Pub Date : 2023-03-28DOI: 10.14739/2310-1210.2023.2.271197
O. H. Kotenko, I. O. Kotenko, M. S. Hryhorian, A. Minich, A. O. Matviienkiv, O. S. Mykhailiuk
Aim. The purpose of the article is to study the outcome of using living-related partial liver transplantation in the treatment of unresectable liver metastatic colorectal cancer. Case report. A woman, born in 1989, applied to the Medical Center Universal Clinic “Oberig” with a diagnosis of stage IV sigmoid colon cancer pT4N2M1 with synchronous liver metastases after sigmoidectomy and adjuvant chemotherapy. The patient underwent surgical intervention to the extent of right-sided hemihepatectomy with total caudate lobectomy, enucleation of metastases from the left liver lobe, cholecystectomy, extended lymphadenectomy, followed by systemic antitumor therapy. Six months later, according to laboratory and instrumental examinations, the progression of the disease was revealed in the form of new metastases development in the left liver lobe. After a thorough examination, a decision was made to treat the patient by living-related partial liver transplantation. On February 16, 2021, the patient underwent orthotopic transplantation of the left liver lobe from a living-related donor. The patient was discharged on the 31st postoperative day in a satisfactory condition. According to a control MRI after discharge, no signs of disease progression were detected. In the post-transplantation period, the patient developed an acute steroid-resistant rejection requiring antiplatelet immunoglobulin prescription. Three months after discharge, the patient was diagnosed with a high stricture of the bilio-biliary anastomosis, so resections of liver segment IV, hepaticocholedochus, and bihepaticojejunostomy on a defunctionalized Roux loop of the small intestine were performed. In the post-transplantation period, no signs of disease progression were detected, and no special antitumor treatment was used. Conclusions. Liver transplantation is an effective and radical method of treatment for patients with unresectable liver metastatic colorectal cancer.
{"title":"Living-related partial liver transplantation in unresectable liver metastatic colorectal cancer. A case report","authors":"O. H. Kotenko, I. O. Kotenko, M. S. Hryhorian, A. Minich, A. O. Matviienkiv, O. S. Mykhailiuk","doi":"10.14739/2310-1210.2023.2.271197","DOIUrl":"https://doi.org/10.14739/2310-1210.2023.2.271197","url":null,"abstract":"Aim. The purpose of the article is to study the outcome of using living-related partial liver transplantation in the treatment of unresectable liver metastatic colorectal cancer.\u0000Case report. A woman, born in 1989, applied to the Medical Center Universal Clinic “Oberig” with a diagnosis of stage IV sigmoid colon cancer pT4N2M1 with synchronous liver metastases after sigmoidectomy and adjuvant chemotherapy. The patient underwent surgical intervention to the extent of right-sided hemihepatectomy with total caudate lobectomy, enucleation of metastases from the left liver lobe, cholecystectomy, extended lymphadenectomy, followed by systemic antitumor therapy. Six months later, according to laboratory and instrumental examinations, the progression of the disease was revealed in the form of new metastases development in the left liver lobe. After a thorough examination, a decision was made to treat the patient by living-related partial liver transplantation. On February 16, 2021, the patient underwent orthotopic transplantation of the left liver lobe from a living-related donor. The patient was discharged on the 31st postoperative day in a satisfactory condition. According to a control MRI after discharge, no signs of disease progression were detected. In the post-transplantation period, the patient developed an acute steroid-resistant rejection requiring antiplatelet immunoglobulin prescription. Three months after discharge, the patient was diagnosed with a high stricture of the bilio-biliary anastomosis, so resections of liver segment IV, hepaticocholedochus, and bihepaticojejunostomy on a defunctionalized Roux loop of the small intestine were performed. In the post-transplantation period, no signs of disease progression were detected, and no special antitumor treatment was used.\u0000Conclusions. Liver transplantation is an effective and radical method of treatment for patients with unresectable liver metastatic colorectal cancer.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76505083","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 : 2023-03-28DOI: 10.14739/2310-1210.2023.2.267251
T. H. Bakaliuk, N. R. Маkarchuk, Kh. M. Seniuk, H. O. Stelmakh, A. Sverstiuk
Diabetic foot syndrome is an increasingly serious public health problem in both developed and developing countries. Many patients with diabetes complicated by ineffectively treated foot ulcer undergo limb amputation which leads to disability. Therefore, finding and applying effective methods of treating diabetic ulcers in clinical practice is an urgent task. According to recent research, the most effective and complementary to known treatment approaches are rehabilitation methods, but not all of them have been sufficiently studied. Aim: to study the effectiveness of the treatment for diabetic foot syndrome in patients with diabetes when implementing the use of polarizing light with a Bioptron device and kinesiotherapy exercises according to the Buerger–Allen method into the treatment process. Materials and methods. 35 patients with diabetes mellitus complicated with diabetic foot syndrome were examined. The patients were divided into two groups: the main group (MG) (n = 17) received standard treatment in accordance with the protocol for providing medical care to patients with diabetic foot syndrome, whereas the comparison group (CG) (n = 18) received light therapy procedures with the Bioptron device in addition to the protocol treatment and kinesiotherapy exercises according to the Buerger–Allen method. To choose treatment tactics and predict the course of the disease, the bone-brachial index was determined. The ulcer area was determined by means of the imitoMeasure application for the Android operating system. Quality of life was assessed using the SF-36 questionnaire. Analysis and processing of clinical trial statistics were performed on a personal computer using Statistica 10 and MS Excel 2016 application packages. Results. Our results have shown that a single-day reduction of a wound defect in the MG was approximately 1 % per day, and in the patients of the CG who, in addition to the standard therapy, received polarized light therapy and kinesiotherapy exercises according to the Buerger–Allen method, from 3 % to 4 % per day. Using the Bayesian formula, the probability of complete ulcer healing in the CG was calculated, that was 0.3 compared to the MG – 0.06, indicating greater treatment effectiveness with the inclusion of additional non-drug rehabilitation methods. An assessment of the quality of life indicators in diabetic patients with diabetic foot syndrome after using different treatment schemes has confirmed the effectiveness of the new method based on the obtained significant difference between the studied indicators in the MG and CG according to the Mann-Whitney criterion (Р ˂ 0.05) with regard to the following components: physical functioning, role functioning, pain, general health, and emotional functioning. According to the obtained statistical results, the best effect was observed in the CG with the additional use of polarizing light and kinesiotherapy. Conclusions. The proposed complex treatment of diabetic patients with diabetic
{"title":"Evaluation of the effectiveness of rehabilitation for diabetic foot syndrome","authors":"T. H. Bakaliuk, N. R. Маkarchuk, Kh. M. Seniuk, H. O. Stelmakh, A. Sverstiuk","doi":"10.14739/2310-1210.2023.2.267251","DOIUrl":"https://doi.org/10.14739/2310-1210.2023.2.267251","url":null,"abstract":"Diabetic foot syndrome is an increasingly serious public health problem in both developed and developing countries. Many patients with diabetes complicated by ineffectively treated foot ulcer undergo limb amputation which leads to disability. Therefore, finding and applying effective methods of treating diabetic ulcers in clinical practice is an urgent task. According to recent research, the most effective and complementary to known treatment approaches are rehabilitation methods, but not all of them have been sufficiently studied.\u0000Aim: to study the effectiveness of the treatment for diabetic foot syndrome in patients with diabetes when implementing the use of polarizing light with a Bioptron device and kinesiotherapy exercises according to the Buerger–Allen method into the treatment process.\u0000Materials and methods. 35 patients with diabetes mellitus complicated with diabetic foot syndrome were examined. The patients were divided into two groups: the main group (MG) (n = 17) received standard treatment in accordance with the protocol for providing medical care to patients with diabetic foot syndrome, whereas the comparison group (CG) (n = 18) received light therapy procedures with the Bioptron device in addition to the protocol treatment and kinesiotherapy exercises according to the Buerger–Allen method.\u0000To choose treatment tactics and predict the course of the disease, the bone-brachial index was determined. The ulcer area was determined by means of the imitoMeasure application for the Android operating system. Quality of life was assessed using the SF-36 questionnaire. Analysis and processing of clinical trial statistics were performed on a personal computer using Statistica 10 and MS Excel 2016 application packages.\u0000Results. Our results have shown that a single-day reduction of a wound defect in the MG was approximately 1 % per day, and in the patients of the CG who, in addition to the standard therapy, received polarized light therapy and kinesiotherapy exercises according to the Buerger–Allen method, from 3 % to 4 % per day. Using the Bayesian formula, the probability of complete ulcer healing in the CG was calculated, that was 0.3 compared to the MG – 0.06, indicating greater treatment effectiveness with the inclusion of additional non-drug rehabilitation methods. An assessment of the quality of life indicators in diabetic patients with diabetic foot syndrome after using different treatment schemes has confirmed the effectiveness of the new method based on the obtained significant difference between the studied indicators in the MG and CG according to the Mann-Whitney criterion (Р ˂ 0.05) with regard to the following components: physical functioning, role functioning, pain, general health, and emotional functioning. According to the obtained statistical results, the best effect was observed in the CG with the additional use of polarizing light and kinesiotherapy.\u0000Conclusions. The proposed complex treatment of diabetic patients with diabetic ","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87289539","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 : 2023-03-28DOI: 10.14739/2310-1210.2023.2.263222
Y. Stepanov, I. Klenina, O. Tatarchuk, M. Stoikevych, Т. S. Tarasova, N. Fedorova, O. Petishko
Aim. To evaluate the content of calprotectin and volatile fatty acids (VFAs) in feces of patients with inflammatory bowel disease (IBD). Materials and methods. 61 patients (33 men and 28 women) with IBD aged 20 to 66 years (the mean indicator was 41.80 ± 1.14 years) were examined. The patients were treated in the Department of Intestinal Diseases of SI “Institute of Gastroenterology of the National Academy of Medical Sciences of Ukraine”. All the patients were divided into two groups: Group I – 46 patients with ulcerative colitis (UC) and Group II – 15 patients with Crohn’s disease (CD). The control group consisted of 10 practically healthy people (donors). Calprotectin detection in fecal samples was carried out using a kit “Immundiagnostik”, Germany. Fecal VFAs were analyzed using a hardware-software complex for medical research with a gas chromatograph Chromatek-Crystal 5000. Results. A significant increase in the content of fecal calprotectin was found. Its amount depended on the disease nosology and was more expressed in patients with UC (3.5 times higher (P < 0.05) than that in patients with CD). The observed changes were accompanied by an increase in the content of propionic (C3) acid and a decrease in acetic (C2), butyric (C4) acids in coprofiltrates of the examined patients. The detected imbalance in the fecal content of VFAs in patients led to an increase in the amount of fatty acids, which was more pronounced in patients with CD. An association between calprotectin levels and fecal VFA content was identified. Thus, correlation analysis allowed to establish a relationship between calprotectin levels and propionic acid content in patients with IBD (r = 0.370; P = 0.046). Conclusions. In the case of active bowel inflammation, there is the increase in the fecal content of calprotectin and the decrease in VFAs (acetic and butyric acids) in accordance with the degree of disease activity, which allows the use of these indicators to assess the efficacy of therapies.
{"title":"Association between calprotectin and volatile fatty acids in patients with inflammatory bowel diseases","authors":"Y. Stepanov, I. Klenina, O. Tatarchuk, M. Stoikevych, Т. S. Tarasova, N. Fedorova, O. Petishko","doi":"10.14739/2310-1210.2023.2.263222","DOIUrl":"https://doi.org/10.14739/2310-1210.2023.2.263222","url":null,"abstract":"Aim. To evaluate the content of calprotectin and volatile fatty acids (VFAs) in feces of patients with inflammatory bowel disease (IBD).\u0000Materials and methods. 61 patients (33 men and 28 women) with IBD aged 20 to 66 years (the mean indicator was 41.80 ± 1.14 years) were examined. The patients were treated in the Department of Intestinal Diseases of SI “Institute of Gastroenterology of the National Academy of Medical Sciences of Ukraine”. All the patients were divided into two groups: Group I – 46 patients with ulcerative colitis (UC) and Group II – 15 patients with Crohn’s disease (CD). The control group consisted of 10 practically healthy people (donors).\u0000Calprotectin detection in fecal samples was carried out using a kit “Immundiagnostik”, Germany. Fecal VFAs were analyzed using a hardware-software complex for medical research with a gas chromatograph Chromatek-Crystal 5000.\u0000Results. A significant increase in the content of fecal calprotectin was found. Its amount depended on the disease nosology and was more expressed in patients with UC (3.5 times higher (P < 0.05) than that in patients with CD). The observed changes were accompanied by an increase in the content of propionic (C3) acid and a decrease in acetic (C2), butyric (C4) acids in coprofiltrates of the examined patients. The detected imbalance in the fecal content of VFAs in patients led to an increase in the amount of fatty acids, which was more pronounced in patients with CD. An association between calprotectin levels and fecal VFA content was identified. Thus, correlation analysis allowed to establish a relationship between calprotectin levels and propionic acid content in patients with IBD (r = 0.370; P = 0.046).\u0000Conclusions. In the case of active bowel inflammation, there is the increase in the fecal content of calprotectin and the decrease in VFAs (acetic and butyric acids) in accordance with the degree of disease activity, which allows the use of these indicators to assess the efficacy of therapies.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91272630","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 : 2023-03-28DOI: 10.14739/2310-1210.2023.2.273629
I. R. Fedun, V. Zubachyk, A. I. Furdychko, I. Han, M. Ilchyshyn
Aim. To investigate the relationship between the physical properties of saliva and enamel resistance and caries intensity in drug-addicted patients. Materials and methods. The study involved 70 patients, who were divided into three groups: the main group (1) – 28 drug addicts diagnosed with caries, the comparison group (2) – 22 patients with caries of dental hard tissues without a history of drug addiction, and the control group (3) – 20 persons without carious lesions of dental hard tissues. We examined the rate of salivation, which was calculated by the formula: Rs = V / T, pH of oral fluid using litmus test strips (Kelilong Instruments, China), structural and functional stability of tooth enamel by the express method TER-test (V. R. Okushko, L. I. Kosareva, 1983), clinically assessed the rate of mineralization according to the Clinical Assessment of the Rate of Enamel Remineralization-test (T. L. Redinova, V. K. Leontiev and G. D. Ovrutsky, 1982), dental caries intensity using the DMF index; the International Caries Detection and Assessment System (ICDAS) was used to assess of the dental hard tissues. Results. In drug-addicted patients with caries of dental hard tissues, the slowest rate of salivation and significant changes in the oral fluid pH toward acidic were observed, namely 5.5 ± 0.09 units compared with patients of other groups. In drug addicts, the average TER-test score was 9.1 ± 0.4 points and was significantly higher than that in non-drug-addicted patients with dental caries (5.4 ± 0.2 points) and people without dental caries (1.9 ± 0.2 points). The Clinical Assessment of the Rate of Enamel Remineralization-test indicators of drug-addicted patients (6.1 ± 0.3 days) were also significantly higher than those of non-addicted and control group patients. The DMF index in drug-addicted patients was 16.4 ± 0.2 points showing a very high intensity of caries with a large proportion of deep carious lesions in the dental hard tissues. Conclusions. In drug addicts, the study results have indicated a 23 % pH shift of the oral fluid toward acidic, and a 22 % decrease in the rate of saliva secretion has also been recorded compared to the healthy individuals. These results were associated with a 79 % decrease in the tooth enamel durability and a 66 % decrease in the remineralizing capacity of the oral fluid in drug addicts as compared to the healthy individuals. The DMF index of group 1 patients differed from that of group 2 patients by 50 % and from group 3 individuals – by 98 %. Drug-addicted patients had 78 % more carious lesions in the dentin compared to non-drug-addicted patients with dental caries.
的目标。目的:探讨吸毒患者唾液物理特性与牙釉质耐受性及龋病强度的关系。材料和方法。本研究共纳入70例患者，分为三组:主要组(1)- 28例确诊为龋齿的吸毒成瘾者，对照组(2)- 22例无吸毒成瘾史的牙硬组织龋齿患者，对照组(3)- 20例无牙硬组织龋齿病变患者。我们检查了唾液分泌率，计算公式如下:Rs = V / T，口腔液pH用石蕊试纸(Kelilong Instruments, China)测定，牙釉质结构和功能稳定性用ter - express法测定(V. R. Okushko, L. I. Kosareva, 1983)，牙釉质再矿化率临床评价(T. L. Redinova, V. K. Leontiev和G. D. Ovrutsky, 1982)临床评价矿化率，龋病强度用DMF指数测定;采用国际龋病检测与评估系统(ICDAS)对牙硬组织进行评估。伴有牙硬组织龋病的吸毒患者的唾液分泌速度最慢，口腔液pH值较其他组呈明显的酸性变化，为5.5±0.09个单位。吸毒成瘾者TER-test平均得分为9.1±0.4分，明显高于非吸毒成瘾伴龋者(5.4±0.2分)和无龋者(1.9±0.2分)。药物成瘾患者的牙釉质再矿化率临床评估指标(6.1±0.3 d)也明显高于非成瘾组和对照组。吸毒成瘾患者的DMF指数为16.4±0.2分，龋病强度非常高，牙硬组织深部龋损占很大比例。在吸毒成瘾者中，研究结果表明，与健康个体相比，口服液的pH值向酸性转移了23%，唾液分泌率也下降了22%。与健康个体相比，这些结果与吸毒成瘾者牙釉质耐久性下降79%和口服液再矿化能力下降66%有关。1组患者的DMF指数与2组患者相差50%，与3组患者相差98%。与非药物成瘾患者相比，药物成瘾患者的牙本质龋齿病变增加了78%。
{"title":"Relationship between enamel resistance and physical properties of saliva in drug-addicted patients","authors":"I. R. Fedun, V. Zubachyk, A. I. Furdychko, I. Han, M. Ilchyshyn","doi":"10.14739/2310-1210.2023.2.273629","DOIUrl":"https://doi.org/10.14739/2310-1210.2023.2.273629","url":null,"abstract":"Aim. To investigate the relationship between the physical properties of saliva and enamel resistance and caries intensity in drug-addicted patients.\u0000Materials and methods. The study involved 70 patients, who were divided into three groups: the main group (1) – 28 drug addicts diagnosed with caries, the comparison group (2) – 22 patients with caries of dental hard tissues without a history of drug addiction, and the control group (3) – 20 persons without carious lesions of dental hard tissues. We examined the rate of salivation, which was calculated by the formula: Rs = V / T, pH of oral fluid using litmus test strips (Kelilong Instruments, China), structural and functional stability of tooth enamel by the express method TER-test (V. R. Okushko, L. I. Kosareva, 1983), clinically assessed the rate of mineralization according to the Clinical Assessment of the Rate of Enamel Remineralization-test (T. L. Redinova, V. K. Leontiev and G. D. Ovrutsky, 1982), dental caries intensity using the DMF index; the International Caries Detection and Assessment System (ICDAS) was used to assess of the dental hard tissues.\u0000Results. In drug-addicted patients with caries of dental hard tissues, the slowest rate of salivation and significant changes in the oral fluid pH toward acidic were observed, namely 5.5 ± 0.09 units compared with patients of other groups. In drug addicts, the average TER-test score was 9.1 ± 0.4 points and was significantly higher than that in non-drug-addicted patients with dental caries (5.4 ± 0.2 points) and people without dental caries (1.9 ± 0.2 points). The Clinical Assessment of the Rate of Enamel Remineralization-test indicators of drug-addicted patients (6.1 ± 0.3 days) were also significantly higher than those of non-addicted and control group patients. The DMF index in drug-addicted patients was 16.4 ± 0.2 points showing a very high intensity of caries with a large proportion of deep carious lesions in the dental hard tissues.\u0000Conclusions. In drug addicts, the study results have indicated a 23 % pH shift of the oral fluid toward acidic, and a 22 % decrease in the rate of saliva secretion has also been recorded compared to the healthy individuals. These results were associated with a 79 % decrease in the tooth enamel durability and a 66 % decrease in the remineralizing capacity of the oral fluid in drug addicts as compared to the healthy individuals. The DMF index of group 1 patients differed from that of group 2 patients by 50 % and from group 3 individuals – by 98 %. Drug-addicted patients had 78 % more carious lesions in the dentin compared to non-drug-addicted patients with dental caries.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80471450","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 : 2023-03-28DOI: 10.14739/2310-1210.2023.2.269508
O. Raznatovska, R. M. Yasinskyi, A. V. Fedorets
Aim. To analyze the effectiveness and safety of a modified short-term regimen (mSTR) of antimycobacterial therapy (AMBT) for rifampicin-resistant tuberculosis (RR-TB) in a 71-year-old patient with type 2 diabetes mellitus (T2DM) on the clinical case example of own observation. Materials and methods. A clinical case from own observation of the patient who was treated at the clinical base of the Department of Phthisiology and Pulmonology of Zaporizhzhia State Medical University – Pulmonary Tuberculosis Department No. 2 of the Communal Non-profit Organization “Zaporizhzhia Regional Phthisio-Pulmonology Clinical Treatment and Diagnostic Center” is presented. Results. The presented case demonstrates the high safety and efficacy of all oral mSTR, including Lfx-Bdq-Lzd-Cfz-Cs, in the elderly person with RR-TB and concomitant decompensated T2DM who was smear-negative after 4 months as a result of treatment with 9-month mSTR AMBT (Lfx, Bdq, Lzd, Cfz, Сs). Positive radiological dynamics were observed all the time and residual changes in the lungs after tuberculosis were diagnosed at the end of the treatment course. These results complement indications for the use of mSTR, including Lfx-Bdq-Lzd-Cfz-Cs, in RR-TB patients. Conclusions. mSTR AMBT (Lfx, Bdq, Lzd, Cfz, Сs) is effective and safe in elderly patients with RR-TB and concomitant decompensated type 2 diabetes mellitus when adequate treatment of diabetes and timely correction of antimycobacterial drug side effects are undertaken.
{"title":"Effectiveness and safety of a modified short-term regimen of antimycobacterial therapy to treat rifampicin-resistant tuberculosis in elderly patients with concomitant diabetes (a clinical case)","authors":"O. Raznatovska, R. M. Yasinskyi, A. V. Fedorets","doi":"10.14739/2310-1210.2023.2.269508","DOIUrl":"https://doi.org/10.14739/2310-1210.2023.2.269508","url":null,"abstract":"Aim. To analyze the effectiveness and safety of a modified short-term regimen (mSTR) of antimycobacterial therapy (AMBT) for rifampicin-resistant tuberculosis (RR-TB) in a 71-year-old patient with type 2 diabetes mellitus (T2DM) on the clinical case example of own observation.\u0000Materials and methods. A clinical case from own observation of the patient who was treated at the clinical base of the Department of Phthisiology and Pulmonology of Zaporizhzhia State Medical University – Pulmonary Tuberculosis Department No. 2 of the Communal Non-profit Organization “Zaporizhzhia Regional Phthisio-Pulmonology Clinical Treatment and Diagnostic Center” is presented.\u0000Results. The presented case demonstrates the high safety and efficacy of all oral mSTR, including Lfx-Bdq-Lzd-Cfz-Cs, in the elderly person with RR-TB and concomitant decompensated T2DM who was smear-negative after 4 months as a result of treatment with 9-month mSTR AMBT (Lfx, Bdq, Lzd, Cfz, Сs). Positive radiological dynamics were observed all the time and residual changes in the lungs after tuberculosis were diagnosed at the end of the treatment course. These results complement indications for the use of mSTR, including Lfx-Bdq-Lzd-Cfz-Cs, in RR-TB patients.\u0000Conclusions. mSTR AMBT (Lfx, Bdq, Lzd, Cfz, Сs) is effective and safe in elderly patients with RR-TB and concomitant decompensated type 2 diabetes mellitus when adequate treatment of diabetes and timely correction of antimycobacterial drug side effects are undertaken.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77038071","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 : 2023-03-28DOI: 10.14739/2310-1210.2023.2.268274
L. V. Bahnii, S. Heriak, N. I. Bahnii
The aim of the study: to evaluate the cytokine profile state in pregnant women with non-alcoholic fatty liver disease (NAFLD) at the stage of non-alcoholic steatohepatitis (NASH) with varying degrees of obesity under the influence of the developed complex therapy program. Material and methods. We examined 197 pregnant women with NAFLD at the stage of NASH in combination with obesity. The main group I consisted of 98 pregnant women with NAFLD at the stage of NASH with varying degrees of obesity, who were divided into 3 subgroups depending on body mass index (BMI). Among them, 26 pregnant women with BMI of 25.0–29.9 kg/m2 were included in IA group, 48 pregnant women with BMI of 30.0–34.9 kg/m2 were included in IB group, and 24 pregnant women with BMI of 35.0–39.9 kg/m2 – in IC group. All pregnant women in the main group were prescribed complex therapy including vitamin E at a dose of 400 IU/day, ursodeoxycholic acid (UDCA) at a dose of 15 mg/kg/day, and L-carnitine at a dose of 3 g per day. The comparison group consisted of 69 women with NAFLD at the stage of NASH and abdominal obesity, who corresponded to subgroups of the main group (IIA – 23 patients, IIB – 25 women, IIC – 21 pregnant women) and received basic therapy. The control group consisted of 30 healthy women. To evaluate the cytokine profile, levels of IL-1β, IL-6, IL-10 and TNF-α were determined by ELISPOT. Results. Analysis of the cytokine profile in women with NASH and obesity showed the presence of systemic inflammation links in the examined groups, which was manifested by increased levels of pro-inflammatory and decreased levels of anti-inflammatory interleukins in blood serum of pregnant women. A prescription of the complex treatment contributed to a decreased activity of the inflammatory response, which was manifested by an improvement in the levels of cytokine profile indicators. Conclusions. NASH during pregnancy is accompanied by significant changes in the cytokine profile. The prescription of complex therapy in the form of vitamin E, UDCA and L-carnitine is effective in the treatment of pregnant women with NAFLD at the stage of NASH due to cumulative and potentiating effects, reducing manifestations of systemic inflammation by normalizing the level of cytokines.
{"title":"The state of the cytokine profile in pregnant women with non-alcoholic fatty liver disease at the stage of non-alcoholic steatohepatitis with varying degrees of comorbid obesity under the influence of the developed complex therapy program","authors":"L. V. Bahnii, S. Heriak, N. I. Bahnii","doi":"10.14739/2310-1210.2023.2.268274","DOIUrl":"https://doi.org/10.14739/2310-1210.2023.2.268274","url":null,"abstract":"The aim of the study: to evaluate the cytokine profile state in pregnant women with non-alcoholic fatty liver disease (NAFLD) at the stage of non-alcoholic steatohepatitis (NASH) with varying degrees of obesity under the influence of the developed complex therapy program.\u0000Material and methods. We examined 197 pregnant women with NAFLD at the stage of NASH in combination with obesity. The main group I consisted of 98 pregnant women with NAFLD at the stage of NASH with varying degrees of obesity, who were divided into 3 subgroups depending on body mass index (BMI). Among them, 26 pregnant women with BMI of 25.0–29.9 kg/m2 were included in IA group, 48 pregnant women with BMI of 30.0–34.9 kg/m2 were included in IB group, and 24 pregnant women with BMI of 35.0–39.9 kg/m2 – in IC group. All pregnant women in the main group were prescribed complex therapy including vitamin E at a dose of 400 IU/day, ursodeoxycholic acid (UDCA) at a dose of 15 mg/kg/day, and L-carnitine at a dose of 3 g per day. The comparison group consisted of 69 women with NAFLD at the stage of NASH and abdominal obesity, who corresponded to subgroups of the main group (IIA – 23 patients, IIB – 25 women, IIC – 21 pregnant women) and received basic therapy. The control group consisted of 30 healthy women. To evaluate the cytokine profile, levels of IL-1β, IL-6, IL-10 and TNF-α were determined by ELISPOT.\u0000Results. Analysis of the cytokine profile in women with NASH and obesity showed the presence of systemic inflammation links in the examined groups, which was manifested by increased levels of pro-inflammatory and decreased levels of anti-inflammatory interleukins in blood serum of pregnant women. A prescription of the complex treatment contributed to a decreased activity of the inflammatory response, which was manifested by an improvement in the levels of cytokine profile indicators.\u0000Conclusions. NASH during pregnancy is accompanied by significant changes in the cytokine profile. The prescription of complex therapy in the form of vitamin E, UDCA and L-carnitine is effective in the treatment of pregnant women with NAFLD at the stage of NASH due to cumulative and potentiating effects, reducing manifestations of systemic inflammation by normalizing the level of cytokines.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84609232","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 : 2023-03-28DOI: 10.14739/2310-1210.2023.2.263966
I. V. Mozhaiev, V. Y. Yevsiukova, I. Torianyk, V. Minukhin, N. Polishchuck, D. Kyryk
The aim: to study the effect of 3 % carbon dioxide walnut extract (CDWE) on the adhesive properties of gram-positive and gram-negative microorganisms. Materials and methods. The objects of the study – 3 % CDWE, museum strains of the ATCC collection and clinical cultures of microorganisms: A. baumannii, S. aureus, E. coli, K. pneumoniae, P. aeruginosa, C. albicans. Native and formalinized human erythrocytes of 0(I) Rh-positive blood group were used as a substrate for adhesion. A smear was prepared from each sample, which was stained by the Romanovsky–Giemsa method. According to the results of smear microscopy, the adhesion index of microorganisms (AIM) was calculated. Results. A preliminary study of the adhesion ability of museum and clinical strains of microorganisms revealed that all cultures possessed highly adhesive properties. The addition of 3 % CDWE significantly inhibited their adhesive properties. Thus, in studies with museum strains, it was found that the AIM of S. aureus was decreased by 59.47 %, K. pneumonia – by 59.17 %, E. coli – by 56.32 %, P. aeruginosa – by 48.70 %, A. baumannii – by 49.77 %, C. albicans – by 51.59 %. In the experiments, a decrease in AIM of all clinical strains of microorganisms was detected: S. aureus – by 55.00 %, K. pneumonia – by 53.50 %, E. coli – by 53.54 %, P. aeruginosa – by 49.04 %, A. baumannii – by 50.42 %, C. albicans – by 53.13 %. Conclusions. The results gained from the study of the 3 % CDWE effect on the adhesive activity collectively suggest its high ability to inhibit the adhesive activity of museum and clinical strains of purulent-inflammatory infections (S. aureus, P. aeruginosa, A. baumannii, K. pneumoniae, E. coli, C. albicans) and prevent the formation of a bacterial biofilm. These properties indicate potential benefits from further study on the biological properties of CDWE and the development of new antimicrobial drugs based on it for the treatment of purulent-inflammatory infections.
{"title":"Effect of walnut extract supplemented with carbon dioxide on adhesive activity of agents causing wound infection","authors":"I. V. Mozhaiev, V. Y. Yevsiukova, I. Torianyk, V. Minukhin, N. Polishchuck, D. Kyryk","doi":"10.14739/2310-1210.2023.2.263966","DOIUrl":"https://doi.org/10.14739/2310-1210.2023.2.263966","url":null,"abstract":"The aim: to study the effect of 3 % carbon dioxide walnut extract (CDWE) on the adhesive properties of gram-positive and gram-negative microorganisms.\u0000Materials and methods. The objects of the study – 3 % CDWE, museum strains of the ATCC collection and clinical cultures of microorganisms: A. baumannii, S. aureus, E. coli, K. pneumoniae, P. aeruginosa, C. albicans. Native and formalinized human erythrocytes of 0(I) Rh-positive blood group were used as a substrate for adhesion. A smear was prepared from each sample, which was stained by the Romanovsky–Giemsa method. According to the results of smear microscopy, the adhesion index of microorganisms (AIM) was calculated.\u0000Results. A preliminary study of the adhesion ability of museum and clinical strains of microorganisms revealed that all cultures possessed highly adhesive properties. The addition of 3 % CDWE significantly inhibited their adhesive properties. Thus, in studies with museum strains, it was found that the AIM of S. aureus was decreased by 59.47 %, K. pneumonia – by 59.17 %, E. coli – by 56.32 %, P. aeruginosa – by 48.70 %, A. baumannii – by 49.77 %, C. albicans – by 51.59 %. In the experiments, a decrease in AIM of all clinical strains of microorganisms was detected: S. aureus – by 55.00 %, K. pneumonia – by 53.50 %, E. coli – by 53.54 %, P. aeruginosa – by 49.04 %, A. baumannii – by 50.42 %, C. albicans – by 53.13 %.\u0000Conclusions. The results gained from the study of the 3 % CDWE effect on the adhesive activity collectively suggest its high ability to inhibit the adhesive activity of museum and clinical strains of purulent-inflammatory infections (S. aureus, P. aeruginosa, A. baumannii, K. pneumoniae, E. coli, C. albicans) and prevent the formation of a bacterial biofilm. These properties indicate potential benefits from further study on the biological properties of CDWE and the development of new antimicrobial drugs based on it for the treatment of purulent-inflammatory infections.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85762411","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 : 2023-03-06DOI: 10.14739/2310-1210.2023.1.268009
O. Raznatovska, R. M. Yasinskyi, O. S. Shalmin, A. V. Fedorets, O. Svitlytska
Aim. To analyze the nature of Bedaquiline (Bdq) resistance in Mycobacterium tuberculosis (MBT) during antimycobacterial therapy (AMBT) in patients with multidrug-resistant tuberculosis (MDR-TB), its impact on clinical outcomes and to detect risk factors for the Bdq drug resistance development on the example of own observed clinical cases. Materials and methods. 2 clinical cases of own observations of the Bdq resistance development in MBT during AMBT in patients with MDR-TB who were treated at the clinical base of the Department of Phthisiology and Pulmonology of Zaporizhzhia State Medical University – Pulmonary Tuberculosis Department No. 2 of the Communal Non-profit Organization “Zaporizhzhia Regional Phthisio-Pulmonology Clinical Treatment and Diagnostic Center” are presented. Results. The presented clinical cases confirm the literature data that the treatment effectiveness in patients with Rifampicin-resistant TB (RR-TB) and MDR-TB is associated with Bdq drug resistance. Regarding the reasons for the development of acquired Bdq drug resistance, the second clinical case, like the examples of other authors, demonstrates low adherence to treatment. There is no data in the literature about the lack of controlled treatment at the outpatient stage as a risk factor for Bdq drug resistance and negative clinical outcomes in patients with MDR-TB, which would complement the scientific experience in this problem. Conclusions. In both clinical cases, Bdq drug resistance was acquired (secondary), and had an impact on the clinical outcomes of tuberculosis treatment. The risk factors for Bdq drug resistance and negative clinical outcomes were lack of controlled treatment at the outpatient stage in the first case and low adherence to treatment in the second one.
{"title":"Bedaquiline resistance in Mycobacterium tuberculosis during antimycobacterial therapy and its impact on clinical outcomes (clinical cases)","authors":"O. Raznatovska, R. M. Yasinskyi, O. S. Shalmin, A. V. Fedorets, O. Svitlytska","doi":"10.14739/2310-1210.2023.1.268009","DOIUrl":"https://doi.org/10.14739/2310-1210.2023.1.268009","url":null,"abstract":"Aim. To analyze the nature of Bedaquiline (Bdq) resistance in Mycobacterium tuberculosis (MBT) during antimycobacterial therapy (AMBT) in patients with multidrug-resistant tuberculosis (MDR-TB), its impact on clinical outcomes and to detect risk factors for the Bdq drug resistance development on the example of own observed clinical cases.\u0000Materials and methods. 2 clinical cases of own observations of the Bdq resistance development in MBT during AMBT in patients with MDR-TB who were treated at the clinical base of the Department of Phthisiology and Pulmonology of Zaporizhzhia State Medical University – Pulmonary Tuberculosis Department No. 2 of the Communal Non-profit Organization “Zaporizhzhia Regional Phthisio-Pulmonology Clinical Treatment and Diagnostic Center” are presented.\u0000Results. The presented clinical cases confirm the literature data that the treatment effectiveness in patients with Rifampicin-resistant TB (RR-TB) and MDR-TB is associated with Bdq drug resistance. Regarding the reasons for the development of acquired Bdq drug resistance, the second clinical case, like the examples of other authors, demonstrates low adherence to treatment. There is no data in the literature about the lack of controlled treatment at the outpatient stage as a risk factor for Bdq drug resistance and negative clinical outcomes in patients with MDR-TB, which would complement the scientific experience in this problem.\u0000Conclusions. In both clinical cases, Bdq drug resistance was acquired (secondary), and had an impact on the clinical outcomes of tuberculosis treatment. The risk factors for Bdq drug resistance and negative clinical outcomes were lack of controlled treatment at the outpatient stage in the first case and low adherence to treatment in the second one.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85232877","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 : 2023-03-06DOI: 10.14739/2310-1210.2023.1.267456
Z. Honta, I. Shylivskyi, O. Nemesh, Khrystyna B Burda
The aim of the study is a review of modern national and foreign literature on the influence of the oral cavity state and the pathology of periodontal tissues, in particular generalized periodontitis, on the occurrence and severity of the course of internal organ and body system diseases. Inflammatory-dystrophic periodontal diseases lead to an increase in the level of chronic inflammatory agents due to the systemic spread of inflammatory mediators released during local tissue destruction, as well as the systemic spread of pathogenic microorganisms, which contributes to the development of cardiovascular diseases, atherosclerosis, pathological processes in the gastrointestinal tract, complicates the course of diabetes mellitus and respiratory diseases in patients with periodontal diseases. That is why the study on pathogenetic interrelations between periodontal diseases and comorbid conditions is an urgent problem of modern dentistry. Conclusions. Given that certain extraoral pathologies arise as a result of damage by disseminated periodontopathogens, it is possible to provide new therapeutic opportunities to reduce the risk of developing comorbid conditions etiopathogenetically associated with generalized periodontitis. The data of clinical and experimental studies that are presented in this literature review definitely show the need for timely treatment of periodontal diseases, which provides not only the health of the oral cavity, but also prevents the occurrence of general somatic diseases.
{"title":"The role of periodontal pathology and oral cavity condition in the occurrence of general somatic diseases","authors":"Z. Honta, I. Shylivskyi, O. Nemesh, Khrystyna B Burda","doi":"10.14739/2310-1210.2023.1.267456","DOIUrl":"https://doi.org/10.14739/2310-1210.2023.1.267456","url":null,"abstract":"The aim of the study is a review of modern national and foreign literature on the influence of the oral cavity state and the pathology of periodontal tissues, in particular generalized periodontitis, on the occurrence and severity of the course of internal organ and body system diseases.\u0000Inflammatory-dystrophic periodontal diseases lead to an increase in the level of chronic inflammatory agents due to the systemic spread of inflammatory mediators released during local tissue destruction, as well as the systemic spread of pathogenic microorganisms, which contributes to the development of cardiovascular diseases, atherosclerosis, pathological processes in the gastrointestinal tract, complicates the course of diabetes mellitus and respiratory diseases in patients with periodontal diseases. That is why the study on pathogenetic interrelations between periodontal diseases and comorbid conditions is an urgent problem of modern dentistry.\u0000Conclusions. Given that certain extraoral pathologies arise as a result of damage by disseminated periodontopathogens, it is possible to provide new therapeutic opportunities to reduce the risk of developing comorbid conditions etiopathogenetically associated with generalized periodontitis.\u0000The data of clinical and experimental studies that are presented in this literature review definitely show the need for timely treatment of periodontal diseases, which provides not only the health of the oral cavity, but also prevents the occurrence of general somatic diseases.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73818449","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 : 2023-03-06DOI: 10.14739/2310-1210.2023.1.270044
Ya. Yu. Maistrovych, M. Kolesnyk
Chronic heart failure remains one of the main causes of mortality and reduced life quality both in Ukraine and around the world. More than 50 % of all patients with chronic heart failure are those with preserved left ventricular ejection fraction. In current guidelines, the criteria for evaluating heart failure with reduced left ventricular ejection fraction are described properly, but the issue of timely diagnosing chronic heart failure with preserved ejection fraction still remains unsolved. This review presents four diagnostic algorithms for this condition, which were presented by international scientific societies in recent years: 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure; H2FPEF Score for Heart Failure with Preserved Ejection Fraction (Mayo, 2018); HFA-PEFF diagnostic algorithm: a consensus recommendation from the Heart Failure Association (HFA) of the European Society of Cardiology (ESC) (2019); Multimodality imaging in patients with heart failure and preserved ejection fraction: an expert consensus document of the European Association of Cardiovascular Imaging (2021). The main advantages, limitations and disadvantages of each one are analyzed. All steps of diagnostic evaluation are described in detail. The review is illustrated with patterns of the latest diagnostic approaches.
{"title":"Current diagnostic algorithms for chronic heart failure with preserved left ventricular ejection fraction","authors":"Ya. Yu. Maistrovych, M. Kolesnyk","doi":"10.14739/2310-1210.2023.1.270044","DOIUrl":"https://doi.org/10.14739/2310-1210.2023.1.270044","url":null,"abstract":"Chronic heart failure remains one of the main causes of mortality and reduced life quality both in Ukraine and around the world. More than 50 % of all patients with chronic heart failure are those with preserved left ventricular ejection fraction.\u0000In current guidelines, the criteria for evaluating heart failure with reduced left ventricular ejection fraction are described properly, but the issue of timely diagnosing chronic heart failure with preserved ejection fraction still remains unsolved.\u0000This review presents four diagnostic algorithms for this condition, which were presented by international scientific societies in recent years: 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure; H2FPEF Score for Heart Failure with Preserved Ejection Fraction (Mayo, 2018); HFA-PEFF diagnostic algorithm: a consensus recommendation from the Heart Failure Association (HFA) of the European Society of Cardiology (ESC) (2019); Multimodality imaging in patients with heart failure and preserved ejection fraction: an expert consensus document of the European Association of Cardiovascular Imaging (2021). The main advantages, limitations and disadvantages of each one are analyzed. All steps of diagnostic evaluation are described in detail.\u0000The review is illustrated with patterns of the latest diagnostic approaches.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83737762","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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