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

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CURRENT CHALLENGES OF HEPATITIS A IN UKRAINE DURING WARTIME: A LITERATURE REVIEW 战时乌克兰甲型肝炎目前面临的挑战:文献综述
M. Andrushchak, O.M. Bulik, A.D. Yuzko, M.O. Sokolenko, L.M. Goncharuk
Goal: to analyze the situation of the incidence of hepatitis A in Ukraine during wartime. Materials and methods. The literature review was carried out using search engines on the platforms PubMed and Google Scholar, abstract database of scientific literature Scopus. Articles in both English and Ukrainian languages were sought. Employing bibliographic and analytical methods, approximately 50 literary sources were scrutinized. These included review articles, randomized and cohort studies, as well as international recommendations for antiviral drug prescriptions, directives, Ukrainian and European protocols for managing hepatic infection. Results. Fulminant hepatitis is a rare occurrence, accounting for less than 1% of cases, although cholestatic forms and recurrent hepatitis have also been documented. Recurrent hepatitis typically manifests in about 3–20% of patients, usually occurring 3–12 weeks following the initial episode, with symptoms generally less severe than the initial presentation. Unlike other hepatitis viruses, HAV does not establish chronic infections. While extrahepatic manifestations of acute hepatitis A are uncommon, they may include neurological symptoms such as Guillain-Barré syndrome, rash, pancreatitis, arthritis, myocarditis, acute kidney injury, and hematologic disorders such as hemolysis and cryoglobulinemia. Numerous studies have indicated that disease severity and mortality associated with HAV infection are heightened among individuals with chronic liver disease, encompassing hepatitis B or C virus coinfection, alcoholic cirrhosis, and fatty liver disease. Chronic liver disease is prevalent in HIV patients due to factors such as coinfection with HBV or HCV, hepatotoxicity from antiviral medications, or alcoholic liver disease. This population may also face an elevated risk of acute or chronic liver failure. HAV infections represent the predominant cause of viral hepatitis globally. The epidemiology of HAV has undergone significant changes due to globalization and improved sanitation. Person-to-person transmission, particularly among high-risk populations such as men who have sex with men (MSM), individuals who use psychoactive substances, and those experiencing homelessness, predominates in high-income countries. Conclusion. However, outbreaks still occur despite the availability of safe, effective vaccines and long-term HGA vaccination recommendations for these individuals. Efforts should be made to develop resources aimed at raising awareness of HAV among high-risk populations and promoting vaccination. Additionally, the development of a specific antiviral treatment for HAV could be very helpful in preventing outbreaks of the virus.
目标:分析战时乌克兰甲型肝炎的发病情况。材料与方法使用 PubMed 和 Google Scholar 平台上的搜索引擎以及 Scopus 科学文献摘要数据库进行了文献综述。搜索的文章既有英文的,也有乌克兰文的。采用书目和分析方法,仔细研究了约 50 篇文献资料。其中包括综述文章、随机研究和队列研究,以及国际抗病毒药物处方建议、指令、乌克兰和欧洲肝感染管理协议。研究结果尽管胆汁淤积性肝炎和复发性肝炎也有文献记载,但暴发性肝炎并不多见,仅占不到 1%的病例。复发性肝炎通常在约 3-20% 的患者中出现,通常发生在首次发病后 3-12 周,症状通常不如首次发病严重。与其他肝炎病毒不同,HAV 不会形成慢性感染。虽然急性甲型肝炎的肝外表现并不常见,但可能包括神经系统症状(如格林-巴利综合征)、皮疹、胰腺炎、关节炎、心肌炎、急性肾损伤以及血液系统疾病(如溶血和冷球蛋白血症)。大量研究表明,慢性肝病患者(包括乙型或丙型肝炎病毒合并感染、酒精性肝硬化和脂肪肝)感染 HAV 后,疾病的严重程度和死亡率都会升高。由于合并感染乙型肝炎病毒或丙型肝炎病毒、抗病毒药物的肝毒性或酒精性肝病等因素,慢性肝病在艾滋病患者中很普遍。这类人群还可能面临急性或慢性肝功能衰竭的高风险。HAV 感染是全球病毒性肝炎的主要病因。由于全球化和卫生条件的改善,HAV 的流行病学发生了重大变化。人与人之间的传播,尤其是男男性行为者 (MSM)、使用精神活性物质者和无家可归者等高危人群之间的传播,在高收入国家占主导地位。结论尽管有安全、有效的疫苗可供使用,也有针对这些人群的长期 HGA 疫苗接种建议,但疫情仍时有发生。应努力开发资源,以提高高危人群对 HAV 的认识并促进疫苗接种。此外,开发针对 HAV 的特定抗病毒治疗方法对预防病毒爆发也很有帮助。
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引用次数: 0
PROFESSIONAL MOTIVATION OF STUDENTS AS A FACTOR FOR INTEGRATING FUNDAMENTAL AND CLINICAL DISCIPLINES IN HIGHER MEDICAL EDUCATION 学生的专业动机是高等医学教育中基础学科与临床学科相结合的一个因素
O. Z. Melnikova, O. Ivanchenko, K.I. Lurie, G.R. Michaelian
This article addresses the pressing issue of medical education: the integration of fundamental and clinical disciplines. Given the rapid pace of scientific and technological advancements, the professionalism of modern doctors largely relies on their natural and scientific training, which begins in the early stages of medical university education. Medical and biological physics play an important role in this training, but integrating them into medical education is challenging due to the complexity of the discipline's content, which students must grasp at the outset of their education, and the lack of understanding among first-year students about the connections between physics, mathematics, and medicine. The article discusses various approaches to teaching medical and biological physics, focusing on creating professional motivation among students to master fundamental sciences. It highlights the example of designing an X-ray computed tomography (CT) scanner as a means of motivating students to excel in their studies. The importance of leveraging students' prior knowledge from school textbooks on physics, biology, and chemistry to solve tasks fundamental to clinical practice is emphasized. Using the practical lesson topic “Physical foundations of X-ray diagnostics and X-ray therapy” as an example, the article demonstrates the need to focus on the properties of X-ray radiation relevant to medical applications, such as rheography, fluorography, and CT scans. Professional motivation is further enhanced through activities like participating in a biophysics scientific circle and visiting university clinics and training centers, where students can witness the practical application of their theoretical knowledge. The article underscores the importance of integrating fundamental and clinical disciplines while adhering to pedagogical principles such as scientific rigor, continuity, and consistency.
本文探讨了医学教育的迫切问题:基础学科与临床学科的结合。随着科学技术的飞速发展,现代医生的职业素养在很大程度上依赖于他们的自然和科学训练,而这种训练始于医科大学教育的早期阶段。医学物理和生物物理在这种训练中发挥着重要作用,但由于学科内容复杂,学生必须在入学之初就掌握,而且一年级学生对物理、数学和医学之间的联系缺乏了解,因此将它们融入医学教育具有挑战性。文章讨论了医学和生物物理学的各种教学方法,重点是激发学生掌握基础科学的专业动力。文章以设计 X 射线计算机断层扫描(CT)扫描仪为例,强调了激励学生在学习中取得优异成绩的方法。强调了利用学生从学校物理、生物和化学教科书中获得的已有知识来解决临床实践中基本任务的重要性。文章以 "X 射线诊断和 X 射线治疗的物理基础 "这一实践课主题为例,说明有必要关注与流变学、荧光成像和 CT 扫描等医学应用相关的 X 射线辐射特性。通过参加生物物理科学圈、参观大学诊所和培训中心等活动,学生可以亲眼目睹理论知识的实际应用,从而进一步提高专业积极性。文章强调了在坚持科学严谨性、连续性和一致性等教学原则的同时,将基础学科与临床学科相结合的重要性。
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引用次数: 0
EFFICACY OF BOTULINUM TOXIN TYPE A IN REDUCING CHRONIC TENSION HEADACHE IN PATIENTS WITH TEMPOROMANDIBULAR JOINT DYSFUNCTION A 型肉毒毒素对减轻颞下颌关节功能障碍患者慢性紧张性头痛的疗效
Ihor Anatoliiovych Shynchukovskyi
There is a notable prevalence of temporomandibular joint dysfunction, reaching approximately 34% in the general population according to the recent studies. Individuals with such dysfunction often experience tension headaches due to increased tension in the masticatory muscles, a key symptom of temporomandibular joint dysfunction. Botulinum toxin type A injections into these muscles are utilized to alleviate the dysfunction, as this drug inhibits neuromuscular impulses, thereby reducing muscle tension. This study aimed to assess the efficacy of alleviating chronic tension headaches in patients with temporomandibular joint dysfunction through botulinum toxin type A injections into trigger points of the masticatory muscles. Sixty patients exhibiting signs of temporomandibular joint dysfunction and chronic tension headaches participated in the study. They were randomly assigned to either an experimental group receiving botulinum toxin type A injections or a control group receiving saline injections into the masticatory muscles. Injections were administered at sites with the highest muscle tension in the masseter and temporalis muscles. The reduction in chronic tension-type headaches was evaluated using a visual analogue pain scale. The results indicated a statistically significant decrease in headache intensity in the experimental group compared to the control group (P<0.001). Furthermore, the experimental group demonstrated significant treatment efficacy based on headache intensity before and after 12 weeks from the drug administration date (P<0.001).
颞下颌关节功能障碍的发病率很高,根据最近的研究,其发病率约占总人口的 34%。颞下颌关节功能障碍的一个主要症状是咀嚼肌紧张度增加,因此患有这种功能障碍的人经常会感到紧张性头痛。向这些肌肉注射 A 型肉毒杆菌毒素可减轻功能障碍,因为这种药物可抑制神经肌肉冲动,从而减轻肌肉紧张。本研究旨在评估通过在咀嚼肌触发点注射 A 型肉毒毒素缓解颞下颌关节功能障碍患者慢性紧张性头痛的疗效。60名有颞下颌关节功能障碍和慢性紧张性头痛症状的患者参加了这项研究。他们被随机分配到接受 A 型肉毒毒素注射的实验组或接受生理盐水咀嚼肌注射的对照组。注射部位为肌肉张力最高的咀嚼肌和颞肌。采用视觉模拟疼痛量表对慢性紧张型头痛的缓解情况进行评估。结果表明,与对照组相比,实验组的头痛强度在统计学上有显著降低(P<0.001)。此外,根据用药前后 12 周的头痛强度,实验组的治疗效果显著(P<0.001)。
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引用次数: 0
STRATEGIES TO MITIGATE THE IMPACT OF POST-COVID-19 SYNDROME ON HIGHER EDUCATION QUALITY 减轻 "后科维德-19 综合征 "对高等教育质量影响的战略
T. I. Yarmola, O.V. Vlasova, L. Tkachenko, N. Moisieieva, A.V. Vakhnenko
The SARS-CoV-2 pandemic has left a profound impact not only on the physical health of humanity but also on neurological, social, and ecological well-being. Neurological and psychological disorders resulting from the pandemic have negatively affected the quality of learning and significantly worsened learning outcomes among students in higher education institutions. The purpose of this study is to compare the prevalence and evaluate the symptoms of post-COVID syndrome, and to identify their impact on the quality of education among senior students in two higher educational institutions: Poltava State Medical University and Poltava National Pedagogical University named after V.G. Korolenko. It has been observed that damage to the nervous system and the simultaneous appearance of a combination of symptoms including headache, memory impairment, insomnia, anxiety, unmotivated weakness, and excessive fatigue are significantly high among students of both universities. The aforementioned complaints, along with the need for increased time to complete educational tasks post-illness, memory impairment, and sleep disturbances, indicate that the academic performance, psychological state, and psychosomatic background of students are at a low level. Therefore, it is essential to develop recommendations for cognitive rehabilitation tailored to this group of students, considering their significant educational workload (samples were collected from senior students). Moreover, the low and moderate physical activity levels of senior students in higher education may exacerbate symptoms of post-COVID-19 syndrome, necessitating the development of recommendations for physical rehabilitation. Students experiencing weakness, increased fatigue, reduced work capacity, sleep disturbances, and mood instability should consider reviewing the organization of the educational process, especially in distance learning conditions, and making lifestyle changes accordingly. Therefore, thoroughly elaborated healthcare recommendations and rehabilitation measures to enhance the quality of the educational process should be implemented into healthcare practice.
SARS-CoV-2 大流行不仅对人类的身体健康,而且对神经、社会和生态福祉都造成了深远的影响。疫情导致的神经和心理障碍对高等院校学生的学习质量产生了负面影响,并显著恶化了学习效果。本研究的目的是比较后COVID综合症的发病率,评估其症状,并确定其对两所高等院校高年级学生教育质量的影响:波尔塔瓦国立医科大学和以 V.G. Korolenko 命名的波尔塔瓦国立师范大学。据观察,两所大学的学生中神经系统受损以及同时出现头痛、记忆力减退、失眠、焦虑、无精打采、过度疲劳等综合症状的比例都很高。上述主诉,加上病后需要更多时间完成学业、记忆力受损和睡眠障碍,表明学生的学习成绩、心理状态和心身背景处于较低水平。因此,考虑到这部分学生的课业负担较重,有必要为他们量身定制认知康复建议(样本采集自高年级学生)。此外,高校高年级学生的运动量较少或中等,这可能会加重 COVID-19 后综合征的症状,因此有必要制定身体康复建议。身体虚弱、疲劳加剧、工作能力下降、睡眠障碍和情绪不稳定的学生应考虑重新审视教育过程的组织,尤其是在远程学习条件下,并相应地改变生活方式。因此,应在医疗保健实践中实施详尽的医疗保健建议和康复措施,以提高教育过程的质量。
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引用次数: 0
ROLE OF NF-κB TRANSCRIPTION FACTOR ACTIVATION IN THE PROCESSES OF CONNECTIVE TISSUE COMPONENTS DEGRADATION IN SKELETAL MUSCLES UNDER METABOLIC SYNDROME NF-κB 转录因子激活在代谢综合征下骨骼肌连接组织成分退化过程中的作用
O. Akimov, A. Mykytenko, A. Mischenko, V. Kostenko
Connective tissue, encompassing both cellular and non-cellular elements, plays an important role in the progression of numerous pathological processes across various organs and tissues. Within skeletal muscle tissue, the extracellular matrix not only plays a structural and supporting function, but it is a complex multicomponent system that performs a number of regulatory functions. At present, the effect of activation of the transcription factor NF-κB on the quantitative and qualitative composition of the components of the extracellular matrix in skeletal muscles under metabolic syndrome development is insufficiently studied. The aim of this work is to study the effect of ammonium pyrrolidinedithiocarbamate on the concentration of glycosaminoglycans, the concentration of individual fractions of glycosaminoglycans, the content of free L-oxyproline and sialic acids in the biceps femoris muscle of rats under metabolic syndrome. The study was conducted on 24 male Wistar rats weighing 200-260 g, which were randomly divided into 4 groups of 6 animals each. The first was control; the second made up the metabolic syndrome modeling group. Metabolic syndrome was reproduced by adding a 20% fructose solution to the standard vivarium diet as the only source of drinking water. Metabolic syndrome was modelled for 60 days. The third group received ammonium pyrrolidinedithiocarbamate administration at a dose of 76 mg/kg intraperitoneally (i/p) three times a week for 60 days. The fourth group underwent combined treatment involving the administration of both ammonium pyrrolidinedithiocarbamate and metabolic syndrome modeling. In a 10% homogenate of the biceps femoris muscle, the total concentration of glycosaminoglycans, the concentration of the heparin-heparan fraction of glycosaminoglycans, the keratan-dermatan fraction of glycosaminoglycans, the chondroitin fraction of glycosaminoglycans, and the content of free L-oxyproline and sialic acids were assessed. The introduction of ammonium pyrrolidinedithiocarbamate under metabolic syndrome modelling led to a decrease in the total concentration of glycosaminoglycans by 9.2% compared to the metabolic syndrome group. Under these conditions, the concentration of the heparin-heparan fraction increased by 121.1%, the keratan-dermatan fraction decreased by 32.8%, and the concentration of the chondroitin fraction decreased by 38.7% compared to the metabolic syndrome group. The concentration of free L-oxyproline and sialic acids in the biceps femoris muscle decreased by 19.8% and 24.4%, respectively, compared to the metabolic syndrome group. Blockade of activation of the transcription factor NF-κB by intraperitoneal administration of ammonium pyrrolidinedithiocarbamate against the background of metabolic syndrome modelling leads to a decrease in the depolymerization of glycoproteins and proteoglycans, reduces the intensity of collagenolysis and leads to a redistribution of concentrations of individual fractions of glycosami
结缔组织包括细胞和非细胞元素,在各种器官和组织的众多病理过程中发挥着重要作用。在骨骼肌组织内,细胞外基质不仅起着结构和支撑作用,而且是一个复杂的多成分系统,具有多种调节功能。目前,对代谢综合征发生过程中转录因子 NF-κB 的激活对骨骼肌细胞外基质成分的定量和定性组成的影响研究不足。本研究旨在探讨吡咯烷二硫代氨基甲酸铵对代谢综合征大鼠股二头肌中糖胺聚糖浓度、糖胺聚糖单个组分浓度、游离 L-氧脯氨酸和硅酸含量的影响。研究对象是 24 只体重为 200-260 克的雄性 Wistar 大鼠,随机分为 4 组,每组 6 只。第一组为对照组;第二组为代谢综合征模型组。在标准饲养室饮食中添加 20% 的果糖溶液,作为唯一的饮用水源,从而再现代谢综合征。代谢综合征模拟期为 60 天。第三组接受吡咯烷二硫代氨基甲酸铵治疗,剂量为 76 毫克/千克,腹腔注射(i/p),每周三次,持续 60 天。第四组接受吡咯烷二硫代氨基甲酸铵和代谢综合征模型的联合治疗。在股二头肌 10%的匀浆中,评估了糖胺聚糖的总浓度、糖胺聚糖中肝素-天冬氨糖部分、糖胺聚糖中角蛋白-麦角糖部分、糖胺聚糖中软骨素部分的浓度,以及游离 L-氧脯氨酸和硅酸的含量。与代谢综合征组相比,在代谢综合征模型下引入吡咯烷二硫代氨基甲酸铵可使糖胺聚糖的总浓度降低 9.2%。在这些条件下,与代谢综合征组相比,肝素-天冬酰胺部分的浓度增加了 121.1%,角蛋白-麦角固醇部分的浓度降低了 32.8%,软骨素部分的浓度降低了 38.7%。与代谢综合征组相比,股二头肌中游离 L-氧脯氨酸和硫辛酸的浓度分别下降了 19.8%和 24.4%。在代谢综合征建模的背景下,通过腹腔注射吡咯烷二硫代氨基甲酸铵阻断转录因子 NF-κB 的激活,可减少糖蛋白和蛋白聚糖的解聚、降低胶原蛋白溶解的强度,并导致糖胺聚糖各部分浓度的重新分布,其特点是大鼠股二头肌中肝素-天冬酰胺部分含量增加,软骨素和角蛋白-麦角固醇部分含量减少。
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引用次数: 0
IN SILICO PREDICTION OF POTENTIAL DERMATOLOGICAL EFFECTS OF A SYNTHETIC ANTIOXIDANT 合成抗氧化剂对皮肤病潜在影响的硅学预测
O. Y. Baliuk, E.M. Vazhnichaya
Nowadays, in silico prediction has become standard in the development of new drugs. Computer screening of known drugs provides an efficient approach to repurposing these agents for new indications. This sparked our interest in conducting an in silico analysis of ethylmethylhydroxypyridine succinate (EMHPS) for pharmacological effects potentially useful in dermatology. The aim of this study is to perform an in silico search for the effects of the synthetic antioxidant EMHPS that are potentially useful for the treatment of skin diseases. Retrospective computer prediction of the EMGPS structure was performed using the Drug2ways methodical approach and the PASS (Prediction of Activity Spectra for Substances) program online. The EMHPS molecule consists of two active fragments, which were analyzed separately. In the structure of 2-ethyl-6-methyl-3-hydroxypyridine, 125 types of activity were predicted, while in succinate - 734 types of activity. From the array of prognostic data, effects that may be relevant for the treatment of skin diseases were extracted. These include anti-seborrheic, anti-alopecia, anti-eczema, anti-pruritic, and anti-infectious effects, as well as photosensitizing action and lack of skin irritation. According to the forecast, these effects may be due to the influence of the components of the EMHPS molecule on membranes, antioxidant protection, the state of connective tissue, enzymes, and signaling pathways involved in the development of inflammation, as well as on the pathogenicity factors of microorganisms. Therefore, in silico screening of new types of activity in EMHPS allowed us to predict some effects useful in the treatment of dermatological pathology. Undoubtedly, the results of the forecast must be verified by practice, but they allow us to create a working hypothesis and approach the planning of experiments more rationally, which corresponds to modern trends in pharmacology.
如今,硅学预测已成为新药开发的标准。对已知药物进行计算机筛选为将这些药物重新用于新的适应症提供了一种有效的方法。这激发了我们对琥珀酸乙基甲基羟基吡啶(EMHPS)的潜在皮肤病药理作用进行硅学分析的兴趣。本研究的目的是对合成抗氧化剂 EMHPS 可能用于治疗皮肤病的作用进行硅学搜索。使用 Drug2ways 方法和 PASS(物质活性光谱预测)在线程序对 EMGPS 结构进行了回顾性计算机预测。EMHPS 分子由两个活性片段组成,分别进行了分析。在 2-乙基-6-甲基-3-羟基吡啶结构中,预测出 125 种活性,而在琥珀酸结构中,预测出 734 种活性。从一系列预后数据中,提取出了可能与治疗皮肤病有关的作用。其中包括抗脂溢性、抗脱发、抗湿疹、抗瘙痒和抗感染作用,以及光敏作用和无皮肤刺激性。根据预测,这些作用可能是由于 EMHPS 分子中的成分对膜、抗氧化保护、结缔组织状态、酶、参与炎症发展的信号通路以及微生物致病因子的影响。因此,通过对 EMHPS 中新型活性的硅学筛选,我们可以预测一些对皮肤病治疗有用的效果。毫无疑问,预测的结果必须通过实践来验证,但它们使我们能够建立一个工作假设,并更合理地规划实验,这符合现代药理学的发展趋势。
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引用次数: 0
DENTAL CARIES IN CHILDREN OF POLTAVA BEFORE AND DURING THE FIRST YEAR OF WAR (retrospective analysis over 20 years) 战争前和战争第一年波尔塔瓦儿童的牙科疾病(20 年的回顾性分析)
A. S. Mosiienko, S. S. Bauman, O. Sheshukova
Due to the military conflict and the COVID-19 pandemic, Ukraine and the city of Poltava are facing challenges in medical services, including dentistry. Analyzing the dynamics of caries treatment in children in Poltava before and during the war is crucial for assessing the impact of wartime on the municipal dental care system. The aim of this study is to analyze the dynamics of caries treatment in children based on annual reports from the Municipal Pediatric Clinical Dental Polyclinic before and during the wartime. A retrospective analysis of the statistical reporting of the Municipal Pediatric Clinical Dental Polyclinic for the years 2002, 2012, and 2018-2022 was conducted. During the analysis, annual indicators of the Polyclinic were studied, including the total number of visits, number of primary visits, number of treated teeth due to caries and its complications in temporary and permanent teeth. Calculations included the average number of visits per person, the proportion of complicated caries in temporary and permanent teeth, and the quality indicator of complicated caries treatment. The study revealed a 51.43% decrease in clinic visits over the last 20 years. In 2022, there was a sharp increase in primary visits to 24,655, possibly due to internally displaced children. The number of filled permanent teeth increased by 25% in 2022 compared to 2021. The proportion of complicated caries in temporary teeth significantly rose from 0.23 to 0.84 from 2002 to 2022. Additionally, there was a 25% increase in the absolute values of the quality indicator of complicated caries treatment in temporary teeth from 2002 to 2012 and a 12% increase up to 2022, indicating a rise in the number of cases of treating complicated caries in temporary teeth by extraction. These findings highlight the need for further research on the war's impact on the prevalence of caries and its complications in the pediatric population. This research is crucial for developing effective strategies for the prevention and treatment of dental diseases.
由于军事冲突和 COVID-19 大流行,乌克兰和波尔塔瓦市在医疗服务(包括牙科)方面面临挑战。分析战争前和战争期间波尔塔瓦市儿童龋齿治疗的动态对于评估战争对该市牙科保健系统的影响至关重要。本研究的目的是根据战前和战时市儿童临床牙科综合诊所的年度报告分析儿童龋齿治疗的动态。研究对市儿科临床口腔综合门诊2002年、2012年和2018-2022年的统计报告进行了回顾性分析。在分析过程中,研究了综合诊所的年度指标,包括就诊总人数、初诊人数、因龋齿及其并发症治疗的暂牙和恒牙数量。计算包括每人平均就诊次数、临时牙和恒牙中复杂龋齿的比例以及复杂龋齿治疗的质量指标。研究显示,在过去 20 年中,门诊量减少了 51.43%。2022 年,初级门诊量急剧增加到 24 655 人次,这可能是由于境内流离失所儿童造成的。与 2021 年相比,2022 年填补的恒牙数量增加了 25%。从 2002 年到 2022 年,临时牙的复杂龋齿比例从 0.23 显著上升到 0.84。此外,从 2002 年到 2012 年,临时牙复杂龋齿治疗质量指标的绝对值增加了 25%,到 2022 年增加了 12%,这表明通过拔牙治疗临时牙复杂龋齿的病例数有所增加。这些发现突出表明,有必要进一步研究战争对儿科人群龋病及其并发症发病率的影响。这项研究对于制定预防和治疗牙科疾病的有效策略至关重要。
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引用次数: 0
INDICATORS OF CENTRAL HEMODYNAMICS IN ACQUIRED MYOPIA 后天性近视的中央血液动力学指标
А.Yu. Ivasenko, V.І. Sheiko
Introduction. The presented study focuses on investigating the impact of acquired myopia on human central hemodynamics. Myopia, or nearsightedness, ranks as one of the most common ophthalmological disorders globally and in Ukraine, manifesting either congenitally or acquired over a lifetime. Ophthalmology specialists note a rapid increase in myopia cases across all age groups, with its prevalence posing a significant threat to vision and overall health. Viewing myopia as an adaptive response to a substantial visual strain one can presume that this adaptation might not be localized but generalized. The objective of the study is to examine the characteristics of central hemodynamics in individuals with acquired myopia. Materials and methods. The research was conducted on volunteers, 81 individuals aged 18 – 35, who were divided into a control group of 40 persons and a study group of 41 individuals diagnosed as having myopia. The diagnosis was established by specialists in Dnipro. The study was carried out at the General Practice Family Medicine Clinic No. 7 in Dnipro during 2022-2023. Central hemodynamic status was characterized by the following indicators: heart rate, systolic and diastolic blood pressure, pulse pressure, systolic blood volume, and minute blood volume. The Kerdo’s vegetative index was also calculated.  Results. The study revealed that acquired myopia was accompanied by an increase in the absolute values of heart rate, systolic blood pressure, diastolic blood pressure, pulse pressure, and minute blood volume compared to the control group of volunteers. It is noteworthy that the systolic blood volume in the context of acquired myopia was lower than in the control group. The Kerdo’s index was higher in the group with acquired myopia compared to the control group. The obtained results indicate a certain dependency between central hemodynamics indicators, the Kerdo’s index value, and acquired myopia, which is an adaptive reaction of the visual system to significant loads in the modern information-cybernetic society. Changes in central hemodynamics indicators in individuals with myopia may reflect certain adaptive reactions of the cardiovascular system to this eye refraction disorder.
介绍。本研究的重点是调查后天性近视对人体中枢血液动力学的影响。近视或近视眼是全球和乌克兰最常见的眼科疾病之一,表现为先天性或后天性。眼科专家指出,各年龄段的近视病例都在迅速增加,其发病率对视力和整体健康构成了重大威胁。近视是对巨大视觉压力的一种适应性反应,因此可以推测这种适应性反应可能不是局部性的,而是普遍性的。本研究的目的是检查后天性近视患者的中枢血流动力学特征。材料和方法。研究对象是 81 名年龄在 18-35 岁之间的志愿者,他们被分为由 40 人组成的对照组和由 41 名被诊断为近视的人组成的研究组。诊断结果由第聂伯罗州的专家确定。研究于 2022-2023 年期间在第聂伯罗第 7 全科家庭医疗诊所进行。中心血流动力学状态通过以下指标进行描述:心率、收缩压和舒张压、脉搏压、收缩压血容量和分钟血容量。此外,还计算了凯尔多植物人指数。 结果研究显示,与对照组志愿者相比,后天性近视伴随着心率、收缩压、舒张压、脉压和分钟血容量绝对值的增加。值得注意的是,后天性近视患者的收缩压低于对照组。与对照组相比,后天性近视组的凯尔多指数较高。研究结果表明,中枢血液动力学指标、凯尔多指数值与获得性近视之间存在一定的依赖关系,这是视觉系统对现代信息-网络社会重大负荷的一种适应性反应。近视患者中枢血液动力学指标的变化可能反映了心血管系统对这种眼睛屈光障碍的某些适应性反应。
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引用次数: 0
RETROSPECTIVE ANALYSIS OF CLINICAL, EPIDEMIOLOGY AND PATHOMORPHOLOGICAL FEATURES OF MYOCARDIAL INFARCTION 心肌梗塞的临床、流行病学和病理形态学特征的回顾性分析
N. Tkachenko, O. Protsenko, N. Remnyova, L. Chumak, O. Maznyi
The aim of this study is to conduct a retrospective analysis of the clinical, epidemiological, and pathomorphological features of myocardial infarction. Materials and methods: A retrospective analysis was conducted using data from medical records and autopsy results from the pathology department for the year 2023. Results. In 2023, the pathology department performed 182 autopsies, with 123 patients diagnosed with acute, repeated, or recurrent myocardial infarction (MI), accounting for 67.6% of all autopsies. The average age of the deceased was 74.4±0.9 years, with 81.3% being persons of incapacitated age. Women comprised the majority at 55.3% (T=2784.5; p=0.001). The highest proportion of MI-related deaths occurred in September, accounting for 12.2%. In the pathological diagnosis, myocardial infarction (MI) was the primary disease, with varying localization of the pathological process in the left ventricle. Transmural MI was detected in 95.9% of the deceased, while subendocardial MI was found in 4.1%. Acute MI developed against the background of a previously experienced MI in 43.9% of cases, and in 5.5% of cases, it was a repeated acute recurrent MI. Changes in the aorta, coronary vessels, and basal vessels of the brain were observed in 100.0% of the cases, with hypertensive disease detected in 95.9% of cases. Acute cardiopulmonary failure with the development of pulmonary edema was the immediate cause of death in 95.9% of cases. Macroscopic examination revealed hypertrophy of the left ventricle. The myocardium appeared reddish-brown and elastic, with white layers. Brown-gray infarct areas of different sizes were present in the left ventricular wall, while in cases of repeated acute myocardial infarction, the affected area was gray-white and hard to the touch. Microscopically, hypertrophy of cardiomyocytes of the left ventricle with perinuclear lipofuscinosis was observed in all deceased individuals. Sections of the infarct zone contained homogenized, anucleated, fragmented cardiomyocytes, dilated full blood vessels with small perivascular hemorrhages, and neutrophilic-macrophage infiltrates of varying intensity. Large centers of cardiosclerosis were detected in cases of repeated MI, while signs of angiogenesis with the formation of granulation tissue were observed in cases of recurrent MI. Conclusion. In 2023, 123 autopsies revealed a diagnosis of acute, repeated, or recurrent myocardial infarction (MI) in 67.6% of all cases. The average age of the deceased was 74.4±0.9 years, with 81.3% being individuals of incapacitated age. There was a predominance of women, accounting for 55.3% of cases. Acute MI developed against the background of a previously experienced one in 43.9% of the deceased, while repeated acute recurrent MI was detected in 5.5% of cases. Pathomorphological changes corresponded to the typical features of MI depending on its age.
本研究旨在对心肌梗死的临床、流行病学和病理形态学特征进行回顾性分析。材料和方法利用病理科 2023 年的病历数据和尸检结果进行回顾性分析。结果2023 年,病理部门共进行了 182 例尸检,其中 123 例患者被诊断为急性、反复或复发性心肌梗死(MI),占所有尸检的 67.6%。死者的平均年龄为(74.4±0.9)岁,81.3%为无行为能力者。女性占多数,为55.3%(T=2784.5;P=0.001)。与心肌梗死相关的死亡发生在 9 月份的比例最高,占 12.2%。在病理诊断中,心肌梗死(MI)是主要疾病,病理过程在左心室的定位各不相同。在 95.9% 的死者中发现了横纹肌心肌梗死,而在 4.1% 的死者中发现了心内膜下心肌梗死。43.9%的病例是在曾发生过急性心肌梗死的背景下发生的急性心肌梗死,5.5%的病例是反复发生的急性复发性心肌梗死。100.0%的病例观察到主动脉、冠状血管和脑基底血管的变化,95.9%的病例检测到高血压疾病。在 95.9% 的病例中,出现肺水肿的急性心肺功能衰竭是直接死因。宏观检查显示左心室肥大。心肌呈红褐色,富有弹性,有白色层次。左心室壁上有大小不等的棕灰色梗死区,而在反复急性心肌梗死的病例中,患处呈灰白色,触感较硬。显微镜下观察,所有死者的左心室心肌细胞肥大,核周出现脂褐质沉着。梗死区的切片中含有均质化、无核、碎裂的心肌细胞、扩张的全血管和小的血管周围出血,以及不同程度的中性粒细胞-巨噬细胞浸润。在反复发生心肌梗死的病例中发现了大面积的心脏硬化中心,而在反复发生心肌梗死的病例中观察到了血管生成和肉芽组织形成的迹象。结论在 2023 年的 123 例尸检中,67.6% 的病例被诊断为急性、反复或复发性心肌梗死(MI)。死者的平均年龄为(74.4±0.9)岁,81.3%为无行为能力者。女性占多数,占 55.3%。43.9%的死者是在曾发生过急性心肌梗死的背景下发生的,5.5%的病例是反复急性复发性心肌梗死。病理形态学变化与心肌梗死的典型特征相符,这取决于心肌梗死的年龄。
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引用次数: 0
“COGNITIVE FRAGMENTATION” AS A CONSEQUENCE OF CLIP THINKING AND ITS IMPACT ON MODERN SOCIETY EVOLUTION 片段式思维造成的 "认知碎片化 "及其对现代社会进化的影响
A. Mohylnyk, L. Vishnikina, K. Tarasenko, S. Suprunenko, A. Davydenko
In today’s information-saturated world, individuals are inundated with verbal and visual messages, leading to the development of what is termed “clip thinking” as an adaptive response. This phenomenon, characterized by constant interaction with superficial and nonsensical texts, alongside continuous internet browsing, has profound implications beyond mere cognition. Clip thinking, a systemic issue, extends its influence beyond cognitive processes. Its roots lie in the transmission of information through modern gadgets, the ubiquity of the internet, and the prevalence of clip culture. Modern youth, constrained by the small screens of digital devices and the constant scrolling of text, are increasingly averse to engaging with complex material, resulting in decreased information retention and comprehension. This shift in information consumption habits has concerning implications for higher education. Many students rely heavily on electronic aids, neglecting memorization and overlooking the importance of understanding complex texts. Consequently, the prevalence of fragmented thinking among students leads to deficiencies in conceptual and critical thinking skills. Instead of engaging deeply with subject matter, students often resort to generalized concepts, overlooking causal connections. Carriers of clip thinking become vulnerable to any manipulations by the mass media, as the mosaic nature of their consciousness is capable perceive only what is happening right now and information provided through information and telecommunication gadgets without subjecting it to critical analysis. Hence, university lecturers face significant challenges as they endeavor to navigate the need for innovative teaching methodologies in light of the fragmented thinking prevalent among modern students. The searching for innovative teaching technologies should not solely aim at altering the thinking patterns of students with clip-like cognitive tendencies. Rather, the primary objective of modern educational technologies should be to foster the mental skills necessary for information analysis and synthesis, as well as the identification of similarities and differences, generalizations, and classifications within the information landscape. Hence, this topic retains its profound relevance in contemporary education.
在当今这个信息饱和的世界,人们被大量的语言和视觉信息淹没,从而产生了所谓的 "剪辑思维",作为一种适应性反应。这种现象的特点是不断与肤浅和无意义的文本互动,同时持续浏览互联网,其深远影响超越了单纯的认知。片段思维是一个系统性问题,其影响超出了认知过程。其根源在于现代小工具的信息传播、互联网的无处不在以及剪辑文化的盛行。现代年轻人受限于数字设备的小屏幕和不断滚动的文字,越来越不喜欢接触复杂的材料,导致信息保留和理解能力下降。这种信息消费习惯的转变对高等教育产生了令人担忧的影响。许多学生严重依赖电子辅助工具,忽视了记忆,忽略了理解复杂文本的重要性。因此,学生中普遍存在的碎片化思维导致了概念和批判性思维能力的缺陷。学生往往不深入研究主题,而是采用笼统的概念,忽视因果联系。片段思维的载体很容易受到大众传媒的操纵,因为他们的意识是马赛克的,只能感知当下发生的事情以及通过信息和电信小工具提供的信息,而不会对其进行批判性分析。因此,大学讲师面临着巨大的挑战,他们需要根据现代学生普遍存在的碎片化思维,努力探索创新的教学方法。寻求创新教学技术的目的不应仅仅是改变具有片段式认知倾向的学生的思维模式。相反,现代教育技术的主要目标应该是培养学生分析和综合信息的思维能力,以及在信息环境中识别异同、归纳和分类的能力。因此,本课题在当代教育中仍具有深刻的现实意义。
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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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