Pub Date : 2023-03-06DOI: 10.14739/2310-1210.2023.1.264119
R. Nikitenko, V. Zaporozhan, K. Vorotyntseva, Ye. A. Koichev
The aim of the work is to improve the algorithm of intraoperative diagnosis of rectal cancer metastasis in order to optimize surgical intervention and reduce the number of intraoperative and postoperative complications. Materials and methods. 184 operated patients with rectal cancer (RC) were divided into 2 groups: group 1 – patients with stage I RC (T1–2N0M0), and group 2 – stage II RC (T3N0M0), who underwent intraoperative detection and examination of sentinel lymph nodes. The volume and surgical approach depended on the stage and the presence of metastases (MTS). The average period of postoperative observation was 12–60 months, taking into account early (purulent-septic complications, bleeding, intestinal perforation) and late (recurrent rectal cancer) complications. Results. The patients of group 1 had no MTS lesions of the sentinel lymph nodes, the surgical intervention was limited to transanal microsurgery due to this fact. Among the complications were the following: bleeding – 2.2 %; intraoperative perforation of the intestinal wall – 5.6 %. No purulent-septic cases, no recurrences of rectal cancer were detected. In group 2, 36 (38.3 %) out of 94 patients had MTS detected intraoperatively in the sentinel lymph nodes which required a low anterior rectal resection with total mesorectumectomy. Among the complications was bleeding – 6.3 %. No intraoperative perforations of the intestinal wall and no purulent-septic complications were detected. Recurrence of rectal cancer was detected in 12 (12.8 %) patients. Conclusions. Performing transanal endoscopic resections in patients with stage I RC and especially stage II RC is possible only under the conditions of mandatory intraoperative staining and urgent histological examination of the sentinel lymph nodes. The extent of the surgical intervention is determined on the operating table based on urgent histological examination results. When MTS lesions of the mesorectal sentinel lymph nodes are detected, the operation should be continued with mandatory mesorectumectomy.
{"title":"The role and place of transanal endoscopic resections in rectal cancer","authors":"R. Nikitenko, V. Zaporozhan, K. Vorotyntseva, Ye. A. Koichev","doi":"10.14739/2310-1210.2023.1.264119","DOIUrl":"https://doi.org/10.14739/2310-1210.2023.1.264119","url":null,"abstract":"The aim of the work is to improve the algorithm of intraoperative diagnosis of rectal cancer metastasis in order to optimize surgical intervention and reduce the number of intraoperative and postoperative complications.\u0000Materials and methods. 184 operated patients with rectal cancer (RC) were divided into 2 groups: group 1 – patients with stage I RC (T1–2N0M0), and group 2 – stage II RC (T3N0M0), who underwent intraoperative detection and examination of sentinel lymph nodes. The volume and surgical approach depended on the stage and the presence of metastases (MTS).\u0000The average period of postoperative observation was 12–60 months, taking into account early (purulent-septic complications, bleeding, intestinal perforation) and late (recurrent rectal cancer) complications.\u0000Results. The patients of group 1 had no MTS lesions of the sentinel lymph nodes, the surgical intervention was limited to transanal microsurgery due to this fact. Among the complications were the following: bleeding – 2.2 %; intraoperative perforation of the intestinal wall – 5.6 %. No purulent-septic cases, no recurrences of rectal cancer were detected.\u0000In group 2, 36 (38.3 %) out of 94 patients had MTS detected intraoperatively in the sentinel lymph nodes which required a low anterior rectal resection with total mesorectumectomy. Among the complications was bleeding – 6.3 %. No intraoperative perforations of the intestinal wall and no purulent-septic complications were detected. Recurrence of rectal cancer was detected in 12 (12.8 %) patients.\u0000Conclusions. Performing transanal endoscopic resections in patients with stage I RC and especially stage II RC is possible only under the conditions of mandatory intraoperative staining and urgent histological examination of the sentinel lymph nodes. The extent of the surgical intervention is determined on the operating table based on urgent histological examination results. When MTS lesions of the mesorectal sentinel lymph nodes are detected, the operation should be continued with mandatory mesorectumectomy.","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":"89197234","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: 10.14739/2310-1210.2023.1.262837
V. Chuhunov, M. Khomitskyi, V. L. Pidlubnyi
The aim of the work is to study the world experience and views on the clinic and systematics of non-psychotic manifestations in schizoaffective disorder (SAD) by analyzing modern scientific literary sources. The relevance of study on SAD is determined by the significant prevalence in the population (0.2–0.6 %) and negative socio-economic consequences of the disease. Significant problems in SAD are family and work maladjustment, suicidality and states of psychoactive substance use comorbidity. The nosological independence of the disease was put into question and it was reflected in diagnostic approaches and classifications. In the clinical practice, SAD is considered independently and as a variant of schizophrenia or affective disorders. Diagnostics and prognostic criteria regarding personality changes in SAD are still at the stage of determining. Conclusions. Understanding of definitions “prognosis”, “outcome”, and “maladjustment” in SAD is not unified. Signs of SAD in remission and intermission is the most recent aspect of the SAD clinic, which dictates the need to assess personality changes and the level of social adaptation and functioning.
{"title":"Personality changes in patients with schizoaffective disorder (a review)","authors":"V. Chuhunov, M. Khomitskyi, V. L. Pidlubnyi","doi":"10.14739/2310-1210.2023.1.262837","DOIUrl":"https://doi.org/10.14739/2310-1210.2023.1.262837","url":null,"abstract":"The aim of the work is to study the world experience and views on the clinic and systematics of non-psychotic manifestations in schizoaffective disorder (SAD) by analyzing modern scientific literary sources.\u0000The relevance of study on SAD is determined by the significant prevalence in the population (0.2–0.6 %) and negative socio-economic consequences of the disease. Significant problems in SAD are family and work maladjustment, suicidality and states of psychoactive substance use comorbidity.\u0000The nosological independence of the disease was put into question and it was reflected in diagnostic approaches and classifications. In the clinical practice, SAD is considered independently and as a variant of schizophrenia or affective disorders. Diagnostics and prognostic criteria regarding personality changes in SAD are still at the stage of determining.\u0000Conclusions. Understanding of definitions “prognosis”, “outcome”, and “maladjustment” in SAD is not unified. Signs of SAD in remission and intermission is the most recent aspect of the SAD clinic, which dictates the need to assess personality changes and the level of social adaptation and functioning.","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":"78429908","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: 10.14739/2310-1210.2023.1.268081
V. Tashchuk, T. Amelina, P. R. Ivanchuk, M. A. Ivanchuk
Aim of the work is to investigate the quality of life (QoL) of patients with stable angina pectoris (SA) depending on gender, age distribution and severity of angina pectoris. Materials and methods. 78 patients with an objective diagnosis of functional classes (FC) II–III SA were examined, who formed two clinical groups: the 1st – patients with an increase in QoL (57.69 % of cases), the 2nd – patients with the absence of any changes in QoL (42.31 % of cases). All patients underwent clinical, laboratory, instrumental examinations and determination of QoL using the SF-36 questionnaire. Results. The study of the QoL in men revealed that the mental component (MHC) of health was significantly higher due to such indicators as vitality (VT) (P < 0.001), mental health (MH) (P < 0.001), social functioning (SF) (Р = 0.028), general health status (GHS) (Р < 0.001). Younger age was characterized by a higher physical component of health (PHC) due to significantly higher indicators such as physical functioning (PF) and role-based physical functioning (RBPF) (in both cases P < 0.001). In the subgroup of younger women, the PHC was higher due to significantly higher levels of PF and RBPF (P = 0.048 and P = 0.011, respectively), that could be compared with the indicators of younger men, where the PHC was also higher due to GHS (Р = 0.009), RBPF (P = 0.028) and PF (P = 0.050). In men of younger age, the indicator of VT was significantly higher (Р = 0.031). Patients with higher FC of SA were expected to have a significant limitation of QoL in the form of a lower PHC (GHS (P = 0.023), PF (P < 0.001), RBPF (P < 0.001) and pain intensity (PI) (P < 0.001)). With the progression of heart failure (HF), GHS (P = 0.003), PF (P < 0.001), RBPF (P < 0.001) and PI (P < 0.001) significantly worsened. It was confirmed that the increase of QoL did not depend on gender (women P = 0.204, men P = 0.226) and age (P = 0.143). The presence of excess body weight was characterized by limitation of physical (significantly lower indicators of PF (P = 0.010) and PI (P = 0.008)) and mental (significantly decreased indicator – P = 0.053) health. Conclusions. Positive dynamics of the quality of life is associated with a lower functional class of stable angina pectoris, lower severity of heart failure, favorable shifts in the lipid spectrum, an increase in the left ventricular ejection fraction and the threshold load of cycle ergometry. The physical component of health is decisive in the quality of life of patients with stable angina pectoris.
{"title":"Gender, age and morphofunctional characteristics of the quality of life of patients with stable angina","authors":"V. Tashchuk, T. Amelina, P. R. Ivanchuk, M. A. Ivanchuk","doi":"10.14739/2310-1210.2023.1.268081","DOIUrl":"https://doi.org/10.14739/2310-1210.2023.1.268081","url":null,"abstract":"Aim of the work is to investigate the quality of life (QoL) of patients with stable angina pectoris (SA) depending on gender, age distribution and severity of angina pectoris.\u0000Materials and methods. 78 patients with an objective diagnosis of functional classes (FC) II–III SA were examined, who formed two clinical groups: the 1st – patients with an increase in QoL (57.69 % of cases), the 2nd – patients with the absence of any changes in QoL (42.31 % of cases). All patients underwent clinical, laboratory, instrumental examinations and determination of QoL using the SF-36 questionnaire.\u0000Results. The study of the QoL in men revealed that the mental component (MHC) of health was significantly higher due to such indicators as vitality (VT) (P < 0.001), mental health (MH) (P < 0.001), social functioning (SF) (Р = 0.028), general health status (GHS) (Р < 0.001). Younger age was characterized by a higher physical component of health (PHC) due to significantly higher indicators such as physical functioning (PF) and role-based physical functioning (RBPF) (in both cases P < 0.001). In the subgroup of younger women, the PHC was higher due to significantly higher levels of PF and RBPF (P = 0.048 and P = 0.011, respectively), that could be compared with the indicators of younger men, where the PHC was also higher due to GHS (Р = 0.009), RBPF (P = 0.028) and PF (P = 0.050). In men of younger age, the indicator of VT was significantly higher (Р = 0.031).\u0000Patients with higher FC of SA were expected to have a significant limitation of QoL in the form of a lower PHC (GHS (P = 0.023), PF (P < 0.001), RBPF (P < 0.001) and pain intensity (PI) (P < 0.001)). With the progression of heart failure (HF), GHS (P = 0.003), PF (P < 0.001), RBPF (P < 0.001) and PI (P < 0.001) significantly worsened. It was confirmed that the increase of QoL did not depend on gender (women P = 0.204, men P = 0.226) and age (P = 0.143). The presence of excess body weight was characterized by limitation of physical (significantly lower indicators of PF (P = 0.010) and PI (P = 0.008)) and mental (significantly decreased indicator – P = 0.053) health.\u0000Conclusions. Positive dynamics of the quality of life is associated with a lower functional class of stable angina pectoris, lower severity of heart failure, favorable shifts in the lipid spectrum, an increase in the left ventricular ejection fraction and the threshold load of cycle ergometry. The physical component of health is decisive in the quality of life of patients with stable angina pectoris.","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":"87823667","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: 10.14739/2310-1210.2023.1.264763
A. Shvets, V. Kalnysh, O. Maltsev
The aim of this study was to identify informative indicators and establish the level of perception of their impact on the formation of excessive psycho-emotional stress among remote pilots of unmanned aircraft systems (UASs) (class 1 “Light”) during their occupational activities. Materials and methods. 41 servicemen aged 20–35 years old, who had experience in the management of UASs (class I “Light”) and were involved in the performance of a wide range of functional duties as operators of the moving objects, were studied based on the specially developed questionnaire (100-point scale) that reflected questions about the perception of the stress factor impact during their occupational activities. Statistical analysis of data was performed by descriptive and nonparametric statistics, as well as cluster, stepwise discriminant and factor analysis using the software package STATISTICA 13.3. Results. Regarding the perceptions of “stress” factor influence, the UASs pilots (operators of moving objects) were divided into two groups: group 1 could be conventionally called “hypersusceptible”, and representatives of group 2 – “hyposusceptible”. At the same time, it was found that the resulting clustering of the data into two groups provided 99.9 % opportunity for further assignment of new operators to the designated groups using the obtained supporting discriminant model (solving rules). The hidden factors have been revealed that formed the functional state of the “hypersusceptible” UASs operators, which collectively explained 54.9 % of the data variance, and “hyposusceptible” ones, which collectively explained 62.1 % of the original data variance. Conclusions. Two groups of operators, “hypersusceptible” and “hyposusceptible” to the influence of stress factors have been distinguished. The hidden factors that formed the functional state of the “hypersusceptible” UAS operators have been highlighted (the first factor “formation of fear of death” (F1↑) had 33.2 % rate and the second hidden factor “susceptibility to sensory stimuli” (F2↑), covered 21.7 % of the analyzed data variance). Two hidden factors that formed the functional state of the “hyposusceptible” UAS operators have been identified (the first factor “concentration of attention to performance of the functional duties” (F1↓) and the second factor “increased responsibility for occupational activity results” (F2↓). It has been established that there were radically different mechanisms of their functional state regulation, and “hyposusceptible” operators were more adapted to the performance of their functional duties due to the mechanisms of harmonizing their functional state and reducing experiences from the influence of harmful stress-forming factors.
{"title":"The influence of occupational environment on formation of psycho-emotional stress among remote pilots of unmanned aircraft systems","authors":"A. Shvets, V. Kalnysh, O. Maltsev","doi":"10.14739/2310-1210.2023.1.264763","DOIUrl":"https://doi.org/10.14739/2310-1210.2023.1.264763","url":null,"abstract":"The aim of this study was to identify informative indicators and establish the level of perception of their impact on the formation of excessive psycho-emotional stress among remote pilots of unmanned aircraft systems (UASs) (class 1 “Light”) during their occupational activities.\u0000Materials and methods. 41 servicemen aged 20–35 years old, who had experience in the management of UASs (class I “Light”) and were involved in the performance of a wide range of functional duties as operators of the moving objects, were studied based on the specially developed questionnaire (100-point scale) that reflected questions about the perception of the stress factor impact during their occupational activities. Statistical analysis of data was performed by descriptive and nonparametric statistics, as well as cluster, stepwise discriminant and factor analysis using the software package STATISTICA 13.3.\u0000Results. Regarding the perceptions of “stress” factor influence, the UASs pilots (operators of moving objects) were divided into two groups: group 1 could be conventionally called “hypersusceptible”, and representatives of group 2 – “hyposusceptible”. At the same time, it was found that the resulting clustering of the data into two groups provided 99.9 % opportunity for further assignment of new operators to the designated groups using the obtained supporting discriminant model (solving rules). The hidden factors have been revealed that formed the functional state of the “hypersusceptible” UASs operators, which collectively explained 54.9 % of the data variance, and “hyposusceptible” ones, which collectively explained 62.1 % of the original data variance.\u0000Conclusions. Two groups of operators, “hypersusceptible” and “hyposusceptible” to the influence of stress factors have been distinguished. The hidden factors that formed the functional state of the “hypersusceptible” UAS operators have been highlighted (the first factor “formation of fear of death” (F1↑) had 33.2 % rate and the second hidden factor “susceptibility to sensory stimuli” (F2↑), covered 21.7 % of the analyzed data variance). Two hidden factors that formed the functional state of the “hyposusceptible” UAS operators have been identified (the first factor “concentration of attention to performance of the functional duties” (F1↓) and the second factor “increased responsibility for occupational activity results” (F2↓). It has been established that there were radically different mechanisms of their functional state regulation, and “hyposusceptible” operators were more adapted to the performance of their functional duties due to the mechanisms of harmonizing their functional state and reducing experiences from the influence of harmful stress-forming factors.","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":"90550812","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: 10.14739/2310-1210.2023.1.266318
A. Khilkovets, I. Bilai
Acute toxicity studies are an integral part of preclinical studies of any new biologically active compound. It should be noted that it is this stage of research that is crucial regarding the possibility of further use of a pharmacologically active substance as a drug. This indicator also helps to determine the initial dose for clinical trials and establish a range of potentially safe doses. The data obtained will help determine the direction of new chemical syntheses, replenish the relevant libraries in silico, as well as reveal many other fundamentally important parameters that characterize the interaction in the compound – living organism system. The aim of this research is to study the acute toxicity of 2-((4-phenyl-5-(thiophene-3-ylmethyl)-1,2,4-triazole-3-yl)thio)sodium acetate. Materials and methods. Previously, a prediction was made using the GUSAR computer program, which helped determine the dose intervals. Acute toxicity was determined by the experimental method of Kerber in vivo using white nonlinear Wistar rats. The rats were weighed, labeled, and divided into five groups of six individuals of each. Results. After the introduction of compound moving activity decreased, drowsiness, pupil miosis, and thirst were observed. In the fifth group, with the maximum dilution, all rats died within two hours after administration of the test compound. During the death, convulsions were observed. In the fourth group five animals died, and in the third – two rats died. In the first two groups, all the rats survived. During follow-up, the animals behaved normally. Based on the results of the research, calculations were made and the LD50 indicator was determined. Conclusions. According to the results, the studied compound belonged to the V class of toxicity (almost non-toxic), and the resulting LD50 value was 1125 mg/kg. This indicator confirmed the prospects for further study of this compound.
{"title":"Study of acute toxicity of new thiophene-containing derivatives of 1,2,4-triazole","authors":"A. Khilkovets, I. Bilai","doi":"10.14739/2310-1210.2023.1.266318","DOIUrl":"https://doi.org/10.14739/2310-1210.2023.1.266318","url":null,"abstract":"Acute toxicity studies are an integral part of preclinical studies of any new biologically active compound. It should be noted that it is this stage of research that is crucial regarding the possibility of further use of a pharmacologically active substance as a drug. This indicator also helps to determine the initial dose for clinical trials and establish a range of potentially safe doses. The data obtained will help determine the direction of new chemical syntheses, replenish the relevant libraries in silico, as well as reveal many other fundamentally important parameters that characterize the interaction in the compound – living organism system.\u0000The aim of this research is to study the acute toxicity of 2-((4-phenyl-5-(thiophene-3-ylmethyl)-1,2,4-triazole-3-yl)thio)sodium acetate.\u0000Materials and methods. Previously, a prediction was made using the GUSAR computer program, which helped determine the dose intervals. Acute toxicity was determined by the experimental method of Kerber in vivo using white nonlinear Wistar rats. The rats were weighed, labeled, and divided into five groups of six individuals of each.\u0000Results. After the introduction of compound moving activity decreased, drowsiness, pupil miosis, and thirst were observed. In the fifth group, with the maximum dilution, all rats died within two hours after administration of the test compound. During the death, convulsions were observed. In the fourth group five animals died, and in the third – two rats died. In the first two groups, all the rats survived. During follow-up, the animals behaved normally. Based on the results of the research, calculations were made and the LD50 indicator was determined.\u0000Conclusions. According to the results, the studied compound belonged to the V class of toxicity (almost non-toxic), and the resulting LD50 value was 1125 mg/kg. This indicator confirmed the prospects for further study of this compound.","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":"76624926","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: 10.14739/2310-1210.2023.1.264437
S. Heriak, O. Oleksiak
The increasing prevalence of chronic obstructive pulmonary disease (COPD) among the female half of the population is the reason for the increased interest of scientists in the course of COPD and its impact on pregnant women. At the same time, the chronic lung inflammatory process leads to the development of obstetrical and perinatal complications during pregnancy. The aim of our study is to establish the features of changes in the cytokine profile in pregnant women with COPD and their role in the development of obstetrical and perinatal complications. Materials and methods. 77 pregnant women with clinically and instrumentally verified signs of COPD were examined, who were divided into 2 subgroups depending on the degree of bronchial obstruction: IA – 43 pregnant women with FEV1 ≥80 %, IB – 34 pregnant women with FEV1 50–79 %. The control group consisted of 27 healthy pregnant women. The cytokine profile was determined and a correlational interaction with the degree of bronchial obstruction and the frequency of obstetrical and perinatal complications was established. Results. Our analysis of cytokine profile indicators in pregnant women with COPD at the stage of mild and moderate bronchoobstruction has shown a characteristic and significant increase in the level of pro-inflammatory cytokines (IL-1β, IL-6, IL-8, TNF-α) and a simultaneous decrease in the level of anti-inflammatory IL-10 (P ≤ 0.05). Dysregulation of the inflammatory response in COPD in pregnant women became the main basis for the development of obstetrical and perinatal complications. We have established that an increase in the degree of bronchoobstruction was also associated with a higher detection frequency of such pregnancy and childbirth complications as anemia by 3.1 times, the threat of preterm birth by 9 times, preeclampsia by 7 times, placental dysfunction by 3.4 times, intrauterine growth restriction by 8 times, premature birth by 3.5 times, premature rupture of membranes during labor by 4 times, and fetal distress by 3 times. Conclusions. In pregnant women with COPD, an increase in the level of pro-inflammatory cytokines – IL-1β (rI = -0.81, rII = -0.67), IL-6 (rI = -0.88, rII = -0.78), IL-8, TNF-α was found to be directly proportional to the degree of bronchial obstruction, and inversely proportional level of anti-inflammatory IL-10 (rI = 0.80, rII = 0.86), which can be an early prognostic criterion for the development of obstetrical and perinatal complications.
{"title":"The influence of systemic inflammatory markers on the development of obstetrical complications in pregnant women with chronic obstructive pulmonary disease","authors":"S. Heriak, O. Oleksiak","doi":"10.14739/2310-1210.2023.1.264437","DOIUrl":"https://doi.org/10.14739/2310-1210.2023.1.264437","url":null,"abstract":"The increasing prevalence of chronic obstructive pulmonary disease (COPD) among the female half of the population is the reason for the increased interest of scientists in the course of COPD and its impact on pregnant women. At the same time, the chronic lung inflammatory process leads to the development of obstetrical and perinatal complications during pregnancy.\u0000The aim of our study is to establish the features of changes in the cytokine profile in pregnant women with COPD and their role in the development of obstetrical and perinatal complications.\u0000Materials and methods. 77 pregnant women with clinically and instrumentally verified signs of COPD were examined, who were divided into 2 subgroups depending on the degree of bronchial obstruction: IA – 43 pregnant women with FEV1 ≥80 %, IB – 34 pregnant women with FEV1 50–79 %. The control group consisted of 27 healthy pregnant women. The cytokine profile was determined and a correlational interaction with the degree of bronchial obstruction and the frequency of obstetrical and perinatal complications was established.\u0000Results. Our analysis of cytokine profile indicators in pregnant women with COPD at the stage of mild and moderate bronchoobstruction has shown a characteristic and significant increase in the level of pro-inflammatory cytokines (IL-1β, IL-6, IL-8, TNF-α) and a simultaneous decrease in the level of anti-inflammatory IL-10 (P ≤ 0.05). Dysregulation of the inflammatory response in COPD in pregnant women became the main basis for the development of obstetrical and perinatal complications. We have established that an increase in the degree of bronchoobstruction was also associated with a higher detection frequency of such pregnancy and childbirth complications as anemia by 3.1 times, the threat of preterm birth by 9 times, preeclampsia by 7 times, placental dysfunction by 3.4 times, intrauterine growth restriction by 8 times, premature birth by 3.5 times, premature rupture of membranes during labor by 4 times, and fetal distress by 3 times.\u0000Conclusions. In pregnant women with COPD, an increase in the level of pro-inflammatory cytokines – IL-1β (rI = -0.81, rII = -0.67), IL-6 (rI = -0.88, rII = -0.78), IL-8, TNF-α was found to be directly proportional to the degree of bronchial obstruction, and inversely proportional level of anti-inflammatory IL-10 (rI = 0.80, rII = 0.86), which can be an early prognostic criterion for the development of obstetrical and perinatal complications.","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":"79453257","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: 10.14739/2310-1210.2023.1.266424
O. Skakun, N. Seredyuk
Aim. This study aimed to establish the predictive ability of serum ferritin levels for severe / critical condition development, need for supplemental oxygen, and in-hospital mortality in hypertensive patients with COVID-19-associated pneumonia. Materials and methods. 135 unvaccinated patients hospitalized for COVID-19-associated pneumonia were enrolled in the study. 78.5 % of patients were hypertensive. Results. Among hypertensive patients, the median ferritin level at admission was 315.5 (169.0–396.0) ng/mL in patients with moderate condition, 374.0 (171.0–709.5) ng/mL in patients developed severe condition, and 489.0 (362.0–1128.5) ng/mL in patients developed critical condition (P = 0.03). Serum ferritin level at admission was higher in non-survivors (539.0 (440.0–1128.5) ng/mL) than that in survivors (332.5 (172.0–545.0) ng/mL, P = 0.02). Hypertensive patients who required supplemental oxygen had higher median serum ferritin level (446.0 (187.0–763.0) ng/mL) than patients without the requirement of supplemental oxygen (324.0 (165.0–401.0) ng/mL, P = 0.02). There was poor discrimination ability of ferritin level in the prediction of severe / critical conditions (AUC = 0.628, P = 0.02) and the need for supplemental oxygen (AUC = 0.629, P = 0.02). There was an acceptable discrimination ability of ferritin level in the in-hospital mortality prediction (AUC = 0.701, P = 0.03); the Youden index was 0.54, the associated criterion was >438.0 ng/mL with 83.3 % sensitivity and 70.7 % specificity. Ferritin level >438.0 ng/mL at admission was associated with a significant increase in in-hospital mortality (OR = 12.04 (2.47–58.62), P = 0.002). Conclusions. Serum ferritin level at hospital admission increases with the severity of COVID-19 in hypertensive patients. Serum ferritin level predicts in-hospital mortality in hypertensive patients. However, its predictive ability for the disease progression to severe/critical conditions and the need for supplemental oxygen is poor. A ferritin level of 438.0 ng/mL is proposed to be a cut-off value for the prediction of in-hospital mortality.
的目标。本研究旨在建立血清铁蛋白水平对高血压合并covid -19相关性肺炎患者重症/危重症发展、补充氧需求和住院死亡率的预测能力。材料和方法。135名未接种疫苗的covid -19相关肺炎住院患者参加了这项研究。78.5%的患者为高血压。高血压患者入院时铁蛋白水平中位数:中度患者315.5 (169.0 ~ 396.0)ng/mL,重度患者374.0 (171.0 ~ 709.5)ng/mL,危重患者489.0 (362.0 ~ 1128.5)ng/mL (P = 0.03)。入院时,非幸存者血清铁蛋白水平(539.0 (440.0-1128.5)ng/mL)高于幸存者(332.5 (172.0-545.0)ng/mL, P = 0.02)。需要补充氧气的高血压患者血清铁蛋白水平中位数(446.0 (187.0 ~ 763.0)ng/mL)高于不需要补充氧气的患者(324.0 (165.0 ~ 401.0)ng/mL, P = 0.02)。铁蛋白水平在预测重症/危重症(AUC = 0.628, P = 0.02)和补氧需求(AUC = 0.629, P = 0.02)方面的判别能力较差。铁蛋白水平对院内死亡率预测有可接受的判别能力(AUC = 0.701, P = 0.03);约登指数为0.54,相关标准>438.0 ng/mL,敏感性83.3%,特异性70.7%。入院时铁蛋白水平>438.0 ng/mL与住院死亡率显著升高相关(OR = 12.04 (2.47 ~ 58.62), P = 0.002)。高血压患者入院时血清铁蛋白水平随COVID-19严重程度升高。血清铁蛋白水平预测高血压患者住院死亡率。然而,它对疾病进展到严重/危重状态和需要补充氧气的预测能力较差。建议将438.0 ng/mL的铁蛋白水平作为预测住院死亡率的临界值。
{"title":"Ferritin level predicts in-hospital mortality in hypertensive patients with COVID-19","authors":"O. Skakun, N. Seredyuk","doi":"10.14739/2310-1210.2023.1.266424","DOIUrl":"https://doi.org/10.14739/2310-1210.2023.1.266424","url":null,"abstract":"Aim. This study aimed to establish the predictive ability of serum ferritin levels for severe / critical condition development, need for supplemental oxygen, and in-hospital mortality in hypertensive patients with COVID-19-associated pneumonia.\u0000Materials and methods. 135 unvaccinated patients hospitalized for COVID-19-associated pneumonia were enrolled in the study. 78.5 % of patients were hypertensive.\u0000Results. Among hypertensive patients, the median ferritin level at admission was 315.5 (169.0–396.0) ng/mL in patients with moderate condition, 374.0 (171.0–709.5) ng/mL in patients developed severe condition, and 489.0 (362.0–1128.5) ng/mL in patients developed critical condition (P = 0.03). Serum ferritin level at admission was higher in non-survivors (539.0 (440.0–1128.5) ng/mL) than that in survivors (332.5 (172.0–545.0) ng/mL, P = 0.02). Hypertensive patients who required supplemental oxygen had higher median serum ferritin level (446.0 (187.0–763.0) ng/mL) than patients without the requirement of supplemental oxygen (324.0 (165.0–401.0) ng/mL, P = 0.02). There was poor discrimination ability of ferritin level in the prediction of severe / critical conditions (AUC = 0.628, P = 0.02) and the need for supplemental oxygen (AUC = 0.629, P = 0.02). There was an acceptable discrimination ability of ferritin level in the in-hospital mortality prediction (AUC = 0.701, P = 0.03); the Youden index was 0.54, the associated criterion was >438.0 ng/mL with 83.3 % sensitivity and 70.7 % specificity. Ferritin level >438.0 ng/mL at admission was associated with a significant increase in in-hospital mortality (OR = 12.04 (2.47–58.62), P = 0.002).\u0000Conclusions. Serum ferritin level at hospital admission increases with the severity of COVID-19 in hypertensive patients. Serum ferritin level predicts in-hospital mortality in hypertensive patients. However, its predictive ability for the disease progression to severe/critical conditions and the need for supplemental oxygen is poor. A ferritin level of 438.0 ng/mL is proposed to be a cut-off value for the prediction of in-hospital mortality.","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":"84756426","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 : 2023-02-15DOI: 10.14739/2310-1210.2023.1.261797
O. Halushko, O. Protsiuk, O. Pohorila
The aim of the work is to analyze the available scientific information and generalize the main results of modern research on the causes and risk factors of hypoglycemia in patients with COVID-19. Materials and methods. A search and analysis of full-text articles was carried out in the PubMed, Web of Science, Google Scholar, and Scopus databases. The search was conducted using the key terms: COVID-19 and hypoglycemia, hypoglycemia in COVID-19 patients and treatment of COVID-19 and hypoglycemia from the beginning of the pandemic in December 2019 to July 1, 2022. Results. The analysis of literary sources made it possible to identify three groups of factors that lead to the occurrence of hypoglycemia in patients with COVID-19: peculiarities of the diabetes course in patients with COVID-19 and the influence of concomitant diseases, side effects of certain groups of drugs and methods of therapy and prevention; shortcomings in the organization of treatment and patient care. Hypoglycemia has been shown to be a risk factor for cardiovascular and total mortality in patients with diabetes, may trigger the development of a cytokine storm during COVID-19 disease, and negatively impact mortality and length of hospital stay in COVID-19. Conclusions. To prevent hypoglycemic states in patients, one should avoid sudden changes in the type and dose of hypoglycemic drugs, periodically monitor the HbA1c level, expand the reach of patients with virtual consultations and telemedicine programs. In the case of determining the program of treatment and vaccination against COVID-19 in patients with diabetes mellitus, the known and possible hypoglycemic effects of drugs and vaccines should be taken into account.
本研究的目的是分析现有的科学信息,总结新冠肺炎患者低血糖的原因和危险因素的现代研究的主要结果。材料和方法。在PubMed、Web of Science、Google Scholar和Scopus数据库中对全文文章进行了搜索和分析。检索的关键词为2019年12月至2022年7月1日期间的COVID-19和低血糖、COVID-19患者的低血糖以及COVID-19和低血糖的治疗。通过对文献资料的分析,可以确定导致COVID-19患者发生低血糖的三组因素:COVID-19患者糖尿病病程的特殊性和伴随疾病的影响,某些药物组的副作用以及治疗和预防方法;组织治疗和病人护理方面的不足。低血糖已被证明是糖尿病患者心血管和总死亡率的危险因素,可能引发COVID-19疾病期间细胞因子风暴的发展,并对COVID-19的死亡率和住院时间产生负面影响。为了防止患者出现低血糖状态,应避免突然改变降糖药的类型和剂量,定期监测HbA1c水平,通过虚拟会诊和远程医疗项目扩大患者的范围。在确定糖尿病患者的COVID-19治疗和疫苗接种方案时,应考虑药物和疫苗的已知和可能的降糖作用。
{"title":"Hypoglycemia in patients with COVID-19: risk factors and prevention of complications","authors":"O. Halushko, O. Protsiuk, O. Pohorila","doi":"10.14739/2310-1210.2023.1.261797","DOIUrl":"https://doi.org/10.14739/2310-1210.2023.1.261797","url":null,"abstract":"The aim of the work is to analyze the available scientific information and generalize the main results of modern research on the causes and risk factors of hypoglycemia in patients with COVID-19.\u0000Materials and methods. A search and analysis of full-text articles was carried out in the PubMed, Web of Science, Google Scholar, and Scopus databases. The search was conducted using the key terms: COVID-19 and hypoglycemia, hypoglycemia in COVID-19 patients and treatment of COVID-19 and hypoglycemia from the beginning of the pandemic in December 2019 to July 1, 2022.\u0000Results. The analysis of literary sources made it possible to identify three groups of factors that lead to the occurrence of hypoglycemia in patients with COVID-19: peculiarities of the diabetes course in patients with COVID-19 and the influence of concomitant diseases, side effects of certain groups of drugs and methods of therapy and prevention; shortcomings in the organization of treatment and patient care. Hypoglycemia has been shown to be a risk factor for cardiovascular and total mortality in patients with diabetes, may trigger the development of a cytokine storm during COVID-19 disease, and negatively impact mortality and length of hospital stay in COVID-19.\u0000Conclusions. To prevent hypoglycemic states in patients, one should avoid sudden changes in the type and dose of hypoglycemic drugs, periodically monitor the HbA1c level, expand the reach of patients with virtual consultations and telemedicine programs. In the case of determining the program of treatment and vaccination against COVID-19 in patients with diabetes mellitus, the known and possible hypoglycemic effects of drugs and vaccines should be taken into account.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89565961","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 : 2023-02-15DOI: 10.14739/2310-1210.2023.1.261972
О. B. Yaremenko, EF А. О. Sydorova A, CD О. Ya. Antoniuk A
Hemophagocytic lymphohistiocytosis (hemophagocytic syndrome, HLH) is a life-threatening hyperinflammatory condition associated with a high mortality rate; it is characterized by hyperstimulation of histiocytes and cytotoxic T-cells, which leads to cytokine storm and multisystemic injury. Aim. To present our own clinical case of the HLH development at the key aspects of pathogenic mechanisms, differential diagnosis, and therapeutic management of this syndrome. Materials and methods. This article provides information on the HLH development in a 69-year-old man with the onset of this syndrome prior to a diagnosis of the underlying disease – splenic marginal zone lymphoma. The article summarizes the current literature data on clinical manifestations, diagnosis, and treatment of HLH. Results. This article describes a case of secondary HLH from our clinical practice. The most common causes of HLH are malignant neoplasm, infectious factors and rheumatic diseases (when associated with the latest, HLH is called “macrophage activation syndrome”). The main clinical symptoms are prolonged high fever and hepatosplenomegaly, typical laboratory changes such as cytopenia, hyperferritinemia, hypertriglyceridemia, elevated liver enzymes and low fibrinogen levels. Conclusions. Despite typical clinical features, HLH is a condition that often remains unrecognized and it is characterized by a poor prognosis. Prompt prescription of adequate treatment can improve patients’ prognoses and increase the survival rate.
{"title":"Clinical case of hemophagocytic lymphohistiocytosis: rare or undiagnosed syndrome?","authors":"О. B. Yaremenko, EF А. О. Sydorova A, CD О. Ya. Antoniuk A","doi":"10.14739/2310-1210.2023.1.261972","DOIUrl":"https://doi.org/10.14739/2310-1210.2023.1.261972","url":null,"abstract":"Hemophagocytic lymphohistiocytosis (hemophagocytic syndrome, HLH) is a life-threatening hyperinflammatory condition associated with a high mortality rate; it is characterized by hyperstimulation of histiocytes and cytotoxic T-cells, which leads to cytokine storm and multisystemic injury.\u0000Aim. To present our own clinical case of the HLH development at the key aspects of pathogenic mechanisms, differential diagnosis, and therapeutic management of this syndrome.\u0000Materials and methods. This article provides information on the HLH development in a 69-year-old man with the onset of this syndrome prior to a diagnosis of the underlying disease – splenic marginal zone lymphoma. The article summarizes the current literature data on clinical manifestations, diagnosis, and treatment of HLH.\u0000Results. This article describes a case of secondary HLH from our clinical practice. The most common causes of HLH are malignant neoplasm, infectious factors and rheumatic diseases (when associated with the latest, HLH is called “macrophage activation syndrome”). The main clinical symptoms are prolonged high fever and hepatosplenomegaly, typical laboratory changes such as cytopenia, hyperferritinemia, hypertriglyceridemia, elevated liver enzymes and low fibrinogen levels.\u0000Conclusions. Despite typical clinical features, HLH is a condition that often remains unrecognized and it is characterized by a poor prognosis. Prompt prescription of adequate treatment can improve patients’ prognoses and increase the survival rate.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90631338","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 : 2023-02-15DOI: 10.14739/2310-1210.2023.1.262450
N. Y. Tselik, O. Bilchenko
The relevance of determining the factors of the prolonged QTc interval development in patients with arterial hypertension is high, as it solves the issue of preliminary diagnosis among patients from risk groups and allows adjusting the diagnostic and therapeutic tactics of managing such patients. Aim: to determine factors for the development of prolonged average daily QTc interval in patients with arterial hypertension. Materials and methods. The study included 195 patients with arterial hypertension, who were divided into 2 subgroups: 175 individuals with a normal average daily duration of the QTc interval and 20 patients with a prolonged average daily duration of the QTc interval. All the patients underwent 24-hour heart rate monitoring and determination of blood pressure variability. At the stage of involving patients in the study, the following were performed: anamnesis collection and determination of physical data (estimation of systolic and diastolic blood pressure). Results. The study has revealed risk factors of daily QTc interval prolongation in hypertensive patients with further developing a prognostic model with high sensitivity (88.9 %) and specificity (70.6 %). Prolongation of QTc in patients with hypertension was associated with such parameters: male sex (OR = 4.292 [95.0 % CI 1.337–13.779], Р = 0.014), body mass index (OR = 1.107 [95.0 % CI 0.987–1.243], Р = 0.083), mean 24-hour diastolic (OR = 1.076 [95.0 % CI 1.017–1.139], Р = 0.011) and pulse blood pressure (OR = 1.075 [95.0 % CІ 1.012–1.141], Р = 0.018), time since hypertension was diagnosed (OR = 1.093 [95.0 % CI 0.997–1.197], Р = 0.057) and office pulse blood pressure (OR = 0.948 [95.0 % CІ 0.900–0.999], Р = 0.046). Conclusions. The study has determined risk factors of developing a prolonged average daily QTc interval in patients with hypertension, which will allow correcting diagnostic and treatment tactics of management for patients from risk groups.
{"title":"Factors of QTc interval prolongation in patients with arterial hypertension","authors":"N. Y. Tselik, O. Bilchenko","doi":"10.14739/2310-1210.2023.1.262450","DOIUrl":"https://doi.org/10.14739/2310-1210.2023.1.262450","url":null,"abstract":"The relevance of determining the factors of the prolonged QTc interval development in patients with arterial hypertension is high, as it solves the issue of preliminary diagnosis among patients from risk groups and allows adjusting the diagnostic and therapeutic tactics of managing such patients.\u0000Aim: to determine factors for the development of prolonged average daily QTc interval in patients with arterial hypertension.\u0000Materials and methods. The study included 195 patients with arterial hypertension, who were divided into 2 subgroups: 175 individuals with a normal average daily duration of the QTc interval and 20 patients with a prolonged average daily duration of the QTc interval. All the patients underwent 24-hour heart rate monitoring and determination of blood pressure variability. At the stage of involving patients in the study, the following were performed: anamnesis collection and determination of physical data (estimation of systolic and diastolic blood pressure).\u0000Results. The study has revealed risk factors of daily QTc interval prolongation in hypertensive patients with further developing a prognostic model with high sensitivity (88.9 %) and specificity (70.6 %). Prolongation of QTc in patients with hypertension was associated with such parameters: male sex (OR = 4.292 [95.0 % CI 1.337–13.779], Р = 0.014), body mass index (OR = 1.107 [95.0 % CI 0.987–1.243], Р = 0.083), mean 24-hour diastolic (OR = 1.076 [95.0 % CI 1.017–1.139], Р = 0.011) and pulse blood pressure (OR = 1.075 [95.0 % CІ 1.012–1.141], Р = 0.018), time since hypertension was diagnosed (OR = 1.093 [95.0 % CI 0.997–1.197], Р = 0.057) and office pulse blood pressure (OR = 0.948 [95.0 % CІ 0.900–0.999], Р = 0.046).\u0000Conclusions. The study has determined risk factors of developing a prolonged average daily QTc interval in patients with hypertension, which will allow correcting diagnostic and treatment tactics of management for patients from risk groups.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81425647","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}