Lviv clinical bulletin最新文献

{"title":"Species Spectrum of Bacterial Factors of Nosocomial Respiratory Infections in Hospitals of Lviv and the Prevalence of Antimicrobial Resistance Among Them","authors":"O. Korniychuk, R. Shykula, Yurii Khorkavyi, Y. Konechnyi","doi":"10.25040/lkv2022.01-02.014","DOIUrl":"https://doi.org/10.25040/lkv2022.01-02.014","url":null,"abstract":"Introduction. Healthcare-associated infections (HAIs) are a pressing problem in the health care system. Respiratory tract infections (RTI) are the second most common group of HAIs. One of the determining factors in the development of nosocomial pneumonia, which is predominantly bacterial in origin, is the properties and level of virulence of microbial factors. Early nosocomial pneumonia occurs when the upper respiratory tract microbiota infects the respiratory tract. Late nosocomial pneumonia is caused by nosocomial strains of microorganisms, characterized by multidrug resistance to antibiotics and disinfectants high levels of virulence, which include P. aeruginosa, Acinetobacter spp., Enterobacteriaceae family, MRSA. Unfortunately, in Ukraine, the structure and prevalence of HAIs and the antimicrobial resistance of pathogens are extremely poorly studied. The aim of the study. Therefore, the study investigates the species spectrum and antimicrobial resistance of the main causative agents of respiratory tract infections. Materials and methods. A study of microbial factors of nosocomial respiratory tract infections in 4 hospitals in Lviv. 205 patients of intensive care units diagnosed with RTI (36.6 %) were examined. Statistical analysis of the results was performed using the standard package of the program “Microsoft Excel 2010”. Microbiological diagnostics were performed following current regulations in the specialty “Bacteriology and Virology” and “Guidelines for Clinical Microbiology” of the 12th revision of the American Association for Microbiology. Microbiological diagnostics is performed in the research laboratory of the Department of Microbiology of Danylo Halytsky Lviv National Medical University. Results. The species profile of the detected pathogens of RTI indicates that among 14 representatives of different taxa, the gram-positive microbiota predominates, but the quantitative level of seeding per gram-negative microbiota accounts for 70.17 %. Among the isolates – factors of HAIs, multidrug-resistant (MDR) share accounted for 62.8 %. 3 strains are classified as pan drug resistant (PDR): 2 – P. putida and 1 – P. aeruginosa. Of the gram-positive microbiota, Enterococcus spp., represented mainly by E. faecalis and E. faecium, was most often detected in clinical material. E. faecalis was most often detected in the clinical material of the gram-positive microbiota. E. faecalis isolates were characterized by pronounced resistance to penicillins (including oxacillin), cephalosporins, fluoroquinolones, erythromycin and azithromycin, clindamycin with preserved sensitivity to vancomycin and linezolid. Pseudomonas aeruginosa isolates showed absolute sensitivity to colistin. Among other antibiotics, the most effective in terms of the number of sensitive strains were carbapenems – imipenem (57.5 %) and meronem (55.0 %). Only 37.5 % of the cultures were sensitive to tobramycin and tegicillin, an inhibitor of the protected cephalosporin antibiotic, sul","PeriodicalId":279640,"journal":{"name":"Lviv clinical bulletin","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115784889","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}

{"title":"The Impact of Social Media on Skin Care: A Narrative Review","authors":"M. Joshi, N. H. Korrapati, F. Reji, A. Hasan, R. A. Kurudamannil","doi":"10.25040/lkv2022.01-02.085","DOIUrl":"https://doi.org/10.25040/lkv2022.01-02.085","url":null,"abstract":"Introduction. Social media has completely taken over multiple aspects of our lives, it has a prominent influence on an individual’s decisions, particularly regarding their lifestyle. Social networking sites such as Facebook, Twitter, Instagram, TikTok play a prominent role in one’s choices on their skin care, cosmetics, aesthetic procedures, and dermatological treatments. The aim of the study. To review current literature on the role of social media and its impact on skin care. Materials and methods. Search databases – Google Scholar, Research4life, ScienceDirect, PubMed, and Scopus were used. Employing content analysis, methods of comparative analysis & bibliosemantics the literature survey concerning social media and its impact on social media, was conducted. A total of 50 English language publications were selected and thoroughly reviewed based on their relevance to the subject. Results. The beauty industry uses social media as a marketing strategy to reach out to its consumers around the globe, particularly targeting consumers like adolescents and women with skin problems. In recent years, social media has turned from an entertainment platform to an educational platform for many users, providing awareness about various skin-related conditions such as skin cancer and even acne treatment. Dermatologists and medical aestheticians are being proactive in sharing information about common skin conditions. Although currently the dependency on social media has increased due to a variety of reasons, there exists a large amount of false and dubious information on the social media posted by unverified users with no legitimate medical background, hence using these sites for making choices related to our skin care is still a debatable option. Conclusions. A dermatologist is no longer the sole patient advisor, this role being gradually replaced by social media. As a result, social media users are well informed having access to a variety of information, resulting in a large number of people being influenced over their skin care choices. This may do more harm than profit, since every skin is fairly individual organ and a generalized skin care routine may not provide the desirable look one strives for.","PeriodicalId":279640,"journal":{"name":"Lviv clinical bulletin","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121785589","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}

{"title":"Translation, Cross-Cultural Adaptation and Validation of the Central Sensitization Inventory for Patients with Rheumatoid Arthritis","authors":"M. Stanislavchuk, V. Bombela, Y. Shkarivskyy","doi":"10.25040/lkv2022.01-02.021","DOIUrl":"https://doi.org/10.25040/lkv2022.01-02.021","url":null,"abstract":"Introduction. Pain syndrome is one of the leading disabilitating factors in patients with rheumatoid arthritis (RA). Recently the heterogeneity of pathogenetic mechanisms of pain formation in the patients with joints inflammatory diseases has been demonstrated. The phenomenon of central sensitization is among the leading mechanisms of pain perception. In 2012 T. G. Mayer et al. created the Central Sensitization Inventory (CSI), which makes it possible rapid identification of patients whose symptoms may be related to the phenomenon of central sensitization. Currently the Ukrainian version of this questionnaire is not available. The aim of the study. Our investigation was directed towards translation, cross-cultural adaptation, validation, and testing of Central Sensitization Inventory Ukrainian version in rheumatoid arthritis patients. Materials and methods. Translation and cross-cultural adaptation of CSI were carried out according to the standard Guidelines for the process of cross-cultural adaptation of self-report measures. 75 patients diagnosed with RA according to ACR/EULAR (2010) criteria and 15 control group patients were involved in the study. RA activity was determined due to Disease Activity Score – 28 (DAS-28), the Simplified Disease Activity Index (SDAI), the Clinical Disease Activity Index (CDAI), and the functional ability of patients – by Health Assessment Questionnaire – Disability Index (HAQ-DI). Visual analog scoring (VAS) from 0 to 10 points were used to evaluate the intensity of pain. Statistical analysis of the results was performed using the methods of variation statistics in the application package SPSS22 (© SPSS Inc.). The results are presented as the mean value with standard deviation (M ± SD). Results. According to DAS-28, patients had a predominance of moderate and high disease activity (4.99 ± 0.87). Also, high RA activity in most patients was confirmed by CDAI (32.96 ± 9.46) and SDAI (35.90 ± 9.56). Impairment of functional ability in the examined patients according to the HAQ-DI index was 1.36 ± 0.70 points. Severe functional impairment (HAQ-DI value more than 2 points) was observed in 19.0 % of patients. The intensity of pain assessed in patients was 6,92 ± 1,55 points. The reliability of the Ukrainian-language version of the CSI questionnaire was evaluated by a “test-retest” with an interval of 7 days in 65 patients with RA. The obtained data demonstrated the high reliability of the CSI questionnaire – intraclass correlation coefficient was 0.914, and the L. Cronbach’s alpha coefficient was 0.914. The CSI questionnaire in RA patients demonstrated the phenomenon of central sensitization in this category of patients. The CSI value in our patients was 36.32 ± 14.67 versus 15.60 ± 12.10 in controls. At the same time, an indicator of more than 40 (central sensitization present) was detected in 40.0 % of patients. Conclusions. Translation, cross-cultural adaptation and validation of the Central Sensitization Inventory qu","PeriodicalId":279640,"journal":{"name":"Lviv clinical bulletin","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126228390","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}

{"title":"Study of Leptosirosis Prevalence on the Territory of Lviv Region with Using of GIS Technologies","authors":"O. Zubach, I. Ben, O. Semenyshyn, O. Zinchuk","doi":"10.25040/lkv2022.01-02.036","DOIUrl":"https://doi.org/10.25040/lkv2022.01-02.036","url":null,"abstract":"Introduction. Leptospirosis is one of the most widespread bacterial zoonosis in the world. Understanding the changes affecting the spatial and functional structure of natural foci of leptospirosis, peculiarities of epizootic and epidemic processes is of particular importance for practical medicine. For this purpose, we have chosen a geographic information system (GIS), which helps to summarize information about the incidence of leptospirosis in Lviv region. The aim of the study. Our study aimed to assess the territorial spreading of leptospirosis and identify the risks of infection with this disease in Lviv Oblast based on evident retrospective analysis of the epidemic process using geomapping technologies created with geographic information systems. Materials and methods. An electronic database of leptospirosis cases in humans and infected mouse-like rodents was created using Microsoft Excel. The QGIS 2.0.1 was used to analyze the obtained data, the map of the 259 human and 3524 rodent cases of Leptospirosis in Lviv Oblast was created. All calculations were performed using the ʺStatistica 10.0ʺ application package by Windows. The results were statistically processed using the Fisher’s bilateral test. Results. Layered plotting of the data on Lviv Oblast map demonstrated the diversity and distribution of leptospirosis cases in humans and rodents. Further comparisons took into account the geographical landscape of the Lviv Oblast (Ukrainian Carpathians, Forest-steppe and Forest zones). The greatest number rodents that tested positive was observed in the forest-steppe zone (13.16 %), 10.66 % of all positive animals came from the forest zone, and 10.26 % of test-positive animals came from the zone of the Ukrainian Carpathians (both p value less than 0.05). A similar pattern was found in humans: significantly more cases of the disease were recorded in Forest-steppe zone – 62.94 %, compared with the Forest zone (24.32 %) and the zone of the Ukrainian Carpathians (12.74 %), both p value less than 0.001. Conclusions. The geographic information system allowed to obtain a spatial understanding of the Leptospira geographical distribution in Lviv Oblast. The zoning of the territory with using of geographic information systems determins that the area of the highest risk of infection of leptospirosis for people is the Forest-steppe zone of Lviv Region.","PeriodicalId":279640,"journal":{"name":"Lviv clinical bulletin","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115936980","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}

{"title":"Characteristics of Clinical and Laboratory Indicators of Magnesium Content in the Serum of Pregnant Women with Early Gestosis of Various Degree","authors":"H. Hvozdetska, I. Levytskyi, N. Kinash","doi":"10.25040/lkv2022.01-02.053","DOIUrl":"https://doi.org/10.25040/lkv2022.01-02.053","url":null,"abstract":"Introduction. Early gestosis is a pathological pregnancy state linked to the development of a fertilized egg or its elements and is characterized by several symptoms. In today’s conditions, the frequency of early gestosis is observed in 60.0-80.0 % of pregnant women, and the need for hospitalization and special treatment occurs in 12.0-17.8 % of pregnant women. According to statistics, up to 90.0 % of pregnant women suffer from nausea and vomiting of varying severity. One of the main issues of medical care for pregnant women with early preeclampsia, in addition to the number of episodes of vomiting during the day, is the presence and severity of micronutrient and vitamin imbalance, which should be inevitable due to nutritional deficiencies due to incontinence and loss of micronutrients with vomiting. One of the key moments of vomiting in pregnant women is expressed misbalance in microelements, especially magnesium (Mg). Mg is necessary for vitamin D biosynthesis, transportation, and activation which is one of the key factors determining the effectiveness of our immune system. Mg participates in vitamin D metabolism, normalizes it, and increases the sensitivity of the target organs. Magnesium has a significant role in immune response as a cofactor for immunoglobulin synthesis and other processes associated with T- and B-cells function is a natural antistress factor that slows down excitation of the central nervous system. The prospects of magnesium insufficiency influencing the severity of early gestosis are poorly studied, which became the reasoning for this study. The aim of the study. To characterize clinical and laboratory indices of magnesium levels in blood serum in pregnant women with early gestosis of different severity grades. Materials and methods. We examined 150 women, 100 ones (the main group) with signs of early gestoses: 41 females with mild signs, 37 women with moderate signs, 22 ones with severe signs, and 50 females (the control group) with the physiologic course of the first trimester of pregnancy. We considered the patient’s complaints, information from case history, physical examination data, common laboratory tests, and ultrasound imaging. The evaluation of Mg deficit was performed according to an adapted standardized score that was used in the international medical practice according to the scale of deficit signs and the Mg levels in blood serum were tested. The reference values of normal Mg levels in blood serum were 0.80-0.85 mmol/L. The statistical analysis of the results was performed using methods of variability with the help of MS Excel and Statistica SPSS10.0 for Windows. Results. According to the results of the questionnaire, the women from the main group mostly presented the Mg deficit and only 17 (17.0%) of pregnant females had no Mg deficit; at the same time, the pregnant women presented Mg insufficiency in 7 (14.0%), and Mg deficit was observed only in 1 (2%) case. the gotten results showed that at increasing ges","PeriodicalId":279640,"journal":{"name":"Lviv clinical bulletin","volume":"116 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127643180","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}

{"title":"Dynamics of Life Quality in Patients with Myocardial Infarction in Combination with Critical Ischemia of the Lower Extremities under the Influence of Complex Treatment Using Arginine-carnitine Mixture and Standard Protocol Treatment","authors":"M. Shved, T. Dobryansky, I. Yastremska","doi":"10.25040/lkv2022.01-02.008","DOIUrl":"https://doi.org/10.25040/lkv2022.01-02.008","url":null,"abstract":"Introduction. The presence of critical lower extremity ischemia (CLEI) in patients with acute coronary syndrome (ACS) limits the possibility of early invasive interventions and determines the tactics of medical preparation for surgery and prevention of complications. The aim of the study. To assess the dynamics of life quality using the EQ-5D-5L questionnaire in patients with myocardial infarction (MI) in combination with obliterative atherosclerosis of the main vessels at the stage of critical lower extremity ischemia and high risk of cardiac complications in the inpatient phase of treatment under the influence of metabolic therapy. Materials and methods. 67 patients with ACS (MI) in combination with CLEI due to stenotic atherosclerosis of the iliac-femoral arterial segment were examined: 35 patients of the main group who underwent emergency balloon angioplasty and infarct-dependent coronary artery stenting in addition with L-arginine/L-carnitine complex (“TIVOR-L”; “Yuri-Pharm”; in the form of intravenous infusions for seven days of 100.0 ml once / day). 32 patients in the comparison group received only standard protocol treatment. All patients, in addition to general clinical, laboratory and instrumental methods, were additionally assessed for quality of life according to the EQ-5D-5L questionnaire. Statistical processing of indicators was performed by the method of variation statistics. Samples were checked for normality of data distribution according to the test of S. Shapiro – M. Wilk, parametric (t-test, Student’s test) methods were used. Confidence interval (CI) and relative risk (RR) were used to more accurately assess the accuracy. Results. In patients of both groups, the severity of the clinical condition did not differ significantly and was due to typical manifestations of ACS and CLEI. In patients of the main group, the use of intravenous infusions of arginine-carnitine mixture against the background of the standard protocol treatment program led to the elimination of anginal syndrome in all patients and reduced functional class of acute heart failure. When evaluating the effectiveness of the proposed combination treatment and its subjective perception by patients, it was found that initially patients of both groups evaluated their quality of life with similar relatively low scores: an average of 26.14 ± 10.15 and 25.68 ± 9.74 points (p-value more than 0.05). We note a significantly higher assessment of quality of life in patients after a course of comprehensive treatment, whose quality of life index improved by an average of 160.9 % and reached the level of 86.5 ± 8.3 points. During the standard treatment program in patients with ACS in combination with CLEI there was a significant improvement in well-being, the total quality of life index increased by 40.2 %. Сonclusions. Patients in the experimental group with acute coronary syndrome and critical lower extremity ischemia who received arginine-carnitine mixture in addition to compl","PeriodicalId":279640,"journal":{"name":"Lviv clinical bulletin","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115020947","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}

{"title":"Liver Injuries Associated with Coronavirus Disease 2019: View on the Problem","authors":"V. Prysyazhnyuk, T. Ilashchuk, L. Voloshyna, V. Vasjuk, I. Prysiazhniuk, K. Bobkovych","doi":"10.25040/lkv2022.01-02.067","DOIUrl":"https://doi.org/10.25040/lkv2022.01-02.067","url":null,"abstract":"Introduction. Major cardiovascular and pulmonary comorbidities, as well as diabetes mellitus and certain cancers, are associated with worse clinical outcomes of coronavirus disease-2019 (COVID-19). Meanwhile, the impact of concomitant liver diseases on the COVID-19 natural course together with the influence of the COVID-19 on the hepatic tissues have been rarely investigated. The aim of the study was to analyse the available data regarding impact of liver pathologies on COVID-19 natural course and outcome, and, reciprocally, hepatic injuries development induced by COVID-19. Materials and methods. Content analysis, systematic and comparative analysis, bibliosemantic method of investigation of current scientific research results on liver damage associated with COVID-19 were used. Results. The potential mechanism of liver injury in COVID-19 is complex and includes direct cytopathic viral injury, proinflammatory cytokine outbreak, hypoxia/reperfusion damage and potential drug induced liver injury. Among the medications used for the treatment of COVID-19 patients, there are certain that could potentially cause drug-induced liver injury. Treatment of liver transplant patients can be challenging taking into consideration the possible necessity of immunosuppressive therapy correction combined with the needs to find a balance between the risk of graft rejection and effective elimination of the virus. Conclusions. Current review of the available database revealed that liver diseases are among substantive comorbidities in COVID-19 patients alongside with liver injuries which are rather frequent complications of COVID-19 treatment. Potential drug-induced liver injuries in patients subjected tocertain antiviral agents in combination with supportive therapy drugs should be taken into consideration. Special precautions are required to prevent potential drug-to-drug interactions in case of COVID-19 treatment in liver transplant patients.","PeriodicalId":279640,"journal":{"name":"Lviv clinical bulletin","volume":"191 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123323270","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}

{"title":"Adherence to Treatment and Factors Influencing the Quality of Treatment of Hypertension in Patients in the Long Term After Myocardial Infarction","authors":"A. Yagensky, M. Pavelko","doi":"10.25040/lkv2022.01-02.028","DOIUrl":"https://doi.org/10.25040/lkv2022.01-02.028","url":null,"abstract":"Introduction. Adherence to the treatment of arterial hypertension (AH) after myocardial infarction (MI) remains an understudied problem in world cardiology. The aim of the study. Assess adherence to treatment and the factors that affect it in patients with AH in the remote period after MI. Materials and methods. The study included 265 patients after MI (68.2 % of men, mean age 65.4 ± 9.5 years). The mean time from MI to inclusion in the study was 2.3 ± 1.9 years. Assessment of the quality of secondary prevention was performed by analyzing the results of the questionnaire, measuring of anthropometric parameters, blood pressure (BP) and heart rate (HR), as well as determining lipid metabolism, creatinine and venous blood glucose. Results. The frequency of detection of AH in the long period after MI is 69.1 %, regardless of gender, time of MI and its variant and increases in proportion to age. Only in 26.3 % of patients with hypertension in the remote period after MI BP was within the target values. Factors associated with achieving the target values of BP were age up to 60 years (OR – 1.35; p is equal to 0.02), a visit to the doctor during the last 6 months (OR – 1.82; p is equal to 0.002), regular independent blood pressure measurement (OR – 1.63; p is equal to 0.01). 13.3 % of patients with AH after MI did not take antihypertensive drugs, the remaining 60.4 % of patients with AH were treated but did not reach the target BP. Among patients with AH after MI who did not take antihypertensive drugs, patients older than 60 years prevailed (83.3 % vs. 63.2 % of treated patients, p = 0.05). In addition, much less often these patients were under the supervision of a doctor – 47.4 % vs. 82.8 % (p is equal to 0.0005), including a cardiologist (40.9 % vs. 75.0 %, p is equal to 0.001), less visited a doctor for a year, had lower BP, and had poorer knowledge of post-MI treatment. In addition, none of them use statins. Patients with AH who received treatment but did not reach the target BP values received the same amount of antihypertensive drugs as patients with controlled AH – an average of 2.1 ± 1.0 and 2.1 ± 0.9 drugs, respectively. At the same time, 29.3 % of patients in the group of ineffectively treated AH received monotherapy. No differences were found between age, sex, basic clinical and social parameters, financial status, health knowledge, self-measurement of blood pressure, or frequency of physician visits. Conclusions. To achieve the target BP levels in patients with AH after MI, it is necessary to: introduce regular measurement of home BP in all patients; use combination antihypertensive therapy, including, if necessary, with the use of three or more drugs; regularly monitor adherence to treatment, use of antiplatelet, antihypertensive drugs and statins. Patients with difficult-to-control AH should consult a cardiologist at least every 6 months.","PeriodicalId":279640,"journal":{"name":"Lviv clinical bulletin","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130615468","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}

{"title":"Frequency and Nature of Bone Lesions in Patients with Rheumatoid Arthritis Detected by Ultrasound and X-ray Оsteodensitometry, their Diagnostic Value in Assessing Bone Mineral Density","authors":"V. Chemes, U. Abrahamovych, L. Tsyhanyk, S. Guta","doi":"10.25040/lkv2022.01-02.060","DOIUrl":"https://doi.org/10.25040/lkv2022.01-02.060","url":null,"abstract":"Introduction. Rheumatoid arthritis (RA) is an unknown etiology of complex autoimmune pathogenesis, a chronic systemic connective disease that is often complicated by secondary osteoporosis (OS), which worsens the course and prognosis of the underlying disease. The aim of the study. To establish the frequency and nature of bone damage in patients with rheumatoid arthritis detected by ultrasound and X-ray densitometry, to determine their diagnostic value in assessing bone mineral density. Materials and methods. A randomized study with a preliminary stratification for RA diagnosed according to the criteria of the American College of Rheumatologists and the European League Against Rheumatism in 2010, premenopausal women and adult men, included 74 patients (62 women (84.93 %) and 12 men (15.07 %) aged 38 to 60 years (mean age at the time of the survey women - 48.67 ± 2.34 years, men - 45.42 ± 2.78) treated, receiving methylprednisolone at a dose of 4.0 to 24.0 mg/day and not receiving drugs for the treatment of OP) in the rheumatology department of the Municipal Non-Profit Enterprise of the Lviv Regional Council “Lviv Regional Clinical Hospital” from 2013 to 2019 (research group - DG). The control group (CG) was composed of 29 healthy individuals (22 women (75.86 %) and 7 men (24.14 %), the average age of women at the time of the survey was 44.95 ± 2.12 years, men - 40.71 ± 2.75 years) of the same sex and age. All patients underwent assessment of BMD with ultrasound densitometry, X-ray densitometry of the hand. Results. In most patients with rheumatoid arthritis ultrasound densitometry revealed violations of bone mineral density, of which osteopenia was in 34 (45.95 %) patients (of whom first degree in 3 (4.05 %), second degree in 18 (24, 32.00 %), III degree in 13 (17.57 %)), osteoporosis in 22 (29.73 %), and within the reference indicators - in 18 (24.32 %). X-ray densitometry in all patients with rheumatoid arthritis revealed a violation of bone mineral density, of which osteopenia was 46 (62.17 %), of which I degree in 19 (25.68 %), II degree in 14 (18.92 %), III degree in 13 (17.57 %)), osteoporosis - in 28 (37.83 %). Analysis of correlations between the results of BMD assessment by ultrasound of heel bone densitometry and X-ray densitometry of the hand in patients with RA revealed a direct strong correlation between the T-test, obtained by ultrasound of heel densitometry and X-ray densitometry of the hand in patients with RA (r = 0.44; p value less than 0.001); indicating that with a decrease in the T-test according to ultrasound densitometry will decrease the T-test according to X-ray densitometry, which allows to diagnose changes in BMD by both methods in patients with RA. It was found that in patients with RA reduction of BMD by ultrasound densitometry of the heel bone in 100.00 % of cases is confirmed by the results of X-ray densitometry of the hand (sensitivity 0.1). Conclusions. The study demonstrated that determining the mineral density o","PeriodicalId":279640,"journal":{"name":"Lviv clinical bulletin","volume":"107 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131469216","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}

{"title":"Rudolf Weil’s Vaccine in the Fight Against Typhemic","authors":"B. Kuzminov, V. Smolnytska","doi":"10.25040/lkv2022.01-02.081","DOIUrl":"https://doi.org/10.25040/lkv2022.01-02.081","url":null,"abstract":"Introduction. Vaccination has made a breakthrough in history by overcoming the infectious diseases that have plagued humanity for millennia. The twentieth century was marked by the invention of vaccines against epidemics typhus, which have become the only salvation in overcoming this disease. The history of the vaccine was developed on the example of the first effective vaccine against epidemic typhus, developed by a prominent Polish scientist, professor at the University of Lviv Rudolf Weigl, the history of vaccine development and the method of culturing R. Prowazekii in the intestine of Pediculus humanus corporis was studied. From Rickettsia Рrowazekii – the causative agent of epidemic typhus transmitted by aphids (Pediculus humanus corporis) in the history of mankind killed more people than in all known wars. Brazilian researcher Enrique da Rocha Lima differentiated described in detail and gave a specific name to the causative agent of typhus in 1916. In 1920, GW Epstein, as well as S. Burt Weilbach, John L. Todd and FW Palfrey in 1922 confirmed the etiological significance of R. Prowazekii in the presence of typhus. Biological and morphological characteristics, the life cycle of the pathogen and the impossibility of reproduction on artificial nutrient media were established. The aim of the study. According to the study of scientific sources to investigate the history of the technology of R. Weigl vaccine against epidemic typhus from its first series obtained in the laboratory and from 1930, when its production began, the period covering the 20-30s of the twentieth century. To establish that the scientific achievements of the scientists are not only the history of microbiology and virology, it is relevant today. Materials and methods. Content analysis, a method of systematic analysis of research on the typhus vaccine, was used. The implementation of scientific research began with a retrospective analysis of the scientific works of R. Weigl and his students. Selection of sources was carried out in the archives and scientific libraries of Lviv and the Research Institute of Epidemiology and Hygiene of Danylo Halytsky Lviv National Medical University, in scientometric databases PubMed, Medline, Web of Science, Google Scholar by keywords: lice, typhus, rubella, R. Prowazekii. 174 scientific works in English, Ukrainian, Polish, French and Russian were analyzed and sources were selected in which the issue of creating a vaccine against typhus, technology of its production, efficiency of application was covered. Results. The vaccine, developed by Professor Rudolf Weigl, author of the method of cultivating and accumulating the causative agent of this disease – R. Prowazekii in the intestine of the laboratory population of lice, despite the complexity of its preparation, for over 20 years was the only immunobiological drug to control typhus. Conclusions. We should be grateful to Rudolf Weigl and his students, who have often studied R. Рrowazekii at the c","PeriodicalId":279640,"journal":{"name":"Lviv clinical bulletin","volume":"64 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117016298","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}