensive - involves the analysis of the research subject within the framework of a combination of different scientific schools, concepts and methods and provides opportunities for the development of unified standards, benchmarks, principles and general norms of legal regulation.

Conclusion: Conclusions: The constitutional-legal status of the subject is the position of the subject (patient, object of research) established and established by the norms of constitutional law, which distinguishes him as a special subject of legal relations in the process of conducting biomedical research and consists of a set of rights and obligations and specifics of the legal liability of its participants.

Objective: Aim: The objective of this literature review was to determine the optimal diagnostic algorithm for breast cancer detection associated with architectural distortion.

Patients and methods: Materials and Methods: The Pubmed, Google Scholar, Web of Science, and Scopus databases was used to search for materials on architectural distortion, associated pathologies, and radiological imaging methods.

Conclusion: Conclusions: Architectural distortions may represent both benign and malignant pathology, but ultrasound, magnetic resonance, and roentgenological signs may not always with conf i dence determine the etiology of these changes. Therefore, the correct diagnostic algorithm which uses contrast imaging methods and digital breast tomosynthesis can prevent potentially exceeding radiation exposure, and unnecessary biopsies, change surgical operation volumes, decrease patient stress from procedures, and reduce the number of resources spent. After analyzing a number of scientif i c sources, we recommend morphological verif i -cation of all architectural distortions that are not the result of surgery, trauma, or that accumulate contrast media during breast imaging.

Objective: Aim: To study IL-1β, IL-6, IL-8, IL-10 blood serum levels and their relationship with colon tissue prostanoids in experimental ulcerative colitis.

Patients and methods: Materials and Methods: Blood serum interleukins and colon tissue prostanoids were determined by enzyme immunosorbent assay on three groups of WAG population rats (1st control group - rectal saline injection; 2nd control group - 50% ethanol injection; experimental group - injection of 2,4-dinitrobenzene-sulfonic acid in 50% ethanol).

Results: Results: The increased levels of all interleukins both in 2nd control and experimental groups versus 1st control group were found. No dif f erences in IL-6, IL-8 levels between experimental and 2nd control groups were revealed. The relationships between interleukins and PGF2α, between interleukins and TXB2 in all groups, and the appearance of correlations between interleukins and PGE2, between interleukins and PGI2 in experimental group were observed. Negative correlations between IL-8 and COX-2 in 1st control, between IL-8 and COX-1 in both 2nd control and experimental groups were found. Negative correlation between 8-epi-PGF2α and IL-8, positive correlation between 8-epi-PGF2α and PGF2α in experimental group were revealed.

Conclusion: Conclusions: Results obtained testify the possible role of PGF2α and 8-epi-PGF2α in the development of ulcerative colitis and justify the importance of research on the link of 8-epi-PGF2α, IL-8, PGF2α for understanding the mechanisms of development and progression of this disease. Increasing blood serum IL-8 level may be used as marker of reducing colon tissue COX-1 content in both ethanol- and 2,4-dinitrobenzenesulfonic acid-induced ulcerative colites.

Objective: Aim: To investigate lipid profile parameters depending the polymorphism of the A1166C I type gene receptor of the angiotensin II as a predictor of arterial hypertension.

Patients and methods: Materials and Methods: The study involved 86 patients with arterial hypertension. The control group consisted of 30 practically healthy individuals. Indicators of lipid metabolism in the blood serum of patients were determined using "Lachema" kits on an analyzer. The the polymorphism of the A1166C I type gene receptor of the angiotensin II was studied by polymerase chain reaction with electrophoretic detection of the results.

Results: Results: Higher levels of total cholesterol were found in patients with CC genotype compared to AA genotype carriers ((8.94±0.09) vs (5.18±0.02) mmol/L). The level of low-density lipoprotein in CC-genotype carriers was (7.43±0.03) versus (3.66±0.02) mmol/L in A-allele homozygotes. Triglycerides and very low density lipoproteins were also significantly higher in CC genotype carriers compared to patients with AA genotype. The level of high-density lipoprotein was lower in homozygotes with C-allele than in patients with the AA genotype, and was (0.59±0.12) versus (0.99±0.03) mmol/L.

Conclusion: Conclusions: The presence in the CC genotype the I type gene receptor of the angiotensin II type is a predictor of dyslipidemia. In patients with arterial hypertension, the presence in the C-allele of the I type gene of the angiotensin II type contributes to a significant increase in serum adipokines and a decrease in ghrelin levels.

Objective: Aim: To make a systematic review and meta-analysis of published data on the study of histological and immunohistochemical features of the placenta in women who had acute coronavirus infection associated with SARS-CoV-2 ("Covid" placentas) during pregnancy.

Patients and methods: Materials and Methods: The search for literature data is based on the PRISMA methodology); the MEDLINE database (PubMed®) was searched using Medical Subject Headings terms from January 2020 to July 2023. The project was registered in the Open Sience Frame (Project Identifier: DOI 10.17605/OSF.IO/GDR3S, Registration DOI: https://doi.org/10.17605/OSF.IO/H2KPU). Preference was given to studies in which the description of placentas met the requirements of the Amsterdam Placental Workshop Group Consensus Statement.

Results: Results: A total of 31 studies were included; the number of participants whose morphological and histological description of the placentas could be subjected to meta-analysis was 2401, respectively, in the group with a "Covid" history and 1910 - conditionally healthy pregnant women. Pathological changes in the placental complex were not detected in 42±19.62% of pregnant women with a history of Covid. Immunohistochemical examination of placentas preferably focuses on the detection of SARS-CoV-2 spike protein or ACE2. According to currently available studies, in the placentas of women who have had COVID-19 during pregnancy, there are no pathognomic histological patterns specific to this infection and direct damage to the placenta is rarely observed. Histological patterns in "covid" placentas are isolated, most often a combination of lesions in both the maternal and fetal malperfusion.

Conclusion: Conclusions: According to currently available studies, in the placentas of women who have had COVID-19 during pregnancy, there are no pathognomic histological patterns specific to this infection and direct damage to the placenta is rarely observed. The probability of infection of the intrauterine fetus by the transplacental hematogenous route is the lowest compared to other routes, which, in our opinion, is a possible explanation for the high frequency of MVM without subsequent infection of the fetus.

Objective: Aim: To improve the management of morbidly obese patients who undergo gastric bypass surgery to reduce the number of postoperative complications, in particular, bleeding.

Patients and methods: Materials and Methods: From 2011 to 2022, a total of 348 patients with morbid obesity (MO) underwent laparoscopic gastric bypass treatment at the clinical base of the Department of General Surgery №2 of Bogomolets National Medical University. The retrospective group included 178 patients who received treatment between 2011 and 2019. 170 patients were enrolled in the prospective group for the period from 2019 to 2022.

Results: Results: Retrospective group had 8 episodes of postoperative bleeding, representing a rate of 4.49%, prospective group - 3 episodes of postoperative bleeding, representing a rate of 1.76% Four factor characteristics associated with the probability of bleeding were identified: "number of comorbid conditions", "arterial hypertension", "chronic liver diseases" and "chronic obstructive pulmonary disease".

Conclusion: Conclusions: The factors responsible for the occurrence of postoperative bleeding in morbidly obese patients after laparoscopic gastric bypass surgery were the number of comorbid conditions, the presence of arterial hypertension, the presence of chronic liver diseases, and chronic obstructive pulmonary disease. A new strategy for the management of morbidly obese patients after laparoscopic gastric bypass was developed. This strategy involves changing cassettes to create gastroentero- and enteroenteroanastomoses, reducing the period of use of the nasogastric tube, drains, and urinary catheter from 3-4 days to 1 day, and resuming the drinking regimen 6 hours after extubation.

Objective: Aim: To clarify the association between different types of uterine contractility dysfunction and the inflammation of the uterus and chorioamniotic membranes.

Patients and methods: Materials and Methods: The association between the inflammation of the uterine layers, chorioamniotic membranes, umbilical cord, and different types of labor activity abnormalities was examined in 382 patients with singleton pregnancies at 28-42 weeks' gestation who underwent Caesarean section (CS) for abnormal uterine contractions and other complications. Statistical analyses included the Mann-Whitney U, Chi-squared test, and logistic regression.

Results: Results: In the control group, slight infiltration with polymorphonuclear leukocytes (PMNs) and macrophages of the myometrium and decidua of the lower uterine segment at term pregnancy was found in 59.7% and 73.6% of cases. The main clinical risk factors for placental and decidual membrane inflammation in patients with excessive uterine activity (EUA) were prematurity, multiparity, group B streptococcus (GBS) colonization, and duration of ruptured fetal membranes before the CS. Moderate or marked myometrial inflammation of both uterine segments in the EUA group was diagnosed only in patients with cervical dilation of >6 cm and duration of labor of >8h. In women with hypotonic uterine activity (HUA), decidual and myometrial inflammation was significantly associated with nulliparity and intrapartum factors, such as protracted active first stage of labor, advanced cervical dilation, and number of vaginal examinations. In all cases, inflammation of the myometrium was accompanied by deciduitis.

Conclusion: Conclusions: Mild inflammation of the decidual membrane and myometrium of the lower segment at term pregnancy is a common physiological phenomenon contributing to labor initiation. Uterine hyperfunction comes as the response of the unaffected myometrium to the release of high concentrations of proinflammatory cytokines produced by the inflamed decidual and chorioamniotic membranes into the bloodstream. Marked myometrial inflammation that occurs in prolonged labor is an additional factor aggravating the hypotonic uterine activity.

Objective: Aim: The objective of the research was to conduct a comprehensive longitudinal analysis of the temporal dynamics of glutathione system functionality in individuals diagnosed with paranoid schizophrenia. Specifically, the research was focused on investigating variations in the profiles of glutathione-dependent enzymes, with meticulous consideration given to the duration of the illness.

Patients and methods: Materials and Methods: The study group comprised 300 individuals officially diagnosed with 'Paranoid Schizophrenia,' subdivided into five subgroups, each consisting of 60 patients. The subgroups were defined as follows: Subgroup I included 60 patients with a disease duration ranging from 3 to 5 years; Subgroup II comprised 60 patients with a duration of 6 to 10 years; Subgroup III consisted of 60 patients with a duration of 11 to 15 years; Subgroup IV included 60 patients with a duration of 16 to 20 years; and Subgroup V encompassed 60 patients with a duration of 21 years and older. The comparison group comprised 20 patients diagnosed with "Primary psychotic episode".

Results: Results: The research demonstrates a consistent and noteworthy reduction in the enzymatic activities of glutathione peroxidase, glutathione reductase, and glutathione-S-transferase in various Subgroups of paranoid schizophrenia patients. The observed declines are particularly prominent within the first 3-5 years of the illness, show casing statistically significant reductions. Patients with prolonged illness durations, especially surpassing 21 years, display substantial reductions in all three enzymes, suggesting a cumulative enzymatic impact associated with prolonged illness.

Conclusion: Conclusions: The identification of critical periods of inhibition in the glutathione protection chain, provides valuable information about potential therapeutic interventions for individuals with paranoid schizophrenia.

Objective: Aim: To examine the role of vitamin D supplementation in PCOS women who failed to ovulation induction by letrozole in previous trials.

Patients and methods: Materials and Methods: The study included 30 women diagnosed with PCOS and were complaining from primary infertility. Those women had previously been treated for 3 months with letrozole to induce ovulation, but there was failure of response to treatment. Those 30 women were selected from a pool of women who were evaluated for serum vitamin D and were proved to have vitamin D def i ciency (<20 ng/ml).

Results: Results: Daily monitoring of ovulation by transvaginal ultrasound was done staring from day 7 till day 25 of the cycle. The main outcomes were the number and the size of follicles. In addition, they were followed up for evidence of pregnancy using biochemical serum and urine examination.

Conclusion: Conclusions: When women with polycystic ovarian syndrome are treated with letrozole, vitamin D supplementation enhances both the result of ovulation induction and pregnancy.

Objective: Aim: To examine the impacts of aggressive parenting on physical, mental and emotional development; outcomes for society; possible ways of prevention of children' rights or health violation and responsibility of parents to optimize well-being of children.

Patients and methods: Materials and Methods: The analysis of scientific data has been conducted on the basis of PubMed, Scopus and Web of Science databases in order to collect the existed results of researches about social and medical aspects of impact of aggressive parenting. The formal-legal method was used to interpret the provisions of legislation regarding the protection of personal non-property rights and responsibilities of parents and children.

Conclusion: Conclusions: Aggressive parenting affects children of all ages and is associated with chronic stress and long-term negative impacts on physical development, cognitive and behavioral dysfunction, socioemotional difficulties, social and psychological dysfunction in adulthood. Aggressive parenting triggers a child' aggressive behavior which is considered as a predictor of adult's criminality. From a legal standpoint, aggressive parenting is a form of violation of the responsibility of parents to educate a child, which is an element of family legal relations regulated by the norms of the family law institution known as ≪Personal non-property rights and responsibilities of parents and children". The definition of aggressive parenting has been defined with its legal features and characteristics. Effective prevention methods should be directed to predict possible further parental violence, intervention programs to reduce outcomes of aggressive parenting and to improve the ways of responsibility in procedural and material aspects of law.