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Актуальні проблеми сучасної медицини: Вісник Української медичної стоматологічної академії最新文献

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STRUCTURE AND CHARACTERISTICS OF THE FIRST MODULE IN THE EDUCATIONAL COMPONENT “INDIVIDUAL RESEARCH WORK” FOR EDUCATIONAL PROFESSIONAL PROGRAM “MEDICINE” 医学 "教育专业课程 "个人研究工作 "教学内容第一模块的结构和特点
O. Akimov, A. Mischenko, N. Solovyova, S.M. Nazarenko, V. Kostenko
The proportion of skills, abilities, and competencies pertaining to the scientific method of understanding reality—comprising principles, rules, norms, and methodologies for acquiring and organizing new knowledge about both objective and subjective realities—represents the scientific aptitude within the educational framework. A robust scientific aptitude within the educational process is a vital prerequisite for students in specific fields of study (specializations) to receive education of requisite quality. The Department of Pathophysiology at Poltava State Medical University is actively engaged in not only fundamental medical and preclinical research but also in ongoing scientific and methodological endeavors aimed at enhancing the educational process departmentally and university-wide. The educational component ‘Individual Research Work” within the educational professional program “Medicine”, developed by the departmental faculty, serves to elevate educational standards by augmenting the scientific aptitude within the educational process. This study aimed to analyze and delineate the structure of the initial module within the educational component “Individual Research Work” of the educational and professional program “Medicine”. In preparing the manuscript of the article, the authors employed several general theoretical research methods, including analysis, synthesis, comparison of concepts, abstraction, and generalization. Module No. 1, titled “Modeling of Typical Pathological Processes in Various Organs and Systems”, within the educational component “Individual Research Work”, spans 120 hours and is structured as follows: 8 lecture hours, 32 hours of practical classes, and 80 hours designated for independent study of module topics. The thematic plan encompasses the exploration of the following topics: 1. Modelling inflammatory processes in various organs; 2. Modelling disturbances in the cell cycle (hypo- and hyperbiotic processes); 3. Modelling systemic metabolic disorders; 4. Modelling functional disorders across various organs and systems. The ultimate outcome of Module No. 1 entails students selecting a topic and experimental model conducive to their research pursuit. The structure and content of this initial module within the educational component “Individual Research Work”, developed by the Department of Pathophysiology at Poltava State Medical University, align with the standards of contemporary higher medical education. The study, along with its inaugural module, is poised to enhance the quality of education for aspiring individuals enrolled in the educational and professional program “Medicine”.
与理解现实的科学方法有关的技能、能力和才干的比例--包括获取和组织有关客观和主观现实的新知识的原则、规则、规范和方法--代表了教育框架内的科学能力。在教育过程中具备扎实的科学素养,是特定学习领域(专业)的学生接受高质量教育的重要前提。波尔塔瓦国立医科大学病理生理学系不仅积极开展基础医学和临床前研究,还不断进行科学和方法论方面的努力,以加强系内和全校的教育进程。医学 "教育专业课程中的 "个人研究工作 "是由该系教师开发的教育内容,旨在通过提高教育过程中的科学能力来提升教育标准。本研究旨在分析和界定 "医学 "教育专业课程中 "个人研究工作 "这一教学环节的初始模块结构。在撰写文章手稿时,作者采用了几种一般理论研究方法,包括分析、综合、概念比较、抽象和概括。在 "个人研究工作 "的教学内容中,第 1 单元题为 "各种器官和系统典型病理过程的建模",共 120 个学时,结构如下:8 个授课学时,32 个实践学时:其中 8 个课时为讲座,32 个课时为实践课,80 个课时用于对模块主题的独立研究。专题计划包括探讨以下主题:1.模拟各器官的炎症过程;2.模拟细胞周期紊乱(低生化和高生化过程);3.模拟系统代谢紊乱;4.模拟各器官和系统的功能紊乱。模块 1 的最终成果要求学生选择有利于其研究追求的主题和实验模型。波尔塔瓦国立医科大学病理生理学系开发的 "个人研究工作 "教学内容中的这一初始模块的结构和内容符合当代高等医学教育的标准。这项研究及其初始模块将提高 "医学 "教育和专业课程有志者的教育质量。
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引用次数: 0
THE ROLE OF LATE-ONSET HYPOGONADISM IN THE PATHOGENESIS OF MORPHO-FUNCTIONAL CHANGES IN THE URINARY BLADDER DUE TO BENIGN PROSTATIC HYPERPLASIA 晚发性性腺功能减退症在良性前列腺增生导致膀胱形态和功能变化的发病机制中的作用
R.B. Savchenko, O.O. Maksymenko
Introduction. One of the key characteristics of the lower urinary tract is its hormone dependence. Pathophysiological mechanisms of lower urinary tract symptoms in patients with benign prostatic hyperplasia include infravesical obstruction, formation of a fibrous framework in the urinary bladder, disruption of the urothelial barrier, and changes in the nervous and vascular networks of the pelvis. However, to date, there is a lack of data on the pathophysiological relationship between testosterone deficiency and morpho-functional changes of the bladder. The purpose of this study is to investigate the role of age-related hypogonadism in the pathogenesis of morpho-functional changes in the urinary bladder among patients with benign prostatic hyperplasia. The results of the examination of 70 patients with benign prostatic hyperplasia, aged from 47 to 83 years (mean age 67.94 ± 7.42 years), were analyzed. The first group consisted of 20 patients, whose disease duration was 4 ± 1.8 years. They had an International Prostate Symptom Score (IPSS) of 16 ± 4.5 points, a maximum flow rate (Qmax ) of 15.8 ± 2.4 ml/s, an average flow rate (Qave) of 12.8 ± 2.8 ml/s, and no post-void residual. The second group included 20 patients with incomplete bladder emptying, with a disease duration of 5.8 ± 3.5 years. Their IPSS was 26 ± 3.9 points, Qmax was 10.8 ± 2.5 ml/s, Qave was 4.4 ± 1.4 ml/s, and post-void residual was 150.1 ± 80.8 ml. The third group comprised 30 patients who had undergone cystostomy, with a disease duration of 10.6 ± 3.3 years. Before cystostomy, their IPSS was 33.1 ± 1.88 points, and post-void residual was 1093.3 ± 458.8 ml. During surgery, all patients with benign prostatic hyperplasia were taken a biopsy from the anterior wall of the bladder. In benign prostatic hyperplasia patients in the stage of bladder compensation, the level of testosterone was 15.39±1.44 nmol/l, the Aging Males Symptoms indicator was 24.80±5.78 points. Morphometric analysis of bladder tissue demonstrated the following: the diameter of the lumen of arterioles was 27.96±2.14 μm, the thickness of the arteriole wall was 16.03±1.83 μm, the Kernoghan index for arterioles was 1.22±0.17, the specific gravity of connective tissue made 4.48±0.82%, the diameter of SMCs was 7.46±1.66 μm. In benign prostatic hyperplasia patients in the stage of bladder subcompensation, the level of testosterone was 10.92±2.24 nmol/l, the Aging Males Symptoms index was 37.9±8.0 points. Morphometric analysis of bladder tissue revealed the following: the diameter of the arteriole lumen was 23.78±1.62 μm, the thickness of the arteriole wall was 18.30±1.32 μm, the Kernoghan index for arterioles was q1.65±0.18, the specific gravity of the connective tissue made up 11.80±1.22%, the diameter of SMCs was 7.07±1.93 μm. In benign prostatic hyperplasia patients in the stage of bladder decompensation, the level of testosterone is 9.66±2.13 nmol/l, the Aging Males Symptoms index is 55.80±6.69 points. Morphometric
导言。下尿路的主要特征之一是对激素的依赖性。良性前列腺增生症患者出现下尿路症状的病理生理机制包括尿道下段梗阻、膀胱纤维框架的形成、尿道屏障的破坏以及骨盆神经和血管网络的变化。然而,迄今为止,有关睾酮缺乏与膀胱形态功能变化之间的病理生理学关系的数据还很缺乏。本研究旨在探讨与年龄相关的性腺功能减退在良性前列腺增生患者膀胱形态功能变化的发病机制中的作用。研究分析了 70 名良性前列腺增生症患者的检查结果,他们的年龄在 47 至 83 岁之间(平均年龄为 67.94 ± 7.42 岁)。第一组包括 20 名患者,病程为 4 ± 1.8 年。他们的国际前列腺症状评分(IPSS)为(16±4.5)分,最大流量(Qmax)为(15.8±2.4)毫升/秒,平均流量(Qave)为(12.8±2.8)毫升/秒,且无排尿后残余物。第二组包括 20 名膀胱排空不完全患者,病程为(5.8±3.5)年。他们的 IPSS 为 26 ± 3.9 分,Qmax 为 10.8 ± 2.5 毫升/秒,Qave 为 4.4 ± 1.4 毫升/秒,排尿后残余物为 150.1 ± 80.8 毫升。第三组包括 30 名接受过膀胱造口术的患者,病程为(10.6±3.3)年。膀胱造口术前,他们的 IPSS 为 33.1 ± 1.88 分,术后残余尿量为 1093.3 ± 458.8 毫升。手术期间,所有良性前列腺增生患者都在膀胱前壁进行了活检。膀胱代偿期良性前列腺增生患者的睾酮水平为(15.39±1.44)nmol/l,老年男性症状指标为(24.80±5.78)分。膀胱组织形态学分析显示:动脉管腔直径为(27.96±2.14)μm,动脉管壁厚度为(16.03±1.83)μm,动脉Kernoghan指数为(1.22±0.17),结缔组织比重为(4.48±0.82)%,SMC直径为(7.46±1.66)μm。膀胱亚代偿期良性前列腺增生患者的睾酮水平为(10.92±2.24)nmol/l,老年男性症状指数为(37.9±8.0)分。膀胱组织形态分析显示:动脉管腔直径为(23.78±1.62)μm,动脉管壁厚度为(18.30±1.32)μm,动脉Kernoghan指数为(q1.65±0.18),结缔组织比重为(11.80±1.22)%,SMC直径为(7.07±1.93)μm。膀胱失代偿期良性前列腺增生患者的睾酮水平为(9.66±2.13)nmol/l,老年男性症状指数为(55.80±6.69)分。膀胱组织形态学分析显示:动脉管腔直径为(19.0±2.08)μm,动脉管壁厚度为(21.01±1.57)μm,动脉血管 Kernoghan 指数为(2.41±0.32),结缔组织比重为(29.46±1.35%,SMC 的直径为 4.75±1.87 μm。良性前列腺增生症患者膀胱失代偿的致病因素并非只有梗阻因素。睾酮水平的下降会引发一系列病理过程,对前列腺的形态功能状态产生负面影响,并使良性前列腺梗阻患者的手术治疗效果恶化。
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引用次数: 0
DIFFERENTIAL DIAGNOSIS OF TUBERCULOSIS AND NON-SPECIFIC PULMONARY INFILTRATS (Lecture) 结核病和非特异性肺部感染的区别诊断(讲座)
I. P. Kaidashev
Following the reformation of healthcare system and the dissolution of the specialty "Phthisiology," the extensive anti-tuberculosis efforts in Ukraine now fall under the purview of family doctors and specialists across various fields. According to the Law of Ukraine “On Overcoming Tuberculosis in Ukraine”, enacted on 14.07.2023 under No. 3269-IX, Paragraph 4 (Article 4), individuals afflicted with tuberculosis or latent tuberculosis infection are entitled to specialized medical care. This includes the treatment of all forms of tuberculosis and associated conditions across a spectrum of healthcare institutions. Compliance with this legal mandate necessitates that doctors of various specialties possess not only proficiency in contemporary tuberculosis treatment methods, which will be facilitated by the regional tuberculosis control center, but also competence in diagnosing tuberculosis in its various presentations. When health issues arise, patients typically seek assistance first from primary care specialists. The “Pulmonary infiltrate syndrome” is an X-ray syndrome characterized by the presence of shadows in the lungs exceeding 1 cm in diameter. There are numerous causes for such changes in the lungs. Given that the lungs are the most common site for tuberculosis, particularly in the form of infiltrative shadows, which may signify not only tuberculosis but also pneumonia, tumors, lung infarction, eosinophilic infiltrate, and other conditions, the question of their differential diagnosis becomes quite relevant. The increasing frequency and subtle clinical presentation of the “Pulmonary infiltrate syndrome” necessitate proficiency in the clinical aspects and diagnosis of its most common manifestations. The key differential diagnostic features that distinguish infiltrative pulmonary tuberculosis from other nonspecific infiltrates include contact with a tuberculosis patient or a history of tuberculosis, often subacute onset, heterogeneous infiltrative shadow in 1, 2, or 6 segments with a connection to the lung root, moderate leukocytosis, lymphopenia, elevated ESR, presence of acid-fast bacilli in sputum or bronchial lavage, specific endobronchitis, positive response to antitubercular therapy, and lack of improvement with other nonspecific treatment methods.
随着医疗体系的改革和 "肺病学 "专科的解散,乌克兰广泛的结核病防治工作现由家庭医生和各领域专家负责。根据乌克兰于 2023 年 7 月 14 日颁布的第 3269-IX 号《乌克兰结核病防治法》第 4 款(第 4 条),患有结核病或潜伏性结核感染的个人有权获得专业医疗服务。这包括在各种医疗机构治疗各种形式的结核病和相关疾病。要遵守这一法律规定,各科医生不仅要熟练掌握当代结核病治疗方法(地区结核病控制中心将提供协助),还要具备诊断各种表现形式的结核病的能力。当出现健康问题时,患者通常会首先向初级保健专家寻求帮助。肺部浸润综合征 "是一种 X 光综合征,其特征是肺部出现直径超过 1 厘米的阴影。造成肺部这种变化的原因有很多。鉴于肺部是结核病最常见的发病部位,尤其是以浸润性阴影形式出现的肺部病变,不仅可能是结核病,也可能是肺炎、肿瘤、肺梗塞、嗜酸性粒细胞浸润和其他疾病,因此肺部病变的鉴别诊断问题就变得非常重要。由于 "肺部浸润综合征 "的发生率越来越高,临床表现也越来越微妙,因此有必要熟练掌握其最常见表现的临床方面和诊断方法。将浸润性肺结核与其他非特异性浸润区分开来的主要鉴别诊断特征包括:接触过肺结核病人或有肺结核病史、通常是亚急性起病、1、2 或 6 个节段的异质性浸润阴影,并与肺结核病人有联系、中度白细胞增多、淋巴细胞减少、血沉增快、痰液或支气管灌洗液中出现酸性ast 杆菌、特异性支气管内炎、对抗结核治疗呈阳性反应,以及其他非特异性治疗方法效果不佳。
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引用次数: 0
ANALYZING DEVICES AND METHODS FOR ASSESSING THE PRIMARY STABILITY OF ORTHODONTIC MINI-IMPLANTS 评估正畸微型植入体主要稳定性的分析装置和方法
D. P. Shaienko
When disruptions occur in the mechanisms regulating the eruption of lower jaw molars, it becomes necessary to artificially extract and reposition them within the dentition. Various treatment methods are employed for this purpose, with the primary approach involving traction fixed to teeth or other anchorage elements and bone supports. Skeletal support is preferred to minimize resistance from orthodontic appliances when applying force to the patient's teeth. The utilization of mini-implants for anchorage demonstrates a relatively high success rate, though instances of failures and complications are not unheard of. Potential issues such as stability loss and mini-implant displacement may necessitate relocation or adjustments to treatment strategies, posing challenges for both practitioners and patients. Unlike dental implants, where secondary stability often dictates treatment success, primary stability holds paramount importance for orthodontic mini-implants. Investigating primary stability parameters can significantly impact treatment strategy selection and orthodontic mini-implant loading timelines. Focusing solely on mini-implant torque during placement is inadequate, as it fails to comprehensively gauge real stability. Moreover, the available range of torque indicators for orthodontic mini-implant placement is limited, typically ranging from 5ncm to 10 ncm. Furthermore, the selection of specialized devices for measuring primary stability is limited and necessitates meticulous evaluation.
当下颌臼齿的萌出调节机制发生紊乱时,就有必要人为地拔出这些臼齿,并将它们在牙列中重新定位。为此,我们采用了多种治疗方法,其中最主要的方法是将牵引力固定在牙齿或其他固定部件和骨支持上。骨骼支持是首选,这样可以在对患者牙齿施力时将正畸器械的阻力降至最低。使用微型种植体进行固定的成功率相对较高,但也不乏失败和并发症的发生。稳定性丧失和微型种植体移位等潜在问题可能需要重新定位或调整治疗策略,这给医生和患者都带来了挑战。牙科植入物的次要稳定性往往决定了治疗的成功与否,而正畸微型植入物的主要稳定性则不同。对初级稳定性参数的调查会对治疗策略的选择和正畸微型种植体的装载时间产生重大影响。仅仅关注微型种植体植入过程中的扭矩是不够的,因为它无法全面衡量真正的稳定性。此外,用于正畸微型种植体植入的扭矩指标范围有限,通常从 5ncm 到 10 ncm 不等。此外,用于测量初级稳定性的专业设备选择有限,需要进行细致的评估。
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引用次数: 0
GASTRIC GASTROINTESTINAL STROMAL TUMOR WITH SUCCINATE DEHYDROGENASE B DEFICIENCY: CLINICAL CASE 伴有琥珀酸脱氢酶 B 缺乏症的胃胃肠道间质瘤:临床病例
G. Ivanova, M. Dudchenko, M. Kravtsiv, D. Ivashchenko, T. V. Horodova-Andrieieva, M. Shevchuk, R. A. Prykhidko
Gastrointestinal stromal tumors (GISTs) are mesenchymal tumors found in the gastrointestinal tract, constituting a diverse group of c-Kit positive mesenchymal (stromal or connective tissue) tumors. Their development is primarily associated with mutations in the c-Kit proto-oncogene, leading to structural alterations in the type III transmembrane tyrosine kinase receptor (Kit). This receptor is crucial for regulating mitotic activity and cell differentiation. The activation of the Kit-receptor in tumor cells is identified through the expression of the immunohistochemical marker CD 117 (tyrosine kinase receptor protein), with approximately 80-90% of GISTs testing positive for CD 117. The objective of our study is to improve the diagnosis and treatment of gastrointestinal stromal tumors. The clinical case underscores the challenge of diagnosing gastrointestinal stromal tumors (GISTs) due to the absence of specific and definitive symptoms. In this instance, only radical surgical intervention facilitated an accurate diagnosis. Given the location of the tumor in the pyloric part of the gastric submucosal layer, a reliable biopsy during video esophagogastroduodenoscopy was unfeasible, as the gastric mucosa above the tumor appeared unaffected. Consequently, surgery with complete tumor excision and subsequent pathohistological and immunohistochemical analysis emerged as the primary diagnostic and therapeutic approach. These investigations confirmed the presence of a gastrointestinal stromal tumor of the stomach with succinate dehydrogenase B deficiency. In approximately 80% of GIST cases, succinate dehydrogenase deficiency plays a pivotal role. The absence of succinate dehydrogenase disrupts the Krebs cycle, leading to an accumulation of succinate, an oncometabolite that fuels carcinogenesis. Such tumors exhibit distinctive clinical characteristics, prognostic outcomes, and responsiveness to targeted therapies. Succinate dehydrogenase deficiency can arise from mutations or epigenomic alterations affecting gene expression. Notably, mutations or epigenomic disruptions in any succinate dehydrogenase subunit inevitably result in the loss of subunit B expression.
胃肠道间质瘤(GISTs)是在胃肠道中发现的间质肿瘤,是一组多种多样的 c-Kit 阳性间质(基质或结缔组织)肿瘤。它们的发生主要与 c-Kit 原癌基因的突变有关,突变导致 III 型跨膜酪氨酸激酶受体(Kit)的结构改变。这种受体对于调节有丝分裂活动和细胞分化至关重要。肿瘤细胞中Kit受体的激活是通过免疫组化标记物CD 117(酪氨酸激酶受体蛋白)的表达来确定的,大约80-90%的GIST对CD 117检测呈阳性。我们的研究旨在改进胃肠道间质瘤的诊断和治疗。该临床病例突出表明,由于缺乏特异性和明确的症状,诊断胃肠道间质瘤(GIST)是一项挑战。在这个病例中,只有根治性手术干预才有助于准确诊断。由于肿瘤位于胃黏膜下层的幽门部分,在视频食管胃十二指肠镜检查中进行可靠的活检是不可行的,因为肿瘤上方的胃黏膜似乎未受影响。因此,手术完全切除肿瘤,随后进行病理组织学和免疫组化分析,成为主要的诊断和治疗方法。这些检查证实了患者患有琥珀酸脱氢酶 B 缺乏症的胃肠道间质瘤。在大约 80% 的胃肠道间质瘤病例中,琥珀酸脱氢酶缺乏症起着关键作用。琥珀酸脱氢酶的缺乏会破坏克雷布斯循环,导致琥珀酸的积累,而琥珀酸是一种助长癌变的副代谢产物。此类肿瘤表现出独特的临床特征、预后结果以及对靶向疗法的反应性。影响基因表达的突变或表观基因组改变可导致琥珀酸脱氢酶缺乏症。值得注意的是,任何琥珀酸脱氢酶亚基的突变或表观基因组的破坏都会不可避免地导致 B 亚基表达的丧失。
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引用次数: 0
THE ISSUE OF INFECTIOUS DISEASE INCIDENCE AMONG MEDICAL STUDENTS 医学生传染病发病率问题
T. I. Shevchuk
Introduction. The training of future medical professionals involves not only development of skills and professional background, but also maintaining a sufficient health status; therefore the relevance of studying an incidence of infectious pathologies in medical students is exceptionally important. The purpose of the study is to investigate, analyze, and compare incidence of some infectious diseases among medicine students. Materials and methods. We utilized various research methods including analysis of scientific sources, synthesis and comparison of studies by other researchers, surveys, observations, interviews, and statistical data on the incidence of infectious diseases in Ukraine and worldwide. Additionally, we conducted a poll among first-year students of the medical faculty at Vinnytsia National Pirogov Memorial Medical University using Google Forms to gather data on the incidence of respiratory and digestive system infections. The study revealed that approximately 65% of the surveyed students had experienced coronavirus disease, mostly in a mild form. Among acute respiratory viral infections, flu (55.3%), sore throat (31.3%), and rhinopharyngitis (21.3%) were the most common (79.1%) among medical students. About 74% of respondents reported no chronic diseases of the upper and lower respiratory tract, while the rest mentioned conditions such as allergic rhinitis (10%), chronic tonsillitis (10%), chronic pharyngitis (3.4%), and vocal cord diseases (2%). In terms of infectious pathologies of the digestive system, food poisoning of unspecified etiology (33.3%) and viral intestinal infections (11.7%) were the most prevalent. Conclusion. The relevance of the issue of infectious disease incidence among medical students necessitates further investigation and analysis to identify contributing factors, develop monitoring methods, and promote healthy lifestyles to maintain optimal health status.
引言未来医学专业人员的培养不仅包括技能和专业背景的发展,还包括保持足够的健康状况;因此,研究医科学生中传染病的发病率就显得格外重要。本研究旨在调查、分析和比较医科学生中一些传染病的发病率。材料和方法。我们采用了多种研究方法,包括分析科学资料、综合和比较其他研究人员的研究、调查、观察、访谈以及有关乌克兰和全球传染病发病率的统计数据。此外,我们还使用谷歌表格对文尼察国立皮罗戈夫纪念医科大学医学系一年级学生进行了民意调查,以收集有关呼吸系统和消化系统感染发病率的数据。研究结果显示,约 65% 的受访学生曾感染过冠状病毒疾病,其中大部分为轻症。在急性呼吸道病毒感染中,流感(55.3%)、咽喉炎(31.3%)和鼻咽炎(21.3%)在医学生中最为常见(79.1%)。约 74% 的受访者表示没有上下呼吸道慢性疾病,其余受访者提到的疾病包括过敏性鼻炎(10%)、慢性扁桃体炎(10%)、慢性咽炎(3.4%)和声带疾病(2%)。在消化系统感染性疾病方面,病因不明的食物中毒(33.3%)和病毒性肠道感染(11.7%)最为常见。结论医学生传染病发病率问题的相关性需要进一步调查和分析,以确定致病因素,制定监测方法,并提倡健康的生活方式,以保持最佳健康状态。
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引用次数: 0
THE IMPACT OF VACCINATION STATUS ON THE CLINICAL CHARACTERISTICS OF MEASLES COURSE 疫苗接种情况对麻疹病程临床特征的影响
O. Marchenko, T. Koval, O. M. Iziumska, O. Stetsenko, S. A. Olefir
Measles is a dangerous and highly contagious viral disease with a tendency to spread rapidly. The incidence of measles is cyclical with outbreaks occurring every 5-6 years and is directly related to the level of vaccination against the disease. Measles can become severe clinical course and have serious, sometimes fatal consequences. The purpose of the study is to compare the clinical course of measles depending on the vaccination status of patients. We analysed medical records of 218 patients aged 18 to 55 years who were inpatients with a diagnosis of measles at the Poltava Regional Clinical Infectious Diseases Hospital. The clinical features of measles were compared based on vaccine status using descriptive statistics methods in accordance with the analysis requirements. Comparison of the clinical course of the disease depending on vaccination status did not reveal a statistically significant difference in clinical symptoms between the groups of vaccinated and unvaccinated individuals. However, in the group of unvaccinated patients, a severe course of measles was significantly more often observed compared to those who were vaccinated (p = 0.003). The incidence of complications was studied and found to be lower in vaccinated individuals than in non-immune patients (p = 0.051), specifically pneumonia (p = 0.006). No cases of complications such as measles encephalitis and enterocolitis were recorded among vaccinated individuals. Thus, the course of the disease was characterised by typical clinical signs with a predominance of intoxication syndrome, the appearance of a typical rash, its stages, the presence of catarrhal and, less often, intestinal syndromes. It was found that vaccinated individuals had significantly less frequent severe measles, and the incidence of complications, including pneumonia, was was significantly lower than in unvaccinated patients.
麻疹是一种危险的高传染性病毒性疾病,具有迅速传播的趋势。麻疹的发病率呈周期性,每 5-6 年爆发一次,与疫苗接种水平直接相关。麻疹的临床病程较长,可造成严重后果,有时甚至致命。本研究的目的是比较麻疹的临床病程与患者接种疫苗情况的关系。我们分析了波尔塔瓦地区临床传染病医院确诊为麻疹的 218 名 18 至 55 岁住院病人的病历。根据分析要求,使用描述性统计方法比较了疫苗接种情况对麻疹临床特征的影响。根据疫苗接种情况对疾病的临床过程进行比较后发现,接种疫苗组和未接种疫苗组在临床症状上没有明显的统计学差异。不过,在未接种疫苗的患者组中,与接种疫苗的患者相比,严重的麻疹病程明显更常见(p = 0.003)。对并发症的发生率进行研究后发现,接种疫苗的患者的并发症发生率低于未接种疫苗的患者(p = 0.051),尤其是肺炎(p = 0.006)。接种者中没有麻疹脑炎和小肠结肠炎等并发症病例。因此,病程的特点是典型的临床症状,以中毒综合征为主,出现典型的皮疹,皮疹分期,出现卡他综合征,较少出现肠道综合征。研究发现,接种过疫苗的人患重症麻疹的频率明显降低,包括肺炎在内的并发症发生率也明显低于未接种疫苗的患者。
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引用次数: 0
NOSOLOGICAL STRUCTURE OF IN-PATIENT PSYCHIATRIC CARE PROVISION IN THE POLTAVA REGION IN 2023 2023 年波尔塔瓦州精神病住院治疗的分类结构
P.V. Kydon
Introduction. The importance of safeguarding mental health and providing high-quality psychiatric care became increasingly urgent following the onset of full-scale war in Ukraine. Currently, a strategy to transfer psychiatric care from specialized institutions to primary care is being implemented. Therefore, analyzing the nosological distribution of referrals to a psychiatric hospital during martial law is an extremely urgent issue. The aim of this study is to investigate the nosological structure of hospitalizations at the Communal Enterprise “Regional Institution of Mental Psychiatric Care of the Poltava Regional Council” in 2023. Results and their discussion. Schizophrenia remains the leading diagnosis among patients receiving inpatient psychiatric care. The second place is taken by neurotic, stress-related, and somatoform disorders. In third place are organic, including symptomatic, mental disorders, with vascular dementia being the leading primary diagnosis among patients with organic, including symptomatic, mental disorders. Among the substances causing mental and behavioral disorders due to the use of psychoactive substances, alcohol ranks first. Paranoid schizophrenia is the leading diagnosis in patients with schizophrenia, schizotypal states, and delusional disorders. Recurrent depressive disorder is the most common among affective disorders. Adjustment disorders occupy the first place in the structure of the incidence of neurotic, stress-related, and somatoform disorders. Among the behavioral syndromes associated with physiological disturbances and physical factors, anorexia nervosa is the most common. Emotionally unstable personality disorder is most common among patients with disorders of adult personality and behavior. Mild mental retardation is more common than others. Childhood autism has the largest share in the incidence structure of disorders of psychological development. Among behavioral and emotional disorders with onset usually occurring in childhood and adolescence, the most common are mixed disorders of conduct and emotions. Conclusion. The obtained results can be used in planning and forecasting the provision of inpatient psychiatric care to patients during the wartime.
导言。乌克兰全面战争爆发后,保障精神健康和提供高质量的精神病治疗变得日益紧迫。目前,乌克兰正在实施一项战略,将精神病治疗从专门机构转移到基层医疗机构。因此,分析戒严期间精神病院转诊病人的病种分布是一个极为紧迫的问题。本研究旨在调查 2023 年 "波尔塔瓦地区委员会地区精神病院 "公有制企业的住院病人分类结构。研究结果及其讨论。精神分裂症仍然是住院精神病患者的主要诊断。排在第二位的是神经症、应激障碍和躯体形式障碍。第三位是器质性精神障碍(包括症状性精神障碍),其中血管性痴呆是器质性精神障碍(包括症状性精神障碍)患者的主要诊断。在因使用精神活性物质而导致精神和行为障碍的物质中,酒精居首位。妄想型精神分裂症是精神分裂症、分裂型状态和妄想性障碍患者的主要诊断。复发性抑郁障碍是情感障碍中最常见的一种。适应障碍在神经症、压力相关障碍和躯体形式障碍的发病结构中占首位。在与生理紊乱和身体因素相关的行为综合征中,神经性厌食症最为常见。情绪不稳定型人格障碍在成人人格和行为障碍患者中最为常见。轻度智力迟钝比其他疾病更常见。在心理发育障碍的发病结构中,儿童自闭症所占比例最大。在通常于儿童和青少年时期发病的行为和情绪障碍中,最常见的是行为和情绪混合障碍。结论所获得的结果可用于规划和预测战时为病人提供的精神科住院治疗。
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引用次数: 0
TRADITIONAL AND ALTERNATIVE METHODS OF ACNE TREATMENT 治疗痤疮的传统方法和替代方法
O. Bezeha, Y. Yemchenko, K. Vasylyeva, I.B. Popova, V. I. Kameniev
Acne, characterized by chronic inflammation of the skin, has a multifactorial pathogenesis. Despite the array of available treatments, it remains one of the most prevalent dermatological conditions globally. While primarily affecting adolescents, a noteworthy and escalating number of cases occur in adults, particularly women. The complex pathogenesis of acne encompasses follicular hyperkeratinization, colonization by Cutibacterium acnes, sebum production, intricate inflammatory processes involving innate and acquired immunity, neuroendocrine mechanisms, and genetic and non-genetic factors. Risk factors include adolescence, familial predisposition, and oily skin. Although numerous acne treatments exist, ongoing efforts aim to mitigate side effects such as skin irritation, dryness, and photosensitivity, while enhancing efficacy through refined formulations and novel drugs with innovative mechanisms of action. Emerging products target various aspects of acne's multifactorial pathogenesis, offering promising advancements in treatment options. With the escalating concern over antibiotic resistance, current guidelines advocate for the judicious use of oral antibiotics and emphasize exploring alternative treatments. Isotretinoin stands out as a highly efficacious therapy for acne: it operates by reducing sebaceous gland size, decreasing sebum secretion, regulating cell proliferation and keratinization, while also possessing anti-inflammatory and immunomodulatory properties. Spironolactone also plays an important role in acne treatment; functioning as a synthetic aldosterone receptor antagonist with anti-androgenic attributes. Androgens exert significant physiological effects on the skin, regulating processes such as skin renewal, hair follicle growth, sebaceous gland proliferation, sebum production, and embryogenesis. Topical therapies serve as viable options for both initial treatment and maintenance of acne. They can be utilized as monotherapy (excluding topical antibiotics) or in combination with other topical or oral products.
痤疮是一种以慢性皮肤炎症为特征的疾病,其发病机理是多因素的。尽管有多种治疗方法,但痤疮仍然是全球最常见的皮肤病之一。虽然痤疮主要影响青少年,但值得注意的是,成年人,尤其是女性的发病率也在不断上升。痤疮的发病机制复杂,包括毛囊角化过度、痤疮杆菌定植、皮脂分泌、涉及先天和后天免疫的复杂炎症过程、神经内分泌机制以及遗传和非遗传因素。风险因素包括青春期、家族遗传倾向和油性皮肤。虽然痤疮治疗方法众多,但人们一直在努力减轻皮肤刺激、干燥和光敏等副作用,同时通过改进配方和具有创新作用机制的新型药物来提高疗效。新出现的产品针对痤疮多因素致病机理的各个方面,为治疗方案带来了可喜的进步。随着人们对抗生素耐药性的担忧不断升级,目前的指导方针提倡合理使用口服抗生素,并强调探索替代治疗方法。异维A酸是治疗痤疮的一种高效疗法:它通过缩小皮脂腺体积、减少皮脂分泌、调节细胞增殖和角质化,同时还具有抗炎和免疫调节作用。螺内酯在痤疮治疗中也发挥着重要作用,它是一种具有抗雄激素特性的合成醛固酮受体拮抗剂。雄激素对皮肤有重要的生理作用,可调节皮肤更新、毛囊生长、皮脂腺增生、皮脂分泌和胚胎发育等过程。外用疗法是痤疮初期治疗和维持治疗的可行选择。它们可以作为单一疗法(不包括外用抗生素)使用,也可以与其他外用或口服产品结合使用。
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引用次数: 0
INFECTION CONTROL IN COVID-19 PATIENTS BASED ON POLYMORPHISMS OF TMPRSS2 (rs12329760), FGB (rs1800790), AND NOS3 (rs2070744) GENES 基于 TMPRSS2 (rs12329760)、FGB (rs1800790) 和 NOS3 (rs2070744) 多态性基因的 COVID-19 患者感染控制方法
M.O. Sokolenko, L.P. Sydorchuk, A.A. Sokolenko
Objective of this study is to investigate the potential of anti-infective protection in patients with COVID-19 by analyzing the absolute and relative number of the main populations of immunocompetent peripheral blood cells depending on the polymorphism of the genes of transmembrane serine protease 2 (TMPRSS2, rs12329760), fibrinogen beta (FGB, rs1800790) and endothelial nitric oxide synthase (NOS3, T-786C, rs2070744). Materials and methods. A total of 204 patients with mild, moderate, and severe COVID-19-associated pneumonia were included in the single-center study. Among the patients were 51.97% (106) women and 48.03% (98) men. Among the patients, there were 51.97% (106) women and 48.03% (98) men, with an average age of 55.93±8.75 years. Anti-infective protection was assessed based on an extended complete blood count (CBC) with the calculation of the main populations of immunocompetent cells. The polymorphism of the TMPRSS2 (rs12329760), FGB (rs1800790) and NOS3 (rs2070744) genes was investigated by real-time polymerase chain reaction (Real Time PCR). Results. There were no differences in the absolute and relative number of most populations of immunocompetent peripheral blood cells between the genotypes of the TMPRSS2 (rs12329760) gene. The absolute and relative number of immunocompetent peripheral blood cell populations between the genotypes of the FGB (rs1800790) gene also did not differ significantly. However, in AA genotype carriers, there was a tendency to decrease the number of neutrophilic granulocytes due to mature segmented nucleated forms against the background of an increase in eosinophilic granulocytes by 27.27% (p=0, 038) and 55.55% (p=0.007) and agranulocytes due to lymphocyte sprouting and monocytes by 8.87-20.09% that implies a more severe course of the disease and a stronger stress of non-specific immunity than in G-allele holders. Conclusions. Inflammatory changes in the complete blood count of the main populations of immunocompetent cells in patients with COVID-19 do not show a consistent dependence on the genotypes of the TMPRSS2 (rs12329760) and NOS3 (rs2070744) genes. However, the presence of the AA genotype of the FGB gene (rs1800790) in patients with COVID-19 is associated with a more severe course of the disease and increased stress on the monocyte-macrophage system.
本研究的目的是通过分析跨膜丝氨酸蛋白酶 2(TMPRSS2,rs12329760)、纤维蛋白原 beta(FGB,rs1800790)和内皮一氧化氮合酶(NOS3,T-786C,rs2070744)基因多态性对免疫能力强的外周血细胞主要群体绝对数和相对数的影响,研究 COVID-19 患者的抗感染保护潜力。材料与方法该单中心研究共纳入了 204 名轻度、中度和重度 COVID-19 相关肺炎患者。其中女性占 51.97%(106 人),男性占 48.03%(98 人)。患者中女性占 51.97%(106 人),男性占 48.03%(98 人),平均年龄为 55.93±8.75 岁。抗感染保护能力的评估基于扩展的全血细胞计数(CBC)和免疫功能细胞主要群体的计算。通过实时聚合酶链式反应(Real Time PCR)调查了 TMPRSS2(rs12329760)、FGB(rs1800790)和 NOS3(rs2070744)基因的多态性。结果TMPRSS2 (rs12329760)基因的不同基因型在大多数免疫能力强的外周血细胞群的绝对数量和相对数量上没有差异。FGB (rs1800790)基因不同基因型之间免疫能力强的外周血细胞群的绝对数量和相对数量也没有显著差异。然而,在 AA 基因型携带者中,由于成熟的分段核型,中性粒细胞的数量有减少的趋势,而嗜酸性粒细胞的数量则增加了 27.27%(p=0,038)和 55.55%(p=0.007),淋巴细胞萌发导致的粒细胞和单核细胞增加了 8.87%-20.09%,这意味着与 G-等位基因携带者相比,病程更严重,非特异性免疫的压力更大。结论COVID-19 患者全血细胞计数中主要免疫能力细胞群的炎症变化与 TMPRSS2 (rs12329760) 和 NOS3 (rs2070744) 基因的基因型没有一致的依赖关系。然而,COVID-19 患者的 FGB 基因(rs1800790)的 AA 基因型与更严重的病程和单核-巨噬细胞系统的压力增加有关。
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引用次数: 0
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Актуальні проблеми сучасної медицини: Вісник Української медичної стоматологічної академії
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