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

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A CLINICAL REVIEW OF DIAGNOSTIC BIOMARKERS AND THE ROLE OF THE GUT MICROBIOTA IN PRETERM INFANTS WITH NECROTIZING ENTEROCOLITIS 早产儿坏死性小肠结肠炎诊断生物标志物和肠道微生物群作用的临床回顾
Azerbaijan State
The purpose of this work is to clarify the latest opinions of clinicians about the pathogenesis, diagnosis and treatment of necrotic enterocolitis, as well as the role of microflora in the pathogenesis of this pathology. Material and methods. Search Strategy: A literature search was conducted in the following electronic databases: PubMed, Web of Science (Thomson Reuters), Scopus, Cochrane Library, SpringerLink, and EBSCOhost ScienceDirect. The search spanned 20 years, from 2000 to 2020. In this review, we included 39 articles on this topic, which were available in full text and analyzed through critical evaluation. Results.According to the literature, necrotizing enterocolitis is primarily attributed to prematurity, compounded by the disruption of intestinal microflora composition due to artificial feeding, leading to an inflammatory reaction in the immature intestine. Delayed detection of the initial signs of necrotizing enterocolitis exacerbates treatment outcomes. In clinical practice, two main dilemmas in necrotizing enterocolitis diagnosis arise. Firstly, distinguishing early necrotizing enterocolitis from sepsis can be challenging, resulting in delayed diagnosis and treatment. Secondly, the optimal timing for surgical intervention remains unclear. Conclusion. There is a need to elucidate the latest opinions of clinicians regarding the pathogenesis, diagnosis, and treatment of necrotizing enterocolitis, including the role of microflora in its pathogenesis. Treatment strategies should integrate various models of clinical prognosis and biomarkers to accurately diagnose and tailor therapy for necrotizing enterocolitis.
本文旨在阐明临床医生对坏死性小肠结肠炎的发病机制、诊断和治疗的最新观点,以及微生物菌群在该病症发病机制中的作用。材料和方法检索策略:在以下电子数据库中进行文献检索:PubMed、Web of Science(汤森路透)、Scopus、Cochrane Library、SpringerLink 和 EBSCOhost ScienceDirect。搜索时间跨度为 20 年,从 2000 年到 2020 年。在这篇综述中,我们收录了 39 篇有关该主题的文章,这些文章均有全文,并通过批判性评估进行了分析。结果.根据文献,坏死性小肠结肠炎主要归因于早产,加上人工喂养导致肠道微生物菌群失调,导致未成熟肠道出现炎症反应。延迟发现坏死性小肠结肠炎的初期症状会加重治疗效果。在临床实践中,坏死性小肠结肠炎的诊断存在两大难题。首先,区分早期坏死性小肠结肠炎和败血症可能很困难,从而导致诊断和治疗的延误。其次,手术干预的最佳时机仍不明确。结论。有必要阐明临床医生对坏死性小肠结肠炎的发病机制、诊断和治疗的最新观点,包括微生物在发病机制中的作用。治疗策略应整合各种临床预后模型和生物标志物,以准确诊断坏死性小肠结肠炎并进行针对性治疗。
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引用次数: 0
ALTERATIONS IN RAT ILEAL WALL METRICS FOLLOWING ADMINISTRATION OF A COMPLEX OF FOOD CHEMICAL ADDITIVES DURIGN THE EARLY STAGES OF THE EXPERIMENT 在实验早期阶段给大鼠施用复合食品化学添加剂后回肠壁指标的变化
Ya. O. Oliinichenko
The influence of exogenous factors is a common cause of digestive disorders. Food chemical additives are important in the list of harmful exogenous factors. Despite the availability of literature data on their adverse effects on various systems and organs, the information on their complex impact on the ileum is limited and requires further study. The present study aimed to determine the metric changes in the ileal wall of rats during the early stages of administration of a complex of food chemical additives including monosodium glutamate, sodium nitrite, and ponceau 4R. Materials and methods. The study was conducted on mature white rats, divided into control and experimental groups. The control group received saline, and the experimental group received a complex of food chemical additives prepared following the standard methodology for 1 and 4 weeks orally. Material sampling and morphometric studies were performed according to generally accepted methods. The following parameters of the ileum wall were determined: total average wall thickness and average thickness of the serous membrane, muscle layer, submucosal and mucosal layers lseparately. Results. Changes in the indicators were found after the first week of administration of the food additives complex. In particular, the total intestinal wall thickness increased by 1.51 times compared to the control; after the fourth week, this indicator slightly decreased, although it was 1.22 times higher than the control group (p<0.05). The average mucosal thickness was 1.67 and 1.35 higher than in the control group after the first and fourth week, respectively. The average thickness of the submucosal layer also changed; after the first week, this indicator was 1.12 times lower than the control one; after the fourth week, the indicator increased by 1.21 times and 1.34 times compared to the control group and the previous observation period (p<0.05), respectively. As for the muscular layer, compared to the control group, after the first week, this indicator was 1.58 times higher (p<0.05). After the fourth week, it was 1.19 times higher than the control group and 1.33 times lower than the previous period. The average thickness of the serous layer was 1.44 times higher after the first week and 1.58 times higher after the fourth week compared to the control group. Conclusion. Thus, the introduction of a complex of food chemical additives leads to metric changes in the ileal wall of the ileum at the early stages of the experiment due to hyperhydration of connective tissue, impaired blood circulation, and pericellular oedema of the structural components of all membranes.
外源性因素的影响是消化系统疾病的常见原因。食品化学添加剂是有害外源因素中的重要因素。尽管有文献数据表明它们对各系统和器官产生了不良影响,但关于它们对回肠的复杂影响的信息却很有限,需要进一步研究。本研究旨在确定大鼠在摄入复合食品化学添加剂(包括谷氨酸钠、亚硝酸钠和庞索 4R)的早期阶段回肠壁的指标变化。材料和方法研究对象为成熟白鼠,分为对照组和实验组。对照组口服生理盐水,实验组口服按照标准方法制备的食品化学添加剂复合物 1 周和 4 周。材料取样和形态计量研究按照公认的方法进行。测定了回肠壁的以下参数:总平均壁厚以及浆膜、肌肉层、粘膜下层和粘膜层的平均厚度。结果。在服用复合食品添加剂第一周后,各项指标都发生了变化。其中,肠壁总厚度比对照组增加了1.51倍;第四周后,该指标略有下降,但仍比对照组高出1.22倍(P<0.05)。第一周和第四周后,粘膜平均厚度分别比对照组高 1.67 倍和 1.35 倍。粘膜下层的平均厚度也发生了变化;第一周后,该指标比对照组低 1.12 倍;第四周后,该指标比对照组和前一观察期分别增加了 1.21 倍和 1.34 倍(P<0.05)。至于肌肉层,与对照组相比,第一周后,该指标增加了 1.58 倍(P<0.05)。第四周后,该指标比对照组高 1.19 倍,比前一期低 1.33 倍。与对照组相比,血清层的平均厚度在第一周后增加了 1.44 倍,在第四周后增加了 1.58 倍。结论。因此,引入食品化学添加剂复合物后,由于结缔组织水分过多、血液循环受阻以及所有膜的结构成分的细胞周水肿,导致回肠回肠壁在实验早期就发生了指标性变化。
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引用次数: 0
STUDY OF ANTIBIOTIC RESISTANCE AT REGIONAL LEVEL 地区抗生素耐药性研究
O.A. Lutsenko, G. Ostrovska, Yu.M. Lavrenyuk, T.A. Petrova, R.V. Lutsenko
The introduction of antibiotics revolutionized medicine, dramatically reducing deaths and illnesses caused by infections. However, decades of overuse have accelerated the evolution of microorganisms, leading to a critical challenge: antibiotic resistance. This research aims to investigate the regional risk factors contributing to antibiotic resistance among the Poltava region population. Materials and methods. 100 patients of the 2nd Municipal Clinical Hospital and the Regional (Republican) Center for Emergency Medical Aid and Disaster Medicine of Poltava were included in the study. Data collection was carried out from November 2023 to March 2024. Patients were offered a series of 11 questions. Research results. This study has revealed the following antibiotic usage patterns among the residents of the Poltava region. It has been found that 22% of respondents are currently undergoing treatment, 8% in the last month, 36% in the last year, and 34% of the respondents tool the treatment for more than a year. When using antibiotics without a prescription, 30% of patients consulted a pharmacy, 52% trusted the Internet, 10% chose the cheapest medicine, and 8% followed advertisements. For subsequent illnesses, 76% of respondents used antibiotics they had taken before: amoxicillin (42%), ciprofloxacin (28%), azithromycin (22%), and chloramphenicol (8%). While 80% reported following prescribed antibiotic regimens, 20% interrupted treatment prematurely due to perceived improvement. Despite 84% acknowledging the importance of completing antibiotic courses, a concerning 16% were unaware of this crucial practice. Interestingly, 11% reported using antibiotics for preventive purposes (before getting sick). However, a positive trend emerged: 85% of respondents confirmed undergoing testing for bacterial susceptibility before receiving antibiotics. Only 9% reported amoxicillin as ineffective. When antibiotics were ineffective, 46% of respondents consulted a doctor, 24% took no action and waited for the antibiotic to take effect, 21% stopped one antibiotic and started another, and 14% preferred intramuscular injections and self-medication. Conclusion. A significant number of patients (48%) take antibacterial drugs without a doctor's prescription and 52% search for information on the Internet. 76% of patients use the same drug for a recurrent disease. Amoxicillin is the most often preferred (42%), a smaller number of patients came to the pharmacy for ciprofloxacin (28%), 22% of respondents preferred azithromycin. This study underscores the necessity for public health interventions to tackle antibiotic misuse and misconceptions in the Poltava region. Promoting responsible usage, emphasizing the importance of completing treatment courses, and discouraging self-medication are crucial steps in combating the growing threat of antibiotic resistance.
抗生素的问世彻底改变了医学,大大减少了因感染而导致的死亡和疾病。然而,数十年的过度使用加速了微生物的进化,导致了一个严峻的挑战:抗生素耐药性。本研究旨在调查导致波尔塔瓦地区人口产生抗生素耐药性的地区风险因素。材料与方法100 名波尔塔瓦市第二临床医院和地区(共和国)紧急医疗援助和灾难医学中心的患者被纳入研究范围。数据收集工作于 2023 年 11 月至 2024 年 3 月进行。向患者提出了一系列共 11 个问题。研究结果。这项研究揭示了波尔塔瓦州居民使用抗生素的模式。调查发现,22%的受访者目前正在接受治疗,8%的受访者在上个月接受治疗,36%的受访者在去年接受治疗,34%的受访者使用治疗工具的时间超过一年。在没有处方的情况下使用抗生素时,30% 的患者咨询药店,52% 相信互联网,10% 选择最便宜的药物,8% 遵循广告。在随后的疾病中,76% 的受访者使用了以前服用过的抗生素:阿莫西林(42%)、环丙沙星(28%)、阿奇霉素(22%)和氯霉素(8%)。80%的患者表示遵照处方使用抗生素,20%的患者因认为病情有所好转而过早中断治疗。尽管 84% 的人承认完成抗生素疗程的重要性,但仍有 16% 的人没有意识到这一重要做法。有趣的是,有 11% 的人表示使用抗生素是出于预防目的(在生病之前)。然而,一个积极的趋势出现了:85% 的受访者确认在接受抗生素治疗前进行了细菌药敏试验。只有 9% 的受访者表示阿莫西林无效。当抗生素无效时,46% 的受访者会咨询医生,24% 的受访者不采取任何措施,等待抗生素生效,21% 的受访者停止使用一种抗生素并开始使用另一种抗生素,14% 的受访者选择肌肉注射和自行用药。结论相当多的患者(48%)在没有医生处方的情况下服用抗菌药物,52%的患者在互联网上搜索相关信息。76%的患者使用同一种药物治疗反复发作的疾病。阿莫西林是最常见的首选药物(42%),来药房购买环丙沙星的患者人数较少(28%),22%的受访者首选阿奇霉素。这项研究强调了在波尔塔瓦州采取公共卫生干预措施解决抗生素滥用和误解问题的必要性。提倡负责任地使用抗生素、强调完成疗程的重要性以及阻止自行用药是应对日益严重的抗生素耐药性威胁的关键步骤。
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引用次数: 0
IMPACT OF CORONARY ARTERY DISEASE ON STEATOTIC LIVER DISEASE PROGRESSION 冠状动脉疾病对脂肪肝进展的影响
I.O. Pilat, I.M. Skrypnyk
Introduction. Metabolic dysfunction-associated steatotic liver disease and coronary artery disease often exacerbate each other, leading to a more severe course of both conditions. The aim of this study is to evaluate the role of coronary artery disease in dislipidemia and liver fibrosis progression in patients with metabolic dysfunction-associated steatotic liver disease. Materials and methods. Forty-six patients with metabolic dysfunction-associated steatotic liver disease were examined. Patients were divided into two groups based on the presence of concomitant coronary artery disease: group I (n=24) included patients with both metabolic dysfunction-associated steatotic liver disease and coronary artery disease, while group II (n=22) included patients with metabolic dysfunction-associated steatotic liver disease only. A third group (Group III) comprised healthy individuals. Specific lipid metabolism parameters, obesity stage, alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyl transpeptidase (GGT) activity, and platelet count were examined. Fibrosis stage was evaluated using the FIB-4 score. The findings obtained were statistically processed. Results. Arterial hypertension was more prevalent in patients with metabolic dysfunction-associated steatotic liver disease and concomitant coronary artery disease. In group I, arterial hypertension was observed in 95.8% of cases, whereas in group II, it was observed in 40.9% of cases (χ2=16.35, p=0.00005). Patients with metabolic dysfunction-associated steatotic liver disease exhibited elevated levels of total cholesterol, low-density lipoproteins, and triglycerides, leading to an increased atherogenic index. Conversely, high-density lipoprotein levels were decreased (p>0.05). The degree of fibrosis according to the FIB-4 score was 1.45 times higher in patients with metabolic dysfunction-associated steatotic liver disease and concomitant coronary artery disease compared to those without coronary artery disease.
导言。代谢功能障碍相关性脂肪性肝病和冠状动脉疾病往往会相互加重,导致两种疾病的病程更加严重。本研究旨在评估冠状动脉疾病在代谢功能障碍相关性脂肪肝患者的血脂异常和肝纤维化进展中的作用。材料和方法研究对象为 46 例代谢功能障碍相关性脂肪肝患者。根据是否同时患有冠状动脉疾病将患者分为两组:第一组(24 人)包括同时患有代谢功能障碍相关性脂肪肝和冠状动脉疾病的患者,第二组(22 人)包括仅患有代谢功能障碍相关性脂肪肝的患者。第三组(第三组)由健康人组成。对特定的脂质代谢参数、肥胖分期、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、γ-谷氨酰转肽酶(GGT)活性和血小板计数进行了检查。使用 FIB-4 评分对纤维化阶段进行评估。所得结果经统计学处理。结果显示动脉高血压在代谢功能障碍相关性脂肪肝和合并冠状动脉疾病的患者中更为普遍。在第一组中,95.8%的病例观察到动脉高血压,而在第二组中,40.9%的病例观察到动脉高血压(χ2=16.35,P=0.00005)。代谢功能障碍相关脂肪性肝病患者的总胆固醇、低密度脂蛋白和甘油三酯水平升高,导致动脉粥样硬化指数增加。相反,高密度脂蛋白水平下降(P>0.05)。与无冠状动脉疾病的患者相比,代谢功能障碍相关性脂肪性肝病和并发冠状动脉疾病患者的纤维化程度根据 FIB-4 评分要高出 1.45 倍。
{"title":"IMPACT OF CORONARY ARTERY DISEASE ON STEATOTIC LIVER DISEASE PROGRESSION","authors":"I.O. Pilat, I.M. Skrypnyk","doi":"10.31718/2077-1096.24.2.44","DOIUrl":"https://doi.org/10.31718/2077-1096.24.2.44","url":null,"abstract":"Introduction. Metabolic dysfunction-associated steatotic liver disease and coronary artery disease often exacerbate each other, leading to a more severe course of both conditions. \u0000The aim of this study is to evaluate the role of coronary artery disease in dislipidemia and liver fibrosis progression in patients with metabolic dysfunction-associated steatotic liver disease. \u0000Materials and methods. Forty-six patients with metabolic dysfunction-associated steatotic liver disease were examined. Patients were divided into two groups based on the presence of concomitant coronary artery disease: group I (n=24) included patients with both metabolic dysfunction-associated steatotic liver disease and coronary artery disease, while group II (n=22) included patients with metabolic dysfunction-associated steatotic liver disease only. A third group (Group III) comprised healthy individuals. Specific lipid metabolism parameters, obesity stage, alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyl transpeptidase (GGT) activity, and platelet count were examined. Fibrosis stage was evaluated using the FIB-4 score. The findings obtained were statistically processed. \u0000Results. Arterial hypertension was more prevalent in patients with metabolic dysfunction-associated steatotic liver disease and concomitant coronary artery disease. In group I, arterial hypertension was observed in 95.8% of cases, whereas in group II, it was observed in 40.9% of cases (χ2=16.35, p=0.00005). Patients with metabolic dysfunction-associated steatotic liver disease exhibited elevated levels of total cholesterol, low-density lipoproteins, and triglycerides, leading to an increased atherogenic index. Conversely, high-density lipoprotein levels were decreased (p>0.05). The degree of fibrosis according to the FIB-4 score was 1.45 times higher in patients with metabolic dysfunction-associated steatotic liver disease and concomitant coronary artery disease compared to those without coronary artery disease.","PeriodicalId":24028,"journal":{"name":"Актуальні проблеми сучасної медицини: Вісник Української медичної стоматологічної академії","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141121096","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}
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
INTEGRATED APPROACH TO YOUTH MENTAL HEALTH 青少年心理健康综合方法
V.I. Horoshko, E.H. Khomenko, K.V. Sedykh, S.I. Danylchenko
This study aimed to analyze the mental health issues among students at the National University “Yuriy Kondratyuk Poltava Polytechnic”, taking into account the international experiences in implementing psychosocial diagnostic programs. Based on this analysis, recommendations were formulated for the effective implementation of programs aimed at enhancing the mental well-being of the Ukrainian student community. Materials and Methods: A total of 812 students from various specialties at Yuriy Kondratyuk Poltava Polytechnic National University participated in the study. The age range of the participants was between 18 and 22 years old, with 47% (382 individuals) being male and 53% (430 individuals) female, ensuring gender balance in the sample distribution and representing a diverse cross-section of respondents. The survey was conducted anonymously using a Google form, thereby upholding the principle of confidentiality in psychological research. Result and discussion. The survey revealed a correlation between military operations and an escalation in anxiety disorders among civilians and refugees within the Ukrainian context. However, there remains an incomplete understanding of the mental well-being of the youth demographic. Presently, numerous studies indicate a decline in the psycho-emotional state of Ukrainian students. A significant proportion of respondents reported feelings of depression, nervousness, loneliness, and anger, with an uptick in cases involving alcohol, tobacco, and sedative abuse. An investigation into the mental health of women within educational institutions, including female students and teachers, unveiled heightened levels of fear and diminished resilience to stressful situations. This methodological approach facilitated the organization of information, enabling an objective comprehension of the issue and the formulation of specific recommendations for future action. Notably, there is a pressing need to implement programs aimed at enhancing both mental and physical health. Initiatives incorporating physical activity, balanced nutrition, and relaxation techniques have demonstrated potential in reducing stress levels and fostering improved mental well-being among students. Conclusions: The proposed recommendations are geared towards enhancing mental health standards and mitigating the impact of psychological challenges on academic performance, social integration, and overall life satisfaction.
本研究旨在分析 "尤里-康德拉秋克-波尔塔瓦理工学院 "国立大学学生的心理健康问题,同时借鉴国际上实施社会心理诊断计划的经验。在此分析基础上,为有效实施旨在提高乌克兰学生群体心理健康水平的计划提出了建议。材料与方法:共有 812 名来自尤里-康德拉秋克-波尔塔瓦国立理工大学各专业的学生参与了研究。参与者的年龄范围在 18 至 22 岁之间,其中 47% (382 人)为男性,53% (430 人)为女性,确保了样本分布的性别平衡,并代表了受访者的不同横截面。调查使用谷歌表格匿名进行,从而维护了心理学研究的保密原则。结果与讨论。调查显示,军事行动与乌克兰平民和难民焦虑症的升级之间存在关联。然而,人们对青年人口的心理健康仍然缺乏全面了解。目前,许多研究表明,乌克兰学生的心理情感状况有所下降。相当大比例的受访者表示有抑郁、紧张、孤独和愤怒的感觉,酗酒、吸烟和滥用镇静剂的情况有所上升。对教育机构中女性(包括女学生和女教师)心理健康状况的调查显示,女性的恐惧心理和对压力环境的适应能力都有所增强。这种方法有助于整理信息,客观地理解问题,并为今后的行动提出具体建议。值得注意的是,迫切需要实施旨在增进身心健康的计划。包括体育锻炼、均衡营养和放松技巧在内的各种举措在降低压力水平和促进学生心理健康方面都显示出了潜力。结论提出的建议旨在提高心理健康标准,减轻心理挑战对学习成绩、社会融合和整体生活满意度的影响。
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引用次数: 0
ANALYSIS OF DENTAL CARE INDICATORS FOR CHILDREN BASED ON DATA FROM THE PEDIATRIC DENTAL CLINIC OF POLTAVA CITY 根据波尔塔瓦市儿童牙科诊所的数据分析儿童牙科保健指标
L. Kaskova, N. Yanko, V. V. Tovma, I. Vashchenko, L. P. Ulasevich
In the period from 2020 to 2023, the dental care system in Ukraine underwent significant changes considering the effects of healthcare reforms, the COVID-19 pandemic, and the ongoing conflict. The objective of this article is to assess the changes in the provision of general dental care at the Pediatric Dental Polyclinic in Poltava City over the past five years based on a retrospective analysis of statistical reports from 2019 to 2023. In 2019, emergency dental care accounted 9.69% of all visits. Complicated caries of permanent teeth was found in 2.28% of filled teeth, with light-cured resin fillings representing 29.52% of them. Periodontal diseases were detected in 0.62% of visits. Preventive examinations comprises a significant portion of visits, 86.43% of visits; 94.66% of children who needed dental sanitation received full treatment. Preventive measures including fissure sealing, remineralizing therapy, and supervised tooth brushing played a significant role in these outcomes. In 2020, the number of visits dramatically decreased, but the share of emergency dental care increased to 11.65%, compared to 2019 (p < 0.0001). The number of filled teeth decreased, while the percentage of complicated caries of permanent teeth increased to 4.09% (p < 0.0001). The proportion of fillings made of light-cured resins rose to 40.19%, representing a 1.36-fold increase (p < 0.0001). Preventive examinations accounted for 26.47% of visits, and 88.47% of examined children in need of dental sanitation were fully treated. However, the share of preventive measures and the number of visits for children with periodontal disease dropped. In 2021, the number of preventive examinations increased to 49.49% of visits. The percentage of complicated caries of permanent teeth in the filling structure rose to 4.93% compared to 2020 (p < 0.0001). The share of fillings made of light-cured resins reached 51.19%, and the rate of children receiving treatment under anesthesia increased (p < 0.0001). Indicators of preventive measures, which received less attention during quarantine, continued to decline. In 2022, complicated caries of permanent teeth constituted 4.96% of fillings that was higher than in 2021 (p < 0.0001). The proportion of preventive examinations significantly decreased to 33.45% (p < 0.0001), and the percentage of treated children among those who needed treatment dropped to 77.5%. Pedodontists started paying more attention to periodontal disease, preventive care, and treatment under anesthesia, which increased significantly. In 2023, the share of complicated caries of permanent teeth increased to 5.53% (p < 0.0001). The number of children treated under local or general anesthesia increased by 2.5 times. The number of visits for children with periodontal disease and indicators of preventive measures also increased (p < 0.001). In 2023, the share of preventive examinations was 36.28%, and the percentage of treated children among those who needed help decreased com
在 2020 年至 2023 年期间,考虑到医疗改革、COVID-19 大流行病和持续冲突的影响,乌克兰的牙科保健系统发生了重大变化。本文旨在根据对 2019 年至 2023 年统计报告的回顾性分析,评估波尔塔瓦市儿童牙科综合诊所在过去五年中提供的普通牙科护理的变化情况。2019 年,牙科急诊占就诊总数的 9.69%。2.28%的补过牙中发现了恒牙复杂性龋齿,其中光固化树脂补牙占 29.52%。在 0.62% 的就诊者中发现了牙周病。预防性检查占就诊人数的很大一部分,占 86.43%;94.66%需要进行牙科保健的儿童得到了全面治疗。包括窝沟封闭、再矿化治疗和监督刷牙在内的预防措施在这些结果中发挥了重要作用。与 2019 年相比,2020 年的就诊人数大幅减少,但牙科急诊的比例增至 11.65%(p < 0.0001)。补牙数量减少,而恒牙复杂龋齿的比例增加到 4.09%(p < 0.0001)。光固化树脂补牙的比例上升到 40.19%,增加了 1.36 倍(p < 0.0001)。预防性检查占就诊人数的 26.47%,88.47%需要进行牙齿卫生检查的儿童得到了全面治疗。然而,牙周病患儿的预防措施比例和就诊次数均有所下降。2021 年,预防性检查次数占就诊次数的比例增至 49.49%。与 2020 年相比,补牙结构中恒牙复杂龋齿的比例上升至 4.93%(p < 0.0001)。光固化树脂补牙的比例达到 51.19%,在麻醉下接受治疗的儿童比例有所上升(p < 0.0001)。在隔离期间不太受关注的预防措施指标继续下降。2022 年,恒牙复杂性龋齿占补牙的 4.96%,高于 2021 年(p < 0.0001)。预防性检查的比例大幅下降至 33.45%(p < 0.0001),需要治疗的儿童中接受治疗的比例下降至 77.5%。牙科医生开始更加关注牙周病、预防性护理和麻醉下治疗,这些方面的比例明显上升。2023 年,恒牙复杂性龋齿的比例增至 5.53%(p < 0.0001)。在局部或全身麻醉下接受治疗的儿童人数增加了 2.5 倍。儿童牙周病就诊次数和预防措施指标也有所增加(p < 0.001)。2023 年,预防性检查的比例为 36.28%,与 2022 年相比,需要帮助的儿童中接受治疗的比例有所下降(p < 0.0001),达到 79.29%。2020 年,Covid-19 导致学校牙科诊所关闭,大大减少了儿童牙科综合诊所的就诊人数,导致计划中的儿童卫生和预防措施大幅减少。2021 年,尽管就诊人数进一步减少,但儿童的计划卫生条件有所改善。2022 年,由于国内流离失所者的治疗,综合诊所的量化绩效指标有所改善。从 2019 年到 2023 年,光固化补牙的数量有所增加,反映了现代牙科的发展趋势。自 2022 年以来,牙周病治疗、预防措施和麻醉治疗的指标都有所上升。在 2020-2023 年期间,因复杂性龋齿而填充的恒牙数量有所增加,这可能是由于综合诊所为此类牙科援助提供了预算资金,也可能是由于年轻患者可能会延迟就医。2023 年,在计划的卫生保健期间得到完全治疗的患者人数减少的趋势得到了克服。有必要进一步分析儿童牙科援助指标,以便进行规划和提供资金,减少社会经济因素对儿童健康的影响。
{"title":"ANALYSIS OF DENTAL CARE INDICATORS FOR CHILDREN BASED ON DATA FROM THE PEDIATRIC DENTAL CLINIC OF POLTAVA CITY","authors":"L. Kaskova, N. Yanko, V. V. Tovma, I. Vashchenko, L. P. Ulasevich","doi":"10.31718/2077-1096.24.2.160","DOIUrl":"https://doi.org/10.31718/2077-1096.24.2.160","url":null,"abstract":"In the period from 2020 to 2023, the dental care system in Ukraine underwent significant changes considering the effects of healthcare reforms, the COVID-19 pandemic, and the ongoing conflict. The objective of this article is to assess the changes in the provision of general dental care at the Pediatric Dental Polyclinic in Poltava City over the past five years based on a retrospective analysis of statistical reports from 2019 to 2023. In 2019, emergency dental care accounted 9.69% of all visits. Complicated caries of permanent teeth was found in 2.28% of filled teeth, with light-cured resin fillings representing 29.52% of them. Periodontal diseases were detected in 0.62% of visits. Preventive examinations comprises a significant portion of visits, 86.43% of visits; 94.66% of children who needed dental sanitation received full treatment. Preventive measures including fissure sealing, remineralizing therapy, and supervised tooth brushing played a significant role in these outcomes. \u0000In 2020, the number of visits dramatically decreased, but the share of emergency dental care increased to 11.65%, compared to 2019 (p < 0.0001). The number of filled teeth decreased, while the percentage of complicated caries of permanent teeth increased to 4.09% (p < 0.0001). The proportion of fillings made of light-cured resins rose to 40.19%, representing a 1.36-fold increase (p < 0.0001). Preventive examinations accounted for 26.47% of visits, and 88.47% of examined children in need of dental sanitation were fully treated. However, the share of preventive measures and the number of visits for children with periodontal disease dropped. \u0000In 2021, the number of preventive examinations increased to 49.49% of visits. The percentage of complicated caries of permanent teeth in the filling structure rose to 4.93% compared to 2020 (p < 0.0001). The share of fillings made of light-cured resins reached 51.19%, and the rate of children receiving treatment under anesthesia increased (p < 0.0001). Indicators of preventive measures, which received less attention during quarantine, continued to decline. \u0000In 2022, complicated caries of permanent teeth constituted 4.96% of fillings that was higher than in 2021 (p < 0.0001). The proportion of preventive examinations significantly decreased to 33.45% (p < 0.0001), and the percentage of treated children among those who needed treatment dropped to 77.5%. Pedodontists started paying more attention to periodontal disease, preventive care, and treatment under anesthesia, which increased significantly. \u0000In 2023, the share of complicated caries of permanent teeth increased to 5.53% (p < 0.0001). The number of children treated under local or general anesthesia increased by 2.5 times. The number of visits for children with periodontal disease and indicators of preventive measures also increased (p < 0.001). In 2023, the share of preventive examinations was 36.28%, and the percentage of treated children among those who needed help decreased com","PeriodicalId":24028,"journal":{"name":"Актуальні проблеми сучасної медицини: Вісник Української медичної стоматологічної академії","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141123156","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}
引用次数: 0
ANALYSIS OF SURFACE QUALITY IN BASE ACRYLIC PLASTIC USING FLAW DETECTION METHOD 使用探伤方法分析丙烯酸塑料基材的表面质量
V.O. Kurilo, D.M. Korol, M.M. Maluchenko, A.M. Ramus
Before scanning the surface of the base acrylic plastic, ten samples were selected with a surface that had undergone all stages of finishing according to the proper dental protocol and ten samples that had previously been artificially damaged with scratches using sandpaper. This study addresses the assessment of the quality of removable orthopedic appliances concerning surface polishing and detection of microdefects. The research employs a comparative analysis of reference samples of base plastic and artificially damaged samples using flaw detection analysis. Prior to scanning the surface of the base acrylic plastic, ten samples underwent all stages of finishing according to dental protocol, while another ten samples were intentionally damaged with scratches using sandpaper. The macrophotographs obtained were processed using the "Image J" program, allowing for quantitative analysis of images, enabling the evaluation of surface quality through various parameters. This included evaluating the total number of defects, as well as the average area and perimeter of the defects. Statistical analysis conducted in the JUSP program enabled comparison between the two groups of samples, identifying significant quantitative differences. Based on the prominent indicators available in the Image J program, conclusions were drawn regarding the quality of the acrylic plastic surface and the factors influencing its condition through specific mechanical defects. The proposed method of light-optical flaw detection expands the clinical assessment capabilities of removable orthopedic structures (base plastic), particularly concerning potential bacterial contamination, which can serve as a significant factor in the formation of inflammation foci on the mucous membrane of the denture-supporting oral tissues. Flaw detection analysis enables a comprehensive assessment of material surface polishing quality and the detection of surface defects that may arise during production or use, thus preventing biofilm accumulation. The experiment demonstrated the effectiveness of light-optical flaw detection and highlights the potential for its further improvement and broader implementation in clinical practice.
在对基底丙烯酸塑料表面进行扫描之前,选择了十个样品,其中十个样品的表面已按照正确的牙科规程进行了所有阶段的抛光处理,另十个样品之前已使用砂纸人为地造成了划痕。这项研究旨在评估可移动矫形器的表面抛光和微缺陷检测质量。研究采用探伤分析法对基底塑料参考样本和人为损坏样本进行比较分析。在扫描基底丙烯酸塑料表面之前,十个样本按照牙科规程进行了所有阶段的抛光,而另外十个样本则被故意用砂纸划伤。使用 "Image J "程序对获得的微距照片进行处理,以便对图像进行定量分析,通过各种参数对表面质量进行评估。这包括评估缺陷总数以及缺陷的平均面积和周长。通过 JUSP 程序进行的统计分析,可以对两组样品进行比较,找出显著的数量差异。根据 Image J 程序提供的重要指标,得出了丙烯酸塑料表面质量的结论,以及通过特定机械缺陷影响其状况的因素。所提出的光-光缺陷检测方法扩展了可摘义齿矫形结构(基底塑料)的临床评估能力,特别是在潜在的细菌污染方面,这可能是义齿支撑口腔组织粘膜上形成炎症病灶的一个重要因素。瑕疵检测分析可以全面评估材料表面抛光质量,检测生产或使用过程中可能出现的表面瑕疵,从而防止生物膜的积累。该实验证明了光-光缺陷检测的有效性,并强调了其进一步改进和在临床实践中更广泛应用的潜力。
{"title":"ANALYSIS OF SURFACE QUALITY IN BASE ACRYLIC PLASTIC USING FLAW DETECTION METHOD","authors":"V.O. Kurilo, D.M. Korol, M.M. Maluchenko, A.M. Ramus","doi":"10.31718/2077-1096.24.2.74","DOIUrl":"https://doi.org/10.31718/2077-1096.24.2.74","url":null,"abstract":"Before scanning the surface of the base acrylic plastic, ten samples were selected with a surface that had undergone all stages of finishing according to the proper dental protocol and ten samples that had previously been artificially damaged with scratches using sandpaper. \u0000This study addresses the assessment of the quality of removable orthopedic appliances concerning surface polishing and detection of microdefects. The research employs a comparative analysis of reference samples of base plastic and artificially damaged samples using flaw detection analysis. \u0000Prior to scanning the surface of the base acrylic plastic, ten samples underwent all stages of finishing according to dental protocol, while another ten samples were intentionally damaged with scratches using sandpaper. The macrophotographs obtained were processed using the \"Image J\" program, allowing for quantitative analysis of images, enabling the evaluation of surface quality through various parameters. This included evaluating the total number of defects, as well as the average area and perimeter of the defects. Statistical analysis conducted in the JUSP program enabled comparison between the two groups of samples, identifying significant quantitative differences. Based on the prominent indicators available in the Image J program, conclusions were drawn regarding the quality of the acrylic plastic surface and the factors influencing its condition through specific mechanical defects. \u0000The proposed method of light-optical flaw detection expands the clinical assessment capabilities of removable orthopedic structures (base plastic), particularly concerning potential bacterial contamination, which can serve as a significant factor in the formation of inflammation foci on the mucous membrane of the denture-supporting oral tissues. Flaw detection analysis enables a comprehensive assessment of material surface polishing quality and the detection of surface defects that may arise during production or use, thus preventing biofilm accumulation. \u0000The experiment demonstrated the effectiveness of light-optical flaw detection and highlights the potential for its further improvement and broader implementation in clinical practice.","PeriodicalId":24028,"journal":{"name":"Актуальні проблеми сучасної медицини: Вісник Української медичної стоматологічної академії","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141120539","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}
引用次数: 0
DYNAMIC CHANGES IN HISTOLOGICAL AND MORPHOMETRIC INDICATORS OF THE LUNGS IN SEXUALLY IMMATURE RATS DURING SIMULATION OF PARTIAL TRACHEAL STENOSIS 模拟气管部分狭窄过程中性成熟大鼠肺组织学和形态学指标的动态变化
Yu.A. Molochek, S. I. Savosko
Introduction. The morphological features of the respiratory system in laryngomalacia remain insufficiently understood, particularly regarding structural, cytological, and functional alterations. The aim of this study is to investigate the morphological characteristics of the respiratory compartment in the lungs of sexually immature rats, conduct a morphometric assessment of lung tissue density, analyze the dynamics of erythrocyte mass and collagen accumulation, and identify correlations between these parameters. Materials and Methods: The study involved sexually immature male Wistar rats aged 25-28 days and weighing 40-55 g. Partial tracheal stenosis was induced in experimental animals using a developed method, restricting the tracheal lumen by 20-25%. The stenosis was maintained for 7 and 21 days in different groups. In one group, tracheal stenosis was relieved after 7 days by removing the compressive ligature. Histological, histochemical, and morphometric methods were employed to study changes in lung tissue. Results. Pathological changes in lung tissue during hypoxia were characterized by an increase in the number of different types of cells and erythrocyte mass, especially on the 21st day of the experiment and the removal of ligatures from the trachea in experimental animals. Disturbances in the microcirculation of the lung acini were manifested by a sharp increase in blood filling of the microvessels and expansion of their lumen. In this case, the process of erythrocyte penetration into the lumen of the alveoli was sometimes noted. The results of histochemical detection of collagen indicate that in the lung tissue of experimental animals there is no activation of fibrogenetic processes, which would be accompanied by a simultaneous increase in the specific density of collagen. Indicators characterizing the lung tissue (number of cells, their specific density) made it possible to evaluate the corresponding correlations. At the same time, they were not associated with the level of collagen or erythrocyte density in the studied loci of the respiratory system of experimental sexually immature rats. A significant increase in the specific density of erythrocyte mass in lung tissue did not depend on the duration of the experiment. Removal of the ligature and restoration of the tracheal lumen did not significantly affect the restoration of alveolar acini and the spectrum of identified cells. In addition, an increase in the specific density of lung tissue was observed. Conclusion. The findings of this study contribute to deeper understanding of lung damage in children with laryngomalacia and associated respiratory system ventilation impairment. The observed reactive changes in lung connective tissue and collagen synthesis during hypoxia do not necessarily indicate the development of respiratory system fibrosis. However, longer exposure to hypoxic conditions may increase the risk of fibrosis in children.
导言。人们对喉头畸形大鼠呼吸系统的形态特征,尤其是结构、细胞学和功能的改变仍缺乏足够的了解。本研究旨在调查性未成熟大鼠肺部呼吸系统的形态特征,对肺组织密度进行形态学评估,分析红细胞质量和胶原蛋白积累的动态变化,并确定这些参数之间的相关性。材料和方法:研究对象为年龄 25-28 天、体重 40-55 克的性未成熟雄性 Wistar 大鼠。采用一种已开发的方法诱导实验动物气管部分狭窄,使气管腔狭窄 20-25%。在不同组别中,气管狭窄分别维持了 7 天和 21 天。其中一组在 7 天后通过移除压迫性结扎解除了气管狭窄。采用组织学、组织化学和形态计量学方法研究肺组织的变化。结果缺氧时肺部组织的病理变化表现为不同类型细胞数量和红细胞数量的增加,尤其是在实验的第 21 天和去除气管结扎后。肺尖叶微循环的紊乱表现为微血管充血急剧增加和管腔扩张。在这种情况下,有时会注意到红细胞渗入肺泡腔的过程。胶原组织化学检测结果表明,在实验动物的肺组织中,没有激活纤维化过程,而纤维化过程会伴随着胶原蛋白特定密度的增加。肺组织的特征指标(细胞数量、比密度)使得评估相应的相关性成为可能。同时,这些指标与实验性未成熟大鼠呼吸系统研究部位的胶原蛋白水平或红细胞密度无关。肺组织中红细胞质量密度的明显增加与实验持续时间无关。去除结扎和恢复气管腔对肺泡尖头的恢复和已识别细胞的光谱没有明显影响。此外,还观察到肺组织的比密度有所增加。结论本研究的结果有助于加深对喉头水肿患儿肺损伤及相关呼吸系统通气障碍的认识。在缺氧过程中观察到的肺结缔组织和胶原合成的反应性变化并不一定表明呼吸系统纤维化的发生。然而,长时间暴露于缺氧条件下可能会增加儿童发生纤维化的风险。
{"title":"DYNAMIC CHANGES IN HISTOLOGICAL AND MORPHOMETRIC INDICATORS OF THE LUNGS IN SEXUALLY IMMATURE RATS DURING SIMULATION OF PARTIAL TRACHEAL STENOSIS","authors":"Yu.A. Molochek, S. I. Savosko","doi":"10.31718/2077-1096.24.2.113","DOIUrl":"https://doi.org/10.31718/2077-1096.24.2.113","url":null,"abstract":"Introduction. The morphological features of the respiratory system in laryngomalacia remain insufficiently understood, particularly regarding structural, cytological, and functional alterations. The aim of this study is to investigate the morphological characteristics of the respiratory compartment in the lungs of sexually immature rats, conduct a morphometric assessment of lung tissue density, analyze the dynamics of erythrocyte mass and collagen accumulation, and identify correlations between these parameters. Materials and Methods: The study involved sexually immature male Wistar rats aged 25-28 days and weighing 40-55 g. Partial tracheal stenosis was induced in experimental animals using a developed method, restricting the tracheal lumen by 20-25%. The stenosis was maintained for 7 and 21 days in different groups. In one group, tracheal stenosis was relieved after 7 days by removing the compressive ligature. Histological, histochemical, and morphometric methods were employed to study changes in lung tissue. Results. Pathological changes in lung tissue during hypoxia were characterized by an increase in the number of different types of cells and erythrocyte mass, especially on the 21st day of the experiment and the removal of ligatures from the trachea in experimental animals. Disturbances in the microcirculation of the lung acini were manifested by a sharp increase in blood filling of the microvessels and expansion of their lumen. In this case, the process of erythrocyte penetration into the lumen of the alveoli was sometimes noted. The results of histochemical detection of collagen indicate that in the lung tissue of experimental animals there is no activation of fibrogenetic processes, which would be accompanied by a simultaneous increase in the specific density of collagen. Indicators characterizing the lung tissue (number of cells, their specific density) made it possible to evaluate the corresponding correlations. At the same time, they were not associated with the level of collagen or erythrocyte density in the studied loci of the respiratory system of experimental sexually immature rats. A significant increase in the specific density of erythrocyte mass in lung tissue did not depend on the duration of the experiment. Removal of the ligature and restoration of the tracheal lumen did not significantly affect the restoration of alveolar acini and the spectrum of identified cells. In addition, an increase in the specific density of lung tissue was observed. Conclusion. The findings of this study contribute to deeper understanding of lung damage in children with laryngomalacia and associated respiratory system ventilation impairment. The observed reactive changes in lung connective tissue and collagen synthesis during hypoxia do not necessarily indicate the development of respiratory system fibrosis. However, longer exposure to hypoxic conditions may increase the risk of fibrosis in children.","PeriodicalId":24028,"journal":{"name":"Актуальні проблеми сучасної медицини: Вісник Української медичної стоматологічної академії","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141119165","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}
引用次数: 0
PECULIARITIES OF ADAPTATION AND COURSE OF POST-TRAUMATIC STRESS DISORDER IN SERVICEMEN DEPLOYED TO INTENSE COMBAT ZONES 被派往激烈战斗地区的军人创伤后应激障碍的适应特点和过程
I.O. Zolochevskyi
In the context of war, post-traumatic stress disorder (PTSD) emerges as one of the most prevalent psychological conditions, particularly among military personnel deployed in combat zones. The primary triggers for PTSD in military personnel often include the loss of comrades or the necessity to use lethal weapons, resulting in significant consequences. For PTSD to manifest, individuals must undergo a traumatic experience that exceeds normal human stress levels and leads to distress. The aim of this study is to investigate the course of PTSD in military personnel who have been exposed to intense combat operations and to explore their maladaptive manifestations. The study comprised 38 patients diagnosed with PTSD (F43.1) according to the ICD-10, who received treatment at the Regional Mental Health Care Institution for the Protection of the Armed Forces. All patients provided informed consent to participate in the study. A structured clinical diagnostic interview known as CAPS-DX was applied in this study. Developed based on the DSM-IV, this interview assesses the symptoms of posttraumatic stress disorder (PTSD), the duration of the disorder, and the degree of impairment of social functioning. The CAPS-DX scale provided insights into the presence of PTSD symptoms both currently and throughout the individual's life following psychotrauma. To diagnose psychosocial maladjustment and its characteristics, we employed the Psychosocial Maladjustment Scale by L. Herasymenko (2018). Clinical and anamnestic examinations revealed that 86% of servicemen had experienced multiple traumatic events, indicating a history of several psychotraumas. The study identified that the primary psychopathological manifestations of PTSD did not differ significantly from the traditional course of the disorder, but they were more intense and pronounced in this group of servicemen. The study has demonstrated that servicemen with combat experience and PTSD exhibited reduced levels of psychosocial adaptation. Their adaptive resources and capabilities, as well as their neuropsychological stability, were significantly diminished, along with a decrease in their communication abilities. Based on the overall level and quality of social and psychological adaptation, three levels of adaptation/maladaptation were distinguished among servicemen with combat-related PTSD: sufficient, partial, or maladaptation. It should be noted that the levels of adaptation were correlated with the severity of anxiety. Servicemen with sufficient adaptation typically exhibited low levels of anxiety, while those with partial adaptation showed an average level, and those with maladaptation displayed high levels of anxiety. The study revealed a spectrum of psychopathological manifestations in servicemen who were in the combat zone, ranging from semiotic complexes resembling panic attacks to psychogenic catalepsy. Furthermore, it was found that servicemen with combat experience and post-traumatic stress disor
在战争背景下,创伤后应激障碍(PTSD)成为最常见的心理疾病之一,特别是在部署在战区的军人中。军人创伤后应激障碍的主要诱因通常包括失去战友或必须使用致命武器,从而导致重大后果。要表现出创伤后应激障碍,个人必须经历超过正常人压力水平的创伤经历并导致痛苦。本研究的目的是调查经历过激烈战斗行动的军人的创伤后应激障碍病程,并探讨其适应不良表现。研究对象包括 38 名根据国际疾病分类-10 被诊断为创伤后应激障碍(F43.1)的患者,他们都在保护武装部队的地区心理保健机构接受了治疗。所有患者都在知情同意的情况下参与了研究。本研究采用了名为 CAPS-DX 的结构化临床诊断访谈。该访谈是根据 DSM-IV 编制的,用于评估创伤后应激障碍(PTSD)的症状、持续时间和社会功能受损程度。通过 CAPS-DX 量表,可以了解创伤后应激障碍症状的存在情况,包括当前症状和精神创伤后的终生症状。为了诊断心理社会适应不良及其特征,我们采用了 L. Herasymenko(2018 年)的心理社会适应不良量表。临床和肛门检查显示,86%的军人经历过多次创伤事件,表明他们有多次精神创伤史。研究发现,创伤后应激障碍的主要精神病理表现与该疾病的传统病程并无显著差异,但在这一军人群体中更为强烈和明显。研究表明,有战斗经历和创伤后应激障碍的军人表现出社会心理适应水平下降。他们的适应资源和能力以及神经心理的稳定性都明显减弱,沟通能力也有所下降。根据社会和心理适应的总体水平和质量,与战斗有关的创伤后应激障碍患者的适应/不适应程度分为三个等级:充分适应、部分适应或不适应。值得注意的是,适应水平与焦虑的严重程度相关。适应充分的军人通常表现出较低程度的焦虑,而部分适应的军人表现出一般程度的焦虑,适应不良的军人则表现出较高程度的焦虑。研究揭示了处于战区的军人的一系列精神病理学表现,从类似恐慌发作的符号综合症到精神性催眠。此外,研究还发现,有战斗经验和创伤后应激障碍的军人的社会心理适应水平较低,这与焦虑的严重程度有关。
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Актуальні проблеми сучасної медицини: Вісник Української медичної стоматологічної академії
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