Pub Date : 2024-07-17DOI: 10.14739/2310-1210.2024.4.299531
D. V. Oleniuk, O. V. Tsarov
Traumatic brain injury (TBI) remains one of the leading causes of long-term disability, especially among young and middle-aged people. One of the main directions of treatment for patients with TBI is to prevent the development of secondary brain damage due to systemic dysfunction. Anemia occupies an important place among them. Anemia is considered a marker of illness severity in critically ill patients and is included in the list of parameters for risk prediction in intensive care units. However, the relationship between anemia and adverse outcomes in patients with TBI is controversial. Aim. The purpose of the work is to analyze the effect of anemia on the course of severe TBI, to determine the position of anemia in the pathophysiological mechanisms of brain damage, the development of blood transfusion-associated complications, to evaluate different blood transfusion strategies (liberal and restrictive) and their impact on treatment results, taking into account individual tolerance to anemia. Studies suggest that the restrictive transfusion strategy could be useful in reducing complications and length of hospital stay. However, the lack of clear evidence for optimal hemoglobin levels as a trigger to initiate blood transfusions reinforces the need for further clinical studies. The use of multimodal neuromonitoring allows to evaluate the latest approaches to assessing individual hemoglobin thresholds. These methods could help in identifying patients at increased risk of complications and determining optimal strategies to manage anemia. Conclusions. The problem of tolerance to anemia in patients with severe TBI remains a controversial topic, and determining hemoglobin thresholds for blood transfusion in this group of patients requires further studies, special attention should therefore be paid to an individual approach to resolving the issue of red blood cell transfusion, in particular, integrating clinical status of a patient and concomitant pathology. The risk of possible brain damage worsening associated with anemia due to deterioration of cerebral oxygenation should always be weighed against the risk of developing transfusion-associated complications.
{"title":"The choice of blood transfusion strategy in severe traumatic brain injury","authors":"D. V. Oleniuk, O. V. Tsarov","doi":"10.14739/2310-1210.2024.4.299531","DOIUrl":"https://doi.org/10.14739/2310-1210.2024.4.299531","url":null,"abstract":"Traumatic brain injury (TBI) remains one of the leading causes of long-term disability, especially among young and middle-aged people. One of the main directions of treatment for patients with TBI is to prevent the development of secondary brain damage due to systemic dysfunction. Anemia occupies an important place among them. Anemia is considered a marker of illness severity in critically ill patients and is included in the list of parameters for risk prediction in intensive care units. However, the relationship between anemia and adverse outcomes in patients with TBI is controversial.\u0000Aim. The purpose of the work is to analyze the effect of anemia on the course of severe TBI, to determine the position of anemia in the pathophysiological mechanisms of brain damage, the development of blood transfusion-associated complications, to evaluate different blood transfusion strategies (liberal and restrictive) and their impact on treatment results, taking into account individual tolerance to anemia.\u0000Studies suggest that the restrictive transfusion strategy could be useful in reducing complications and length of hospital stay. However, the lack of clear evidence for optimal hemoglobin levels as a trigger to initiate blood transfusions reinforces the need for further clinical studies. The use of multimodal neuromonitoring allows to evaluate the latest approaches to assessing individual hemoglobin thresholds. These methods could help in identifying patients at increased risk of complications and determining optimal strategies to manage anemia.\u0000Conclusions. The problem of tolerance to anemia in patients with severe TBI remains a controversial topic, and determining hemoglobin thresholds for blood transfusion in this group of patients requires further studies, special attention should therefore be paid to an individual approach to resolving the issue of red blood cell transfusion, in particular, integrating clinical status of a patient and concomitant pathology. The risk of possible brain damage worsening associated with anemia due to deterioration of cerebral oxygenation should always be weighed against the risk of developing transfusion-associated complications.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141828783","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 : 2024-07-17DOI: 10.14739/2310-1210.2024.4.300008
A. V. Klymenko, B. Kravchenko, V. Klymenko, S. M. Kravchenko, K. P. Polishchuk
Aim. To assess pain syndrome in patients with inguinal hernia after laparoscopic transabdominal preperitoneal (TAPP) plastic surgery. Materials and methods. The study involved 58 patients with unilateral Nyhus type 2 and 3 inguinal hernia. The patients underwent laparoscopic TAPP plastic surgery using a mesh implant that was not fixed independently. According to the method of graft fixation, the patients were divided into two groups. In the first patient group, staple fixation of the mesh was applied – 28 (48.3 %), the second group – 30 (51.7 %) patients without mesh fixation. Patients with a history of surgical interventions on the abdominal cavity and pelvis, complicated or recurrent inguinal hernia were excluded from the study. Pain syndrome was assessed using the visual analog scale and an independent survey during postoperative follow-ups of the patients every three months for two years. Results. In the assessment of postoperative pain in the first patient group, moderate pain intensity was noted, and it was minimal in the second group, p < 0.001. 9 (32.1 %) patients who underwent mesh implant fixation required opioid analgesics, compared with 4 (13.3 %) patients who did not undergo fixation, p = 0.043. At the first examination, chronic pain was detected in 6 (21.4 %) patients of the first group and in 3 (10.0 %) patients of the second group. During a year, pain syndrome gradually disappeared. After 9 months, pain was reported by 4 (14.3 %) patients in the group with mesh fixation and by 1 (3.3 %) patient without fixation. At the 6th examination in the first group, 2 (7.1 %) patients reported pain; 1 (3.6 %) patient underwent Lichtenstein hernioplasty due to recurrent, increasing acute pain. Conclusions. Laparoscopic TAPP plastic surgery without graft fixation shows a lower possibility of pain syndrome development than with mesh implant fixation. In the case of chronic pain syndrome development following the TAPP technique without mesh fixation, the general condition of patients improves more quickly.
{"title":"Assessment of chronic pain syndrome after laparoscopic transabdominal preperitoneal plastic surgery in patients with inguinal hernia","authors":"A. V. Klymenko, B. Kravchenko, V. Klymenko, S. M. Kravchenko, K. P. Polishchuk","doi":"10.14739/2310-1210.2024.4.300008","DOIUrl":"https://doi.org/10.14739/2310-1210.2024.4.300008","url":null,"abstract":"Aim. To assess pain syndrome in patients with inguinal hernia after laparoscopic transabdominal preperitoneal (TAPP) plastic surgery.\u0000Materials and methods. The study involved 58 patients with unilateral Nyhus type 2 and 3 inguinal hernia. The patients underwent laparoscopic TAPP plastic surgery using a mesh implant that was not fixed independently. According to the method of graft fixation, the patients were divided into two groups. In the first patient group, staple fixation of the mesh was applied – 28 (48.3 %), the second group – 30 (51.7 %) patients without mesh fixation. Patients with a history of surgical interventions on the abdominal cavity and pelvis, complicated or recurrent inguinal hernia were excluded from the study. Pain syndrome was assessed using the visual analog scale and an independent survey during postoperative follow-ups of the patients every three months for two years.\u0000Results. In the assessment of postoperative pain in the first patient group, moderate pain intensity was noted, and it was minimal in the second group, p < 0.001. 9 (32.1 %) patients who underwent mesh implant fixation required opioid analgesics, compared with 4 (13.3 %) patients who did not undergo fixation, p = 0.043. At the first examination, chronic pain was detected in 6 (21.4 %) patients of the first group and in 3 (10.0 %) patients of the second group. During a year, pain syndrome gradually disappeared. After 9 months, pain was reported by 4 (14.3 %) patients in the group with mesh fixation and by 1 (3.3 %) patient without fixation. At the 6th examination in the first group, 2 (7.1 %) patients reported pain; 1 (3.6 %) patient underwent Lichtenstein hernioplasty due to recurrent, increasing acute pain.\u0000Conclusions. Laparoscopic TAPP plastic surgery without graft fixation shows a lower possibility of pain syndrome development than with mesh implant fixation. In the case of chronic pain syndrome development following the TAPP technique without mesh fixation, the general condition of patients improves more quickly.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141828896","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 : 2024-07-17DOI: 10.14739/2310-1210.2024.4.304454
R. Brukhno, O. P. Yavorovskyi, Y. Skaletskyi, T. O. Zinchenko
Aim. To evaluate the influence of biological and socio-political emergencies on the safety of healthcare staff members. Materials and methods. The study used bibliosemantic, statistical, and mathematical methods, analyzing official statistical data on the healthcare system state in Ukraine. Results. While performing their functions in healthcare facilities, medical workers are exposed to the risk of negative effects from biological, psychophysiological, chemical, physical, and social harmful and hazardous factors. Adverse occupational factors in hospital environments exert a complex, combined, or concurrent effect, and its impact intensity can be enormously increased in various types of emergency situations. During the COVID-19 pandemic, a steep increase in occupational injuries in the national healthcare (in fact, by 30 times) has been documented, including due to the registration of acute infectious diseases among medical personnel at the workplace. Similar trends are also evidenced in indicators of lethal injuries, professional and occupationally induced morbidity. Furthermore, Ukraine has faced overlapping emergency situations of socio-political terms, caused by the full-scale aggression of the Russian Federation, and medical-biological problems caused by the COVID-19 pandemic, significantly complicating the state of affairs. According to official data, only in the first year of the full-scale invasion of Ukraine, about 1500 healthcare facilities were damaged, 106 medical workers died, including 33 at their workplace. Conclusions. The resilience of healthcare facilities to various types of emergency situations is an extremely important component of ensuring the hospital environment safety and, as practice shows, requires improvement. There is an urgent need to develop clear response algorithms for healthcare facilities to cope with emergency situations that could influence them. Reinforcing a safety culture in the national medical sector could become the goal and foundation for future strategies to create a safe hospital environment by improving and enhancing the safety culture.
{"title":"Priorities of ensuring hygiene and occupational safety of medical personnel and the resilience of healthcare facilities in emergency situations","authors":"R. Brukhno, O. P. Yavorovskyi, Y. Skaletskyi, T. O. Zinchenko","doi":"10.14739/2310-1210.2024.4.304454","DOIUrl":"https://doi.org/10.14739/2310-1210.2024.4.304454","url":null,"abstract":"Aim. To evaluate the influence of biological and socio-political emergencies on the safety of healthcare staff members.\u0000Materials and methods. The study used bibliosemantic, statistical, and mathematical methods, analyzing official statistical data on the healthcare system state in Ukraine.\u0000Results. While performing their functions in healthcare facilities, medical workers are exposed to the risk of negative effects from biological, psychophysiological, chemical, physical, and social harmful and hazardous factors. Adverse occupational factors in hospital environments exert a complex, combined, or concurrent effect, and its impact intensity can be enormously increased in various types of emergency situations.\u0000During the COVID-19 pandemic, a steep increase in occupational injuries in the national healthcare (in fact, by 30 times) has been documented, including due to the registration of acute infectious diseases among medical personnel at the workplace. Similar trends are also evidenced in indicators of lethal injuries, professional and occupationally induced morbidity.\u0000Furthermore, Ukraine has faced overlapping emergency situations of socio-political terms, caused by the full-scale aggression of the Russian Federation, and medical-biological problems caused by the COVID-19 pandemic, significantly complicating the state of affairs. According to official data, only in the first year of the full-scale invasion of Ukraine, about 1500 healthcare facilities were damaged, 106 medical workers died, including 33 at their workplace.\u0000Conclusions. The resilience of healthcare facilities to various types of emergency situations is an extremely important component of ensuring the hospital environment safety and, as practice shows, requires improvement. There is an urgent need to develop clear response algorithms for healthcare facilities to cope with emergency situations that could influence them.\u0000Reinforcing a safety culture in the national medical sector could become the goal and foundation for future strategies to create a safe hospital environment by improving and enhancing the safety culture.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141831119","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 : 2024-06-05DOI: 10.14739/2310-1210.2024.3.302731
T. V. Ivanenko, Y. Kolesnyk, A. Abramov
Mechanisms of beta-endocrinocyte differentiation involving c-kit may be associated with a number of processes, including signaling pathways and regulatory mechanisms. Such factors as activation of the c-kit signaling pathway, an increase or decrease in cell proliferation and survival, regulation of differentiation gene programs and stem cells are important in controlling self-preservation and regulating the cellular number and types, that are differentiated being impacted by intermittent hypoxic hypoxia, hypertension and diabetes mellitus. The aim of the work is to determine the dynamics of c-kit proliferative factor in beta cells under an exogenous influence (intermittent hypoxic hypoxia) and endogenous pathology (arterial hypertension and diabetes mellitus). Materials and methods. The study was conducted using 15 white Wistar rats and 5 spontaneously hypertensive rats (SHR), which were divided into 4 groups of 5 animals each. Group 1 – control (intact) rats, group 2 – animals with experimental diabetes mellitus, group 3 – rats with hereditary arterial hypertension (SHR), group 4 – animals exposed to the effect of intermittent hypoxic hypoxia. At the end of the experiment, the animals were euthanized, organs were harvested and processed, serial histological pancreatic sections 5 µm thick were deparaffinized and retrieved. Insulin and c-kit+ beta progenitor cells were detected by the immunofluorescence method using antibodies. Immunofluorescent reactions were studied using an AxioImager-M2 fluorescence microscope. Results. The quantitative indicator of beta cells was almost 6 times decreased in rats with diabetes mellitus. Concentrations of insulin in animals of this group were increased compared to intact animals and the marker of proliferative activity was decreased without changes in the percentage of c-kit-immunopositive beta cells. The course of hereditary arterial hypertension in SHR was accompanied by an 8-fold decrease in the number of beta cells per 1 cm2, an increase in insulin in beta cells as compared to the animals of both intact and experimental diabetes groups. Regarding the c-kit expression in beta cells, it was significantly reduced only in the group of intact animals and the number of c-kit-immunopositive beta cells was almost 2.8 times decreased. In the experimental group of animals exposed to hypoxic hypoxia, the number of beta cells per measurement unit was significantly increased, the concentration of insulin in beta cells was increased as compared to the intact animals, but lower than that in rats with diabetes and hypertension. The marker of proliferative activity c-kit was decreased compared to both intact and diabetic animals. As for the number of c-kit-immunopositive beta cells, it did not differ statistically from that in intact and diabetic animals, but was higher than that in SHR. Conclusions. The development of experimental diabetes in Wistar rats and hereditary hypertension in SHR results in a significant decrease
{"title":"Dynamics of c-kit immunopositive pancreatic beta cells influenced by exogenous factors or endogenous pathology","authors":"T. V. Ivanenko, Y. Kolesnyk, A. Abramov","doi":"10.14739/2310-1210.2024.3.302731","DOIUrl":"https://doi.org/10.14739/2310-1210.2024.3.302731","url":null,"abstract":"Mechanisms of beta-endocrinocyte differentiation involving c-kit may be associated with a number of processes, including signaling pathways and regulatory mechanisms. Such factors as activation of the c-kit signaling pathway, an increase or decrease in cell proliferation and survival, regulation of differentiation gene programs and stem cells are important in controlling self-preservation and regulating the cellular number and types, that are differentiated being impacted by intermittent hypoxic hypoxia, hypertension and diabetes mellitus.\u0000The aim of the work is to determine the dynamics of c-kit proliferative factor in beta cells under an exogenous influence (intermittent hypoxic hypoxia) and endogenous pathology (arterial hypertension and diabetes mellitus).\u0000Materials and methods. The study was conducted using 15 white Wistar rats and 5 spontaneously hypertensive rats (SHR), which were divided into 4 groups of 5 animals each. Group 1 – control (intact) rats, group 2 – animals with experimental diabetes mellitus, group 3 – rats with hereditary arterial hypertension (SHR), group 4 – animals exposed to the effect of intermittent hypoxic hypoxia. At the end of the experiment, the animals were euthanized, organs were harvested and processed, serial histological pancreatic sections 5 µm thick were deparaffinized and retrieved. Insulin and c-kit+ beta progenitor cells were detected by the immunofluorescence method using antibodies. Immunofluorescent reactions were studied using an AxioImager-M2 fluorescence microscope.\u0000Results. The quantitative indicator of beta cells was almost 6 times decreased in rats with diabetes mellitus. Concentrations of insulin in animals of this group were increased compared to intact animals and the marker of proliferative activity was decreased without changes in the percentage of c-kit-immunopositive beta cells. The course of hereditary arterial hypertension in SHR was accompanied by an 8-fold decrease in the number of beta cells per 1 cm2, an increase in insulin in beta cells as compared to the animals of both intact and experimental diabetes groups. Regarding the c-kit expression in beta cells, it was significantly reduced only in the group of intact animals and the number of c-kit-immunopositive beta cells was almost 2.8 times decreased.\u0000In the experimental group of animals exposed to hypoxic hypoxia, the number of beta cells per measurement unit was significantly increased, the concentration of insulin in beta cells was increased as compared to the intact animals, but lower than that in rats with diabetes and hypertension. The marker of proliferative activity c-kit was decreased compared to both intact and diabetic animals. As for the number of c-kit-immunopositive beta cells, it did not differ statistically from that in intact and diabetic animals, but was higher than that in SHR.\u0000Conclusions. The development of experimental diabetes in Wistar rats and hereditary hypertension in SHR results in a significant decrease ","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141383257","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 : 2023-07-20DOI: 10.14739/2310-1210.2023.4.274414
K. S. Hanchev, O. O. Kokar
Recurrent aphthous stomatitis (RAS) is an inflammatory disease of the oral mucosa, which has a chronic course with periods of remission and exacerbations. RAS requires adequate diagnosis for the purposes of properly treating. The study on RAS remains relevant over many years and continues to be a priority in modern dentistry. The aim of the work is to analyze the information in the professional literature on pathogenetic variants of RAS and approaches to its treatment and prevention. Despite the variety of studies, the etiology and pathogenesis of the disease remain the subject of numerous discussions. This article provides a review of current research on the main etiopathogenetic mechanisms of the disease development and progression, specifies current recommendations for therapeutic approaches to treatment and prevention. Conclusions. To date, there is no definitive therapeutic tactic for recurrent aphthous stomatitis, so it is advisable to systematize and study methods for the prevention and treatment of this pathology, including pain relief, acceleration of ulcer healing and reduction of its episode frequency and severity. Considering the etiopathogenetic variant of the disease development (metabolic disorders, stress, allergies, etc.), preventive measures should be comprehensive and include oral hygiene, a sparing diet, multivitamin and micro-, macroelement complexes, etc.
{"title":"Etiopathogenetic features of recurrent aphthous stomatitis: modern approaches to prevention and treatment","authors":"K. S. Hanchev, O. O. Kokar","doi":"10.14739/2310-1210.2023.4.274414","DOIUrl":"https://doi.org/10.14739/2310-1210.2023.4.274414","url":null,"abstract":"Recurrent aphthous stomatitis (RAS) is an inflammatory disease of the oral mucosa, which has a chronic course with periods of remission and exacerbations. RAS requires adequate diagnosis for the purposes of properly treating.\u0000The study on RAS remains relevant over many years and continues to be a priority in modern dentistry.\u0000The aim of the work is to analyze the information in the professional literature on pathogenetic variants of RAS and approaches to its treatment and prevention.\u0000Despite the variety of studies, the etiology and pathogenesis of the disease remain the subject of numerous discussions.\u0000This article provides a review of current research on the main etiopathogenetic mechanisms of the disease development and progression, specifies current recommendations for therapeutic approaches to treatment and prevention.\u0000Conclusions. To date, there is no definitive therapeutic tactic for recurrent aphthous stomatitis, so it is advisable to systematize and study methods for the prevention and treatment of this pathology, including pain relief, acceleration of ulcer healing and reduction of its episode frequency and severity.\u0000Considering the etiopathogenetic variant of the disease development (metabolic disorders, stress, allergies, etc.), preventive measures should be comprehensive and include oral hygiene, a sparing diet, multivitamin and micro-, macroelement complexes, etc.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74026252","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 : 2023-07-20DOI: 10.14739/2310-1210.2023.4.273073
N. M. Nevmerzhytska, L. Yaremenko, S. M. Chuhray, O. M. Grabovyi
Aim: to analyze modern professional literature and summarize data on treatment methods for peripheral nerve injuries, taking into account the mechanisms of positive effects. The article presents an overview of possible methods for treatment of peripheral nerve injuries, fundamental classifications of peripheral nerve injuries, their differences are considered, pathophysiological mechanisms and the probability of spontaneous recovery depending on the degree of injury, general principles and conditions for successful regeneration of the peripheral nerve. Options, combinations, advantages and disadvantages of such surgical methods for peripheral nerve injury treatment as neurorrhaphy, autotransplantation and allotransplantation are described in detail, such terms as “small”, “large” and “critical” gaps between the nerve stumps are specified. Classifications and characteristics of conduits are described, types of synthetic conduits are considered. The use of drugs, Schwann cells, growth and neurotrophic factors, neural, embryonic and mesenchymal stem cells of various origins, exosomes of mesenchymal stem cells in the so-called “stem cell-free therapy” in treating this pathology is mentioned. Genetically modified mesenchymal stem cells, optokinetics are also noted, such physical methods for peripheral nerve injury treatment as short-term low-frequency electrical stimulation of the nerve, magnetic stimulation, low-intensity ultrasound, photobiomodulation therapy, photochemical bonding are discussed, indicating some mechanisms of their positive effects. Conclusions. Improving the quality of life and reducing the degree of disability in patients with injuries of the main nerve trunks depends on the combined use of a number of surgical, bioengineering and regenerative technologies. These involve the restoration of the anatomical continuity of the nerve, including through the use of natural or artificial elements, cellular technologies and the management of regenerative processes. Therefore, every time, a surgeon is facing a major challenge to create a combination of various means from the indicated basic components for the treatment of nerve damage in managing a particular patient. However, such a treatment approach requires proper competences of surgeons as well as specific material and technical bases in order to bring down the level of social tension in patients with injuries of the main nerve trunks.
{"title":"Treatment methods for peripheral nerve injuries (a literature review)","authors":"N. M. Nevmerzhytska, L. Yaremenko, S. M. Chuhray, O. M. Grabovyi","doi":"10.14739/2310-1210.2023.4.273073","DOIUrl":"https://doi.org/10.14739/2310-1210.2023.4.273073","url":null,"abstract":"Aim: to analyze modern professional literature and summarize data on treatment methods for peripheral nerve injuries, taking into account the mechanisms of positive effects.\u0000The article presents an overview of possible methods for treatment of peripheral nerve injuries, fundamental classifications of peripheral nerve injuries, their differences are considered, pathophysiological mechanisms and the probability of spontaneous recovery depending on the degree of injury, general principles and conditions for successful regeneration of the peripheral nerve. Options, combinations, advantages and disadvantages of such surgical methods for peripheral nerve injury treatment as neurorrhaphy, autotransplantation and allotransplantation are described in detail, such terms as “small”, “large” and “critical” gaps between the nerve stumps are specified. Classifications and characteristics of conduits are described, types of synthetic conduits are considered. The use of drugs, Schwann cells, growth and neurotrophic factors, neural, embryonic and mesenchymal stem cells of various origins, exosomes of mesenchymal stem cells in the so-called “stem cell-free therapy” in treating this pathology is mentioned. Genetically modified mesenchymal stem cells, optokinetics are also noted, such physical methods for peripheral nerve injury treatment as short-term low-frequency electrical stimulation of the nerve, magnetic stimulation, low-intensity ultrasound, photobiomodulation therapy, photochemical bonding are discussed, indicating some mechanisms of their positive effects.\u0000Conclusions. Improving the quality of life and reducing the degree of disability in patients with injuries of the main nerve trunks depends on the combined use of a number of surgical, bioengineering and regenerative technologies. These involve the restoration of the anatomical continuity of the nerve, including through the use of natural or artificial elements, cellular technologies and the management of regenerative processes. Therefore, every time, a surgeon is facing a major challenge to create a combination of various means from the indicated basic components for the treatment of nerve damage in managing a particular patient. However, such a treatment approach requires proper competences of surgeons as well as specific material and technical bases in order to bring down the level of social tension in patients with injuries of the main nerve trunks.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80281018","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 : 2023-07-20DOI: 10.14739/2310-1210.2023.4.275412
A. Dorofieiev, H. A. Dorohavtseva, С. А. Е. Дорофєєв А, Дорогавцева
The aim of the study was to analyze the age structure, correlation with body mass index in patients with symptomatic uncomplicated diverticular disease (SUDD) in the central region of Ukraine. To reveal the prevalence of left-sided, right-sided or total diverticular lesions of the large intestine, to evaluate the microbiota composition, to identify peculiarities of the enterotype. Materials and methods. The study included 125 patients with SUDD aged 18 to 90 years who were at a Gastroenterology Hospital in the period from 2019 to 2022. All the patients were residents of the central region of Ukraine. Body mass index was calculated for all patients, total colonoscopy was performed, and fecal analysis was done using culturing and qRT-PCR methods. Results. The incidence of SUDD among patients in the central region of Ukraine increases with age and reaches its peak in the 71–80 age group. Almost all age groups are dominated by women. Left-sided localization of diverticula occurs in 84.8 % of patients, right-sided in 8.0 %, total in 7.2 %. The majority of patients with diverticular disease (87.2 %) are overweight or with varying degrees of obesity. Patients with SUDD are characterized by a decrease in the main representatives of obligate microflora, namely, Bifidobacterium, Lactobacillus, Escherichia coli. In 46.4 % of patients, representatives of opportunistic flora are detected, in 24.0 % – an increase in fungi from the genus Candida. Also, changes in enterotypes are detected, namely an increase in Firmicutes and Actinobacteria, with a decrease in Bacteroides. The number of Faecalibacterium prausnitzii tends to decrease, while the Akkermansia muciniphila count is unchanged. Conclusions. The incidence of SUDD increases with age among the population of the central region of Ukraine. Among patients with SUDD, women predominate in almost all age groups. 87.2 % of patients with SUDD are overweight or with various degrees of obesity. The left-sided localization of diverticula prevails among patients with SUDD in the central region of Ukraine – 84.8 %. Patients with SUDD in the central region of Ukraine are characterized by the decrease in the main representatives of obligate microflora, namely: Bifidobacterium, Lactobacillus, Escherichia coli. In 46.4 % of patients with SUDD, representatives of conditionally pathogenic flora are found, in 24.0 % – the increase in fungi from the genus Candida. Changes in enterotypes are detected, namely the increase in Firmicutes and Actinobacteria, with the decrease in Bacteroides. Faecalibacterium prausnitzii tends to decrease, while Akkermansia muciniphila are unchanged.
{"title":"Characteristics of the microbiome in patients with symptomatic uncomplicated colonic diverticular disease in the central region of Ukraine","authors":"A. Dorofieiev, H. A. Dorohavtseva, С. А. Е. Дорофєєв А, Дорогавцева","doi":"10.14739/2310-1210.2023.4.275412","DOIUrl":"https://doi.org/10.14739/2310-1210.2023.4.275412","url":null,"abstract":"The aim of the study was to analyze the age structure, correlation with body mass index in patients with symptomatic uncomplicated diverticular disease (SUDD) in the central region of Ukraine. To reveal the prevalence of left-sided, right-sided or total diverticular lesions of the large intestine, to evaluate the microbiota composition, to identify peculiarities of the enterotype.\u0000Materials and methods. The study included 125 patients with SUDD aged 18 to 90 years who were at a Gastroenterology Hospital in the period from 2019 to 2022. All the patients were residents of the central region of Ukraine. Body mass index was calculated for all patients, total colonoscopy was performed, and fecal analysis was done using culturing and qRT-PCR methods.\u0000Results. The incidence of SUDD among patients in the central region of Ukraine increases with age and reaches its peak in the 71–80 age group. Almost all age groups are dominated by women. Left-sided localization of diverticula occurs in 84.8 % of patients, right-sided in 8.0 %, total in 7.2 %. The majority of patients with diverticular disease (87.2 %) are overweight or with varying degrees of obesity. Patients with SUDD are characterized by a decrease in the main representatives of obligate microflora, namely, Bifidobacterium, Lactobacillus, Escherichia coli. In 46.4 % of patients, representatives of opportunistic flora are detected, in 24.0 % – an increase in fungi from the genus Candida. Also, changes in enterotypes are detected, namely an increase in Firmicutes and Actinobacteria, with a decrease in Bacteroides. The number of Faecalibacterium prausnitzii tends to decrease, while the Akkermansia muciniphila count is unchanged.\u0000Conclusions. The incidence of SUDD increases with age among the population of the central region of Ukraine. Among patients with SUDD, women predominate in almost all age groups. 87.2 % of patients with SUDD are overweight or with various degrees of obesity. The left-sided localization of diverticula prevails among patients with SUDD in the central region of Ukraine – 84.8 %. Patients with SUDD in the central region of Ukraine are characterized by the decrease in the main representatives of obligate microflora, namely: Bifidobacterium, Lactobacillus, Escherichia coli. In 46.4 % of patients with SUDD, representatives of conditionally pathogenic flora are found, in 24.0 % – the increase in fungi from the genus Candida. Changes in enterotypes are detected, namely the increase in Firmicutes and Actinobacteria, with the decrease in Bacteroides. Faecalibacterium prausnitzii tends to decrease, while Akkermansia muciniphila are unchanged.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73602757","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 : 2023-07-20DOI: 10.14739/2310-1210.2023.4.276462
CD O. V H. V. Venytska B, Riabokon, DE R. O Yu. Yu. Riabokon C, Shcherbyna
Aim. The purpose of our work is to find out diagnostic values of serum MMP-9 and TGF-1β determination for assessing the severity of liver fibrosis and the rate of its progression in patients with chronic hepatitis C genotype 1 (CHC GT1) infection. Materials and methods. 92 patients with CHC GT1 were examined. The severity of liver fibrosis was assessed by elastometry. The rate of liver fibrosis progression was calculated using the T. Poynard formula. Serum levels of TGF-1β and MMP-9 were measured by ELISA method. Results. In patients with CHC GT1, the most noticeable changes in the serum parameters of fibrogenesis / fibrinolysis were observed in the presence of F 3–4. The probability of liver fibrosis stages F 3–4 was high at the serum levels of TGF-1β >12.03 pg/ml (p < 0.001), MMP-9 ≤987.20 pg/ml (p = 0.016), TGF-1β/MMP-9 ratio >0.011 (p < 0.001). Fast liver fibrosis progression was more often registered in F 3–4 than in F 0–2 (62.9 % vs. 16.7 %, p < 0.0001). Increasing rate of liver fibrosis progression in these patients was confirmed by a higher ratio of TGF-1β/MMP-9 compared to that in patients with a slow rate of liver fibrosis progression (p < 0.05). The probability of fast liver fibrosis progression was high at the serum levels of TGF-1β >8.69 pg/ml (p < 0.001), MMP-9 ≤920.65 (p = 0.005), TGF-1β/MMP-9 ratio > 0.011 (p < 0.001). Conclusions. The diagnostic value of MMP-9 and TGF-1β in assessing the liver fibrosis severity and the rate of its progression in patients with CHC GT1 has been defined. Cut-off levels of MMP-9, TGF-1β and the TGF-1β/MMP-9 ratio for stratification of patients with severe liver fibrosis and the fast rate of its progression have been proposed.
{"title":"Diagnostic values of MMP-9 and TGF-1β in assessing the severity of liver fibrosis and the rate of its progression in patients with chronic hepatitis C GT 1 infection","authors":"CD O. V H. V. Venytska B, Riabokon, DE R. O Yu. Yu. Riabokon C, Shcherbyna","doi":"10.14739/2310-1210.2023.4.276462","DOIUrl":"https://doi.org/10.14739/2310-1210.2023.4.276462","url":null,"abstract":"Aim. The purpose of our work is to find out diagnostic values of serum MMP-9 and TGF-1β determination for assessing the severity of liver fibrosis and the rate of its progression in patients with chronic hepatitis C genotype 1 (CHC GT1) infection.\u0000Materials and methods. 92 patients with CHC GT1 were examined. The severity of liver fibrosis was assessed by elastometry. The rate of liver fibrosis progression was calculated using the T. Poynard formula. Serum levels of TGF-1β and MMP-9 were measured by ELISA method.\u0000Results. In patients with CHC GT1, the most noticeable changes in the serum parameters of fibrogenesis / fibrinolysis were observed in the presence of F 3–4. The probability of liver fibrosis stages F 3–4 was high at the serum levels of TGF-1β >12.03 pg/ml (p < 0.001), MMP-9 ≤987.20 pg/ml (p = 0.016), TGF-1β/MMP-9 ratio >0.011 (p < 0.001).\u0000Fast liver fibrosis progression was more often registered in F 3–4 than in F 0–2 (62.9 % vs. 16.7 %, p < 0.0001). Increasing rate of liver fibrosis progression in these patients was confirmed by a higher ratio of TGF-1β/MMP-9 compared to that in patients with a slow rate of liver fibrosis progression (p < 0.05). The probability of fast liver fibrosis progression was high at the serum levels of TGF-1β >8.69 pg/ml (p < 0.001), MMP-9 ≤920.65 (p = 0.005), TGF-1β/MMP-9 ratio > 0.011 (p < 0.001).\u0000Conclusions. The diagnostic value of MMP-9 and TGF-1β in assessing the liver fibrosis severity and the rate of its progression in patients with CHC GT1 has been defined. Cut-off levels of MMP-9, TGF-1β and the TGF-1β/MMP-9 ratio for stratification of patients with severe liver fibrosis and the fast rate of its progression have been proposed.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89313325","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 : 2023-07-20DOI: 10.14739/2310-1210.2023.4.279043
N. S. Kosmynina, M. Dats-Opoka
Multisystem inflammatory syndrome in children (MIS-C) who contracted COVID-19 remains an urgent problem. Mortality due to this disease among children ranges from 0.8 % to 2.0 %. According to reports found in the literature, MIS-C can develop both in children who have experienced COVID-19 without clinical manifestations, and in those who have had a severe course of the disease. To date, there are no well-defined factors that allow predicting the risk of developing MIS-C in children after experiencing COVID-19, and the spectrum of clinical manifestations can be quite diverse. Aim: on the example of a specific case, to examine and analyze the features of the course and the range of diagnostic measures in children with MIS-C using an analytical method and a systemic approach. Materials and methods. The material was a clinical case of MIS-C, methods of instrumental diagnosis and objective analysis. The diagnosis of MIS-C was based on the WHO 2021 criteria for the diagnosis of MIS-C associated with COVID-19. Results. The clinical case of MIS-C associated with COVID-19 in a child with congenital thymus pathology that resulted in rapid, aggressive, and worsening multiple organ failure was studied. The manifestations were dominated by liver failure, respiratory failure, circulatory failure, and neurological deficiency, that led to the child’s death. Conclusions. Multisystem inflammatory syndrome in children associated with SARS-CoV-2 infection can lead to serious and life-threatening complications in previously clinically healthy children. Physicians need to be more alert to children of different age groups with manifestations of respiratory infections as potential COVID-19 and to test for its presence, which will subsequently allow timely identification of children with MIS-C associated with SARS-CoV-2. Considering the probable role of the thymus in the pathogenesis and course of MIS-C associated with SARS-CoV-2, we recommend an ultrasound examination of the thymus for all children under 3 years of age with confirmed COVID-19 and followed by examination of T-cellular response if changes are detected.
{"title":"Multisystem inflammatory syndrome in a child associated with COVID-19: a clinical case report","authors":"N. S. Kosmynina, M. Dats-Opoka","doi":"10.14739/2310-1210.2023.4.279043","DOIUrl":"https://doi.org/10.14739/2310-1210.2023.4.279043","url":null,"abstract":"Multisystem inflammatory syndrome in children (MIS-C) who contracted COVID-19 remains an urgent problem. Mortality due to this disease among children ranges from 0.8 % to 2.0 %. According to reports found in the literature, MIS-C can develop both in children who have experienced COVID-19 without clinical manifestations, and in those who have had a severe course of the disease.\u0000To date, there are no well-defined factors that allow predicting the risk of developing MIS-C in children after experiencing COVID-19, and the spectrum of clinical manifestations can be quite diverse.\u0000Aim: on the example of a specific case, to examine and analyze the features of the course and the range of diagnostic measures in children with MIS-C using an analytical method and a systemic approach.\u0000Materials and methods. The material was a clinical case of MIS-C, methods of instrumental diagnosis and objective analysis. The diagnosis of MIS-C was based on the WHO 2021 criteria for the diagnosis of MIS-C associated with COVID-19.\u0000Results. The clinical case of MIS-C associated with COVID-19 in a child with congenital thymus pathology that resulted in rapid, aggressive, and worsening multiple organ failure was studied. The manifestations were dominated by liver failure, respiratory failure, circulatory failure, and neurological deficiency, that led to the child’s death.\u0000Conclusions. Multisystem inflammatory syndrome in children associated with SARS-CoV-2 infection can lead to serious and life-threatening complications in previously clinically healthy children.\u0000Physicians need to be more alert to children of different age groups with manifestations of respiratory infections as potential COVID-19 and to test for its presence, which will subsequently allow timely identification of children with MIS-C associated with SARS-CoV-2.\u0000Considering the probable role of the thymus in the pathogenesis and course of MIS-C associated with SARS-CoV-2, we recommend an ultrasound examination of the thymus for all children under 3 years of age with confirmed COVID-19 and followed by examination of T-cellular response if changes are detected.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72752080","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 : 2023-07-20DOI: 10.14739/2310-1210.2023.4.274894
О. В. Годований, Н. Л. Чухрай, О. І. Мрочко, О. І. Мартовлос, O. Hodovanyi, B. A
The aim of the work was a preclinical assessment of acute toxicity, skin resorptive, irritant effects, cumulative and catalase activity, as well as sensitizing properties of the local gel composition “Benzidaflaziverdine” (GCB) used for the treatment of periodontal diseases in orthodontic patients. Materials and methods. 119 animals were involved in the experiment, assigned to seven main and two control groups. GCB was administered intragastrically in doses of 300–600 mg/kg and intradermally of 200 μg into the outer surface of the ear. The native solution of GCB was applied to the skin and mucous membranes, administered orally by the method of “subchronic toxicity” and to the surface of the chorioallantoic membrane (CAM) of chicken embryos. The intensity of lipid peroxidation (LPO) was assessed by the level of diene conjugates (DCs) and malondialdehyde (MDA), and the antioxidant system by catalase activity. The specific leukocyte agglomeration reaction (SLAR), the specific leukocyte lysis reaction, and neutrophil damage indicators were used. Results. The median lethal dose LD50 for rats and mice of both sexes exceeded 5000 mg/kg. The irritant effect of GCB on the mucous membranes was manifested by hyperemia on the second day. Symptoms of irritation disappeared after 3–4 days without medical intervention. An analysis of the CAM blood vessels after exposure to GCB in two observations at the 120th second showed the beginning of hemorrhages. In one observation, GCB caused minor hemorrhages at the 300th second of the experiment. It was found that the coefficient of GCB irritant action was 5 (the mean score of Me (Q1; Q3) was 5 (4; 5)). The coefficient of cumulation (Kcum) exceeded 8.2. An insignificant increase in the median or mean values of catalase enzyme activity, DCs, and the amount of LPO end product such as MDA was observed compared to the control group animals. The SLAR test indicated the development of a delayed-type allergic reaction under the influence of GCB in a 1:10 dilution. One-hundred-fold dilution did not cause significant changes in the indicator in the main group compared to the control one. Conclusions. GCB belongs to the 4th class of toxicity – practically non-toxic substances, does not have sex- and species sensitivity, has weak cumulative activity, minimal effect on the system of LPO. GCB can be recommended for the use in clinical periodontology for medical support of orthodontic patients.
{"title":"Preclinical evaluation of a gel composition based on a flavonoid complex for the treatment of periodontal diseases in orthodontic patients","authors":"О. В. Годований, Н. Л. Чухрай, О. І. Мрочко, О. І. Мартовлос, O. Hodovanyi, B. A","doi":"10.14739/2310-1210.2023.4.274894","DOIUrl":"https://doi.org/10.14739/2310-1210.2023.4.274894","url":null,"abstract":"The aim of the work was a preclinical assessment of acute toxicity, skin resorptive, irritant effects, cumulative and catalase activity, as well as sensitizing properties of the local gel composition “Benzidaflaziverdine” (GCB) used for the treatment of periodontal diseases in orthodontic patients.\u0000Materials and methods. 119 animals were involved in the experiment, assigned to seven main and two control groups. GCB was administered intragastrically in doses of 300–600 mg/kg and intradermally of 200 μg into the outer surface of the ear. The native solution of GCB was applied to the skin and mucous membranes, administered orally by the method of “subchronic toxicity” and to the surface of the chorioallantoic membrane (CAM) of chicken embryos. The intensity of lipid peroxidation (LPO) was assessed by the level of diene conjugates (DCs) and malondialdehyde (MDA), and the antioxidant system by catalase activity. The specific leukocyte agglomeration reaction (SLAR), the specific leukocyte lysis reaction, and neutrophil damage indicators were used.\u0000Results. The median lethal dose LD50 for rats and mice of both sexes exceeded 5000 mg/kg. The irritant effect of GCB on the mucous membranes was manifested by hyperemia on the second day. Symptoms of irritation disappeared after 3–4 days without medical intervention. An analysis of the CAM blood vessels after exposure to GCB in two observations at the 120th second showed the beginning of hemorrhages. In one observation, GCB caused minor hemorrhages at the 300th second of the experiment.\u0000It was found that the coefficient of GCB irritant action was 5 (the mean score of Me (Q1; Q3) was 5 (4; 5)). The coefficient of cumulation (Kcum) exceeded 8.2. An insignificant increase in the median or mean values of catalase enzyme activity, DCs, and the amount of LPO end product such as MDA was observed compared to the control group animals. The SLAR test indicated the development of a delayed-type allergic reaction under the influence of GCB in a 1:10 dilution. One-hundred-fold dilution did not cause significant changes in the indicator in the main group compared to the control one.\u0000Conclusions. GCB belongs to the 4th class of toxicity – practically non-toxic substances, does not have sex- and species sensitivity, has weak cumulative activity, minimal effect on the system of LPO. GCB can be recommended for the use in clinical periodontology for medical support of orthodontic patients.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86706344","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}
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