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CLINICAL, MORPHOLOGICAL, AND EPIDEMIOLOGICAL CHARACTERISTICS OF ENDOMETRIAL HYPERPLASTIC PROCESSES IN SUMY REGION 苏梅地区子宫内膜增生过程的临床、形态学和流行病学特征
Pub Date : 1900-01-01 DOI: 10.21272/eumj.2021;9(4):342-351
N. Tsyndrenko, A. Romaniuk, Yana R. Nikolayenko
Endometrial hyperplastic processes take an important place among the gynecological diseases in women of various ages and are one of the most common reasons for admission at inpatient gynecology departments. The urgency of the pathology is due to the significant prevalence of endometrial hyperplastic processes, high incidence of malignancy, prolonged relapsing course, and decreased reproductive function, since these diseases are one of the most common causes of infertility in women of childbearing age. The statistics related to the incidence of endometrial hyperplastic processes in Ukraine is not available. An analysis of case histories and medical records showed that in 40% of cases, endometrial hyperplastic processes were asymptomatic. In 60% of cases, the clinical manifestations of endometrial hyperplastic processes were menstrual disorders, such as dysmenorrhea, oligomenorrhea, menorrhagia, and metrorrhagia. In 30% of cases, endometrial hyperplastic processes were recurrent. The most common concomitant pathologies of the pelvic organs were uterine leiomyoma and endometriosis; the most common concomitant extragenital diseases were hypertension and obesity. Our study and data analysis showed that there is an increasing trend in the incidence of endometrial hyperplastic processes in Sumy region in 2011–2020. The maximum incidence was in 2016. A correlation was found between hyperplasia incidence and age. Thus, the largest number of non-atypical and atypical endometrial hyperplasia cases was observed in women aged 45–55 years. The lowest number of non-atypical endometrial hyperplasia cases was registered in women aged 66+, while atypical hyperplasia cases – in women under 30 years of age. Glandular polyps of the endometrium were most often diagnosed at the age of 31–44; the lowest number of these was found in women over 66 years. Most glandular-fibrous endometrial polyps were observed in women aged 45–55 years, while women under 30 presented with the fewest cases. Fibrous endometrial polyps were most common in older age groups – 66+; the lowest number of such endometrial polyps was found in women under 30 years. We attributed the decreased incidence of endometrial hyperplastic processes in 2020 to the quarantine measures introduced, which, as a consequence, led to the decreased number of diagnosed cases, since they are often asymptomatic.
子宫内膜增生性病变在各年龄段妇女的妇科疾病中占有重要地位,是妇科住院患者最常见的原因之一。由于这些疾病是育龄妇女不孕症的最常见原因之一,因此子宫内膜增生过程的显著流行、恶性肿瘤的高发病率、复发过程延长和生殖功能下降是病理学的紧迫性。与乌克兰子宫内膜增生性过程发生率相关的统计数据尚不清楚。对病例史和医疗记录的分析表明,在40%的病例中,子宫内膜增生过程是无症状的。60%的子宫内膜增生性病变临床表现为月经紊乱,如痛经、少经、月经过多、子宫出血。在30%的病例中,子宫内膜增生过程复发。盆腔器官最常见的伴发病变是子宫平滑肌瘤和子宫内膜异位症;最常见的伴随性外阴疾病是高血压和肥胖。我们的研究和数据分析表明,2011-2020年苏梅地区子宫内膜增生性病变的发病率呈上升趋势。发病率最高的年份是2016年。发现增生发生率与年龄有相关性。因此,45-55岁的女性是非典型和非典型子宫内膜增生病例最多。非典型子宫内膜增生病例在66岁以上的女性中最少,而非典型子宫内膜增生病例在30岁以下的女性中最少。子宫内膜腺性息肉最常见于31-44岁;在66岁以上的女性中,这一比例最低。大多数腺纤维性子宫内膜息肉发生在45-55岁的女性中,而30岁以下的女性病例最少。纤维性子宫内膜息肉最常见于66岁以上年龄组;这种子宫内膜息肉在30岁以下的女性中发病率最低。我们将2020年子宫内膜增生性病变的发病率下降归因于引入的隔离措施,这导致确诊病例数量减少,因为它们通常是无症状的。
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引用次数: 0
PARKINSON'S DISEASE — OVERVIEW OF MODERN TREATMENT METHODS 帕金森病——现代治疗方法综述
Pub Date : 1900-01-01 DOI: 10.21272/eumj.2023;11(1):1-13
O. Chyniak, O. Dubenko, Olexander Potapov, A. Shulga, A. Kotsyuba
Introduction. Parkinson's disease (PD) is a neurodegenerative neurological disease with a slowly progressive course. In particular, it manifests as a movement disorder that includes rest tremor, rigidity, bradykinesia, and postural instability. Movement disorder in patients with PD mainly occurs due to the selective loss of pigmented dopaminergic neurons of the compact area of the substantia nigra, as a result of the depletion of dopamine in the striatum. The pathogenetic feature of this disease is the presence of intraneuronal aggregates and inclusions of α-synuclein. To date, there are no proven treatments for Parkinson's disease, but a number of medications exist offering benefits in terms of controlling movement disorders. Although they can significantly improve motor function, they can also lead to problematic side effects, especially as the disease progresses.Materials and methods. To analyze the main directions of modern methods of Parkinson's disease treatment and to conduct a profound review and analysis of literature research data on the modern methods of Parkinson's disease treatment over the past 10 years.The results. It has been established that modern treatment methods are based mainly on exogenous administration of drugs with dopaminergic activity and inhibitors of endogenous dopamine metabolism. Although levodopa has been used in the treatment of Parkinson's disease since its inception, numerous experimental therapeutic and neurosurgical approaches are now being investigated. These include drugs aiming at the inhibition and degradation of α-synuclein aggregation, which is considered the driving force of neurodegeneration in Parkinson's disease. They raise expectations that a disease-modifying agent will be discovered in the short-term future. Thus, in combination with a number of regenerative and neurosurgical approaches, including stem cell and gene therapy and deep brain stimulation, significant progress will be made in the treatment of Parkinson's disease in the coming years and a number of new effective options will become available.
介绍。帕金森病(PD)是一种缓慢进展的神经退行性疾病。特别是,它表现为运动障碍,包括静止性震颤、僵硬、运动迟缓和姿势不稳定。PD患者的运动障碍主要是由于纹状体多巴胺耗损导致黑质致密区色素多巴胺能神经元选择性丢失。这种疾病的发病特征是α-突触核蛋白在神经元内聚集和包涵体的存在。到目前为止,还没有证实的治疗帕金森病的方法,但是有一些药物在控制运动障碍方面提供了好处。虽然它们可以显著改善运动功能,但它们也会导致问题的副作用,特别是随着疾病的进展。材料和方法。分析现代帕金森病治疗方法的主要方向,对近10年来现代帕金森病治疗方法的文献研究资料进行深入的回顾和分析。结果。已经确定,现代治疗方法主要基于外源性给予具有多巴胺能活性和内源性多巴胺代谢抑制剂的药物。虽然左旋多巴从一开始就被用于治疗帕金森病,但目前正在研究许多实验性治疗和神经外科方法。其中包括旨在抑制和降解α-突触核蛋白聚集的药物,α-突触核蛋白聚集被认为是帕金森病神经退行性变的驱动力。它们提高了人们对在不久的将来会发现一种疾病调节剂的期望。因此,结合一些再生和神经外科方法,包括干细胞和基因治疗以及深部脑刺激,帕金森病的治疗将在未来几年取得重大进展,并将出现一些新的有效选择。
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引用次数: 0
FATIGUE IN MULTIPLE SCLEROSIS 多发性硬化症的疲劳
Pub Date : 1900-01-01 DOI: 10.21272/eumj.2022;10(4):309-317
I. Delva
The article discusses and analyzes literature data on the phenomenon of fatigue in patients with multiple sclerosis. More than 80% patients with multiple sclerosis complain of fatigue, which significantly limits their functional capacity and negatively affects the quality of life. In general, fatigue is a complex, multidimensional phenomenon that consists of subjective (one's own feeling of fatigue) and objective (quantitative characteristics of fatigue when performing a certain activity) components. At present, the most accessible method of fatigue assessment is patient survey. In multiple sclerosis, fatigue can be primary (as a direct consequence of the disease) or secondary (as a consequence of reduced functional capabilities, sleep disorders, chronic pain, side effects of medications, etc). In general, fatigue in multiple sclerosis is a heterogeneous phenomenon based on various etiopathogenetic mechanisms. We reviewed neuroimaging markers of global and focal lesions of the white and gray matter of the brain that are associated with the presence of fatigue in patients with multiple sclerosis. The impact of peripheral immune-inflammatory processes on the fatigue occurrence was shown which was realized via humoral, cellular, and neuronal mechanisms. We analyzed the role of inflammatory processes in the brain and spinal cord in the form of activation of microglia with hyperproduction of cytokines, which ultimately disrupts dopamine metabolism and reduces the affinity of dopamine receptors. The excess activity of certain functional components of the nervous system in the form of higher engagement of the motor structures of the brain and spinal cord during the performance of standard motor tasks was highlighted. The role of disruption of interoceptive mechanisms (perception and monitoring of the body's internal environment via hormonal, immune, metabolic, temperature, pain, and visceromotor signals) in the occurrence of fatigue in multiple sclerosis was shown. The paper underlines modern principles of fatigue correction based on these mechanisms.
本文对多发性硬化症患者疲劳现象的文献资料进行了讨论和分析。超过80%的多发性硬化症患者抱怨疲劳,这严重限制了他们的功能能力,并对生活质量产生负面影响。一般来说,疲劳是一种复杂的、多维的现象,由主观(一个人自己的疲劳感觉)和客观(进行某种活动时疲劳的数量特征)组成。目前,最容易获得的疲劳评估方法是病人调查。在多发性硬化症中,疲劳可以是原发性(作为疾病的直接后果)或继发性(作为功能下降、睡眠障碍、慢性疼痛、药物副作用等的后果)。一般来说,多发性硬化症的疲劳是一种基于多种发病机制的异质性现象。我们回顾了与多发性硬化症患者疲劳相关的脑白质和灰质整体和局灶性病变的神经影像学标志物。外周免疫炎症过程对疲劳发生的影响是通过体液、细胞和神经元机制来实现的。我们分析了脑和脊髓中炎症过程的作用,其形式是激活小胶质细胞并产生大量细胞因子,最终破坏多巴胺代谢并降低多巴胺受体的亲和力。在标准运动任务的执行过程中,神经系统某些功能成分的过度活动以大脑和脊髓运动结构的高度参与的形式被强调。内感受机制(通过激素、免疫、代谢、温度、疼痛和内脏运动信号对身体内环境的感知和监测)在多发性硬化症疲劳发生中的作用得到了证实。本文强调了基于这些机制的现代疲劳校正原理。
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引用次数: 0
Modern features of the epidemic process of viral infections with aerosol transmission in Sumy oblast 苏梅州气溶胶传播病毒感染流行过程的现代特征
Pub Date : 1900-01-01 DOI: 10.21272/EUMJ.2021;9(1):115-123
N. Malysh, M. V. Matsyuk, A. V. Senchenko
Viral infections with aerosol transmission are one of the most common infectious diseases in the world. Their relevance is due to the wide distribution and socio-medical consequences.To study the dynamics of the incidence of viral infections with aerosol transmission in Sumy Oblast, to determine the level of influence of social and natural factors on the intensity of the epidemic process.Data from the sectoral statistical reporting of the Ministry of Health of Ukraine, Sumy Regional Laboratory Center, the Main Department of Statistics in Sumy Oblast, Sumy Regional Center of Hydrometeorology were used. Epidemiological and statistical research methods were used.It was established that in Sumy Oblast the epidemic process of aerosol viral infections was characterized by a pronounced tendency to reduced incidence of influenza (Rinc.aver.= -6.2 %) and rubella (Rinc.aver.= -22.7 %), moderate reduction tendency ‒ to mumps (Rinc.aver = -2.4 %); high intensity with no reduction in incidence ‒ for other acute respiratory diseases (Rinc.aver = 0.2 %); a sharp increase in the incidence of measles (Rinc.aver.= 23.1 %). Coronavirus infection caused by SARS-CoV-2 was found in 3% of the population. The average long-term rates of measles, rubella, and mumps vaccinations with MPR-1 and MPR-2 vaccines were 70.9 % and 61.2 %, respectively. An inverse correlation was established between air humidity, population, coefficients of natural and migratory movement and measles incidence (p<0.05). The system of epidemiological surveillance of infections of viral etiology with aerosol transmission requires new approaches to the development of preventive measures.
通过气溶胶传播的病毒感染是世界上最常见的传染病之一。它们的相关性是由于广泛分布和社会医学后果。研究苏梅州气溶胶传播的病毒感染发病率动态,确定社会和自然因素对流行过程强度的影响程度。数据来自乌克兰卫生部、苏梅州区域实验室中心、苏梅州统计总局、苏梅州水文气象区域中心的部门统计报告。采用流行病学和统计学研究方法。已经确定,在苏梅州,气溶胶病毒感染的流行过程的特点是明显倾向于减少流感的发病率(rinc.ver)。= - 6.2%)和风疹(rinc.ver .)。= - 22.7%),中度减少趋势-腮腺炎(环。平均值= - 2.4%);对于其他急性呼吸系统疾病,高强度的治疗没有降低发病率。平均值= 0.2%);麻疹发病率的急剧上升。= 23.1%)。由SARS-CoV-2引起的冠状病毒感染在3%的人口中发现。麻疹、风疹和腮腺炎接种MPR-1和MPR-2疫苗的平均长期接种率分别为70.9%和61.2%。空气湿度、人口、自然和迁徙系数与麻疹发病率呈负相关(p<0.05)。气溶胶传播的病毒病原感染的流行病学监测系统需要新的方法来制定预防措施。
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引用次数: 1
MARTYN MATVIYOVYCH TEREHOVSKYI (1740-1796) AND IMPROVEMENT OF TEACHING IN THE HIGHER MEDICAL SCHOOL 捷列霍夫斯基(1740-1796)与高等医学院教学的改进
Pub Date : 1900-01-01 DOI: 10.21272/eumj.2023;11(1):74-82
Yuriy K. Vasyliev
Objective: to summarize the main facts of M. M. Terekhovskyi’s biography based on a critical analysis of publications and, at the same time, to highlight his contribution to the improvement of teaching in higher medical school.Materials and methods. Published materials were used as historical sources. The historical method was the main research method in the article.Results. We performed an analysis of the literature about prof. Terekhovskyi. For the first time, his role in the reforms of higher medical education in the late 18th – early 19th centuries was clarified.The first critical analysis of the literature about M. M. Terekhovskyi, published over more than a century and a half, made it possible to identify erroneous statements and typos. It was found that the first publication about him appeared in 1845, that is, half a century after his death. It was a brief biographical note in the dictionary of Metropolitan Eugene. It was proved that the main and most complete life description of Professor Terekhovskyi was his biography written by Ya. A. Chistovich (1883), which was based on archival materials and supplemented with archival findings by M. K. Borodii (1984). The fundamental study of his contribution to science was represented by the work of S. L. Sobol (1948, 1963). It was shown that the charter of 1792 of the higher medical school (academy), which Professor Terehovskyi took part in, served as the basis for the staff of the St. Petersburg Medical and Surgical Academy in 1808. The charter of 1792 for the first time included Medical Police (Politia Medica), which was later transformed into Social Hygiene and Public Health, as one of the teaching subjects in the higher medical school. Then it was enshrined in the charter of 1806, which was written by the founder of this science, J. P. Frank. The study made it possible to identify gaps in the biography of M. M. Terekhovskyi. Thus, the date and month of his birth are still unknown; it is not clear who his mother was, whether he had his own family (wife, children), and whether he received a scholarship from Princess Ye. D. Golitsyna. With this regard, further archival searches are needed to confirm Professor Terekhovsky’s authorship of the handwritten essay «Opinion on the correction of medical sciences.»
目的:在对出版物进行批判性分析的基础上,总结捷列霍夫斯基传记的主要事实,同时突出他对改进高等医学院教学的贡献。材料和方法。出版的材料被用作历史资料。历史研究方法是本文的主要研究方法。我们对捷列霍夫斯基教授的文献进行了分析。他在18世纪末至19世纪初高等医学教育改革中所扮演的角色第一次被阐明。对捷列霍夫斯基(M. M. terekhovsky)的文献进行的第一次批判性分析发表了一个半多世纪,使人们有可能发现错误陈述和错别字。人们发现,关于他的第一本出版物出现在1845年,也就是他死后半个世纪。这是尤金大都会的字典里的一篇简短的传记。事实证明,对捷列霍夫斯基教授生平最主要、最完整的描述是雅所著的传记。A. Chistovich(1883),它以档案材料为基础,并补充了M. K. Borodii(1984)的档案发现。他对科学贡献的基础研究以S. L. Sobol(1948, 1963)的工作为代表。据证明,捷列霍夫斯基教授参加的1792年高等医学院(学院)章程是1808年圣彼得堡医学和外科学院工作人员的基础。1792年的《宪章》第一次将医学警察(Politia Medica)纳入其中,后来转变为社会卫生和公共卫生,作为高等医学院的教学科目之一。然后,它被写入了1806年的宪章,该宪章是由这门科学的创始人j·p·弗兰克撰写的。这项研究使人们有可能找出捷列霍夫斯基传记中的漏洞。因此,他的出生日期和月份仍然是未知的;不清楚他的母亲是谁,他是否有自己的家庭(妻子、孩子),以及他是否获得了叶公主的奖学金。d . Golitsyna。在这方面,需要进一步查阅档案,以确认Terekhovsky教授手写的论文《关于纠正医学的意见》的作者身份
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引用次数: 0
A CASE OF ORPHAN HYALINE FIBROMATOSIS SYNDROME IN UKRAINE 乌克兰孤儿透明纤维瘤综合征1例
Pub Date : 1900-01-01 DOI: 10.21272/eumj.2023;11(2):127-135
O. Redko, O. Smiyan, A. Loboda, Viktoriia Petrashenko, I. Shkolna, Ihor Zaitsev, Sergiy Redko, Anzhela Klochko, Tetyana Obzor, Ruban Kyrylo
Background. Hyaline fibromatosis syndrome is a rare, highly dramatic, autosomal recessive multisystem disorder. The basis of the disease is the abnormal diffuse deposition of hyaline material in the connective tissue and internal organs. Mutations in the CMG2 gene (also known as the ANTXR2 gene) cause the disease. CMG2 encodes a transmembrane protein involved in endothelial development. Hyaline fibromatosis syndrome involves two allelic diseases that have the same phenotype. These are infantile systemic hyalinosis and juvenile hyaline fibromatosis. Common signs of these diseases are pain, joint contractures, skin lesions (thickening of the skin with areas of hyperpigmentation, pearl-sized nodules or papules), subcutaneous nodules on the head, neck, and extremities, gingival hypertrophy, osteopenia, protein-losing enteropathy, increased susceptibility to infectious diseases. Diseases differ in the time of the first clinical signs onset, the severity of the course, and the life expectancy of patients. In the case of infantile systemic hyalinosis, the prognosis is fatal. Hyaline fibromatosis syndrome is an orphan disease that is very difficult to diagnose. There is no pathogenetic treatment for the disease today.Clinical case. We described a case of hyaline fibromatosis syndrome in a boy who was observed and treated at the Municipal Non-Profit Enterprise of Sumy Regional Council "Regional Children's Clinical Hospital" (Ukraine). The diagnosis was made based on medical and genetic analysis. The early manifestation of symptoms and the severe course of the disease forced us to think about infantile systemic hyalinosis in the child. Along with characteristic external phenotypic signs, severe enteropathy with protein loss and persistent infections were observed in the child. As far as we know, this is the first case of the disease diagnosed in Ukraine. This publication aims to draw medical professionals' attention to the diversity of the course of genetic diseases in children. Comprehensive care, timely and symptomatic treatment make it possible to prolong the life of patients.
背景。透明纤维瘤病综合征是一种罕见的、高度戏剧性的常染色体隐性多系统疾病。这种疾病的基础是结缔组织和内脏器官中透明物质的异常弥漫性沉积。CMG2基因(也称为ANTXR2基因)的突变导致了这种疾病。CMG2编码一种参与内皮细胞发育的跨膜蛋白。透明纤维瘤病综合征涉及两种具有相同表型的等位基因疾病。这些是婴儿全身性透明质病和青少年透明质纤维瘤病。这些疾病的常见症状是疼痛、关节挛缩、皮肤病变(皮肤增厚,伴有色素沉着、珍珠大小的结节或丘疹)、头、颈和四肢皮下结节、牙龈肥大、骨质减少、蛋白质丢失性肠病、对传染病的易感性增加。疾病在首次出现临床症状的时间、病程的严重程度和患者的预期寿命方面有所不同。对于婴儿全身性透明质病,其预后是致命的。透明纤维瘤综合征是一种罕见病,很难诊断。目前还没有针对这种疾病的致病治疗方法。临床病例。我们描述了一例透明纤维瘤综合征的男孩,他在苏梅地区理事会的市非营利企业“地区儿童临床医院”(乌克兰)观察和治疗。诊断是根据医学和基因分析作出的。早期症状的表现和疾病的严重进程迫使我们考虑儿童全身性透明质病。随着特征性的外部表型征象,在儿童中观察到严重的肠病,伴有蛋白质丢失和持续感染。据我们所知,这是乌克兰确诊的第一例该病。本出版物旨在提请医学专业人员注意儿童遗传疾病病程的多样性。全面护理,及时对症治疗,使延长患者生命成为可能。
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引用次数: 0
METHODS OF TREATMENT OF PATIENTS WITH ARTERIAL HYPERTENSION WITH MANIFESTATIONS OF HYPERVENTILATION SYNDROME 以过度通气综合征为表现的高血压患者的治疗方法
Pub Date : 1900-01-01 DOI: 10.21272/eumj.2023;11(1):21-31
I. Zarivna, V. Levchenko
Introduction. Some patients with stage 1 arterial hypertension often have symptoms originating from various anatomic and functional locations in the absence of organic changes associated with manifestations of psychosomatic autonomic dysfunction. Among the manifestations, patients have "respiratory", cardiovascular, abdominal symptoms, as well as the signs of anxiety-depressive syndrome. These signs indicate the presence of comorbid psychosomatic disorders in the patient, which can affect the course of hypertension and the nature of the treatment.Materials and methods. The screening was carried out in 125 patients with stage 1 AH. Hyperventilating syndrome was detected in 46.40% of them (n = 58) according to the Nijmegen questionnaire; these patients were included in the experimental group. At the same time, standard indicators of hemodynamics, state of anxiety as an additional marker of psychovegetative dysfunctions according to the Spielberger scale were evaluated. The control group consisted of 24 patients with stage 1 AH without signs of hyperventilating syndrome.By randomization, all patients of the experimental group were divided into 4 groups depending on the treatment: patients from 1st and 2nd group received perindopril and amlessa; 3rd and 4th group – medication in combination with systematic diaphragmatic breathing. The latter provides an anti-stressor effect, normalizes the breathing pattern, eliminates the consequences of hypocapnia and possibly reduces the effect of bradykinin on bronchial tone after taking ACE inhibitors.Results and discussion. A correlation was found (r = 0.72; p ˂ 0.05) between the severity of hyperventilating syndrome (41.63 ± 0.82) points and indicators of total peripheral vascular resistance (1476.13 ± 42.39) dyn•s•cm-5. The latter was significantly higher than the results obtained in the control group of patients – (1374.62 ± 36.11) dyn•s•cm-5 (р ˂ 0.05). At the same time, the signs of state anxiety comprised (42.96 ± 2.05) points vs. the result in the control group (22.36 ± 1.33) points (р ˂ 0.05). The evaluation of the results of the treatment after 2–3 months revealed a significant advantage of the combined effect of medications and systematic diaphragmatic breathing, which reduced hyperventilation in the 3rd and 4th groups by 12.92% and 15.37% (р ˂ 0.05); state anxiety by 16.73% and 20.31% (р ˂ 0.05), respectively, which was not significant in groups 1–2. In addition, diaphragmatic breathing increased the effect of amlessa. When treating patients with stage 1 hypertensive disease it is recommended to search for the signs of hyperventilating syndrome and prescribe combined therapy which includes diaphragmatic breathing and hypotensive medications.
介绍。一些1期动脉高血压患者通常有起源于不同解剖和功能部位的症状,而没有与心身自主神经功能障碍表现相关的器质性改变。在表现中,患者有“呼吸”、心血管、腹部症状,以及焦虑抑郁综合征的体征。这些迹象表明患者存在共病性心身疾病,这可能影响高血压的病程和治疗的性质。材料和方法。在125例1期AH患者中进行了筛查。根据奈梅亨问卷,其中46.40% (n = 58)被检出过度呼吸综合征;将这些患者纳入实验组。同时,根据Spielberger量表评估血液动力学标准指标,焦虑状态作为精神植物功能障碍的附加标记。对照组包括24例无过度呼吸综合征征象的一期AH患者。采用随机分组的方法,将实验组患者根据治疗情况分为4组:第一组和第二组患者分别给予培哚普利和阿莫拉西;第三和第四组-药物联合系统膈呼吸。后者提供抗应激作用,使呼吸模式正常化,消除低碳酸血症的后果,并可能降低服用ACE抑制剂后缓激肽对支气管张力的影响。结果和讨论。相关性发现(r = 0.72;呼吸过度综合征严重程度(41.63±0.82)点与外周血管总阻力指标(1476.13±42.39)dyn•s•cm-5之间的P值小于0.05)。后者显著高于对照组(1374.62±36.11)dyn•s•cm-5(±0.05)。与此同时,状态焦虑症状得分为(42.96±2.05)分,而对照组得分为(22.36±1.33)分(±0.05)。2-3个月后对治疗结果的评估显示,药物治疗和系统横膈膜呼吸的联合作用具有显著优势,第3组和第4组的过度换气率分别降低12.92%和15.37% (p < 0.05);状态焦虑分别提高16.73%和20.31% (p < 0.05),差异无统计学意义(p < 0.05)。此外,横膈膜呼吸增加了无痛呼吸的效果。在治疗1期高血压患者时,建议寻找过度通气综合征的迹象,并开出包括膈呼吸和降压药物在内的联合治疗方案。
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引用次数: 0
THE IMPACT OF THE COVID-19 PANDEMIC ON MENTAL HEALTH OF MEDICAL STUDENTS: GENDER ASPECTS 新冠肺炎疫情对医学生心理健康的影响:性别层面
Pub Date : 1900-01-01 DOI: 10.21272/eumj.2022;10(3):283-291
N. Inshyna, I. Chorna, L. Hrebenyk, L. Primova
Introduction. The COVID-19 pandemic and the resulting decline in social communication have negatively affected many people’s mental health, especially young people. This research aimed to investigate the mental health of Sumy State University medical students during the Covid-19 pandemic. This study was conducted from September 2020 to May 2021.Materials and Methods. The second-year students of the Academic and Research Medical Institute of Sumy State University participated in the study – 100 female and 100 male students. The average age of the students was 18–22 years. The mental health of the medical students was examined using the Goldberg General Health Questionnaire (GHQ-28). The total scores for mental health, psychosomatic symptoms, anxiety, insomnia, social dysfunction, and depression were investigated. The experimental data were analyzed using PAST statistical software v4.05. The research was conducted in compliance with the WMA Declaration of Helsinki’s “Ethical Principles for Medical Research Involving Human Subjects” after obtaining consent from all participants.Results and Discussion. It was found that the COVID-19 pandemic caused mental health disorders in 63.5 % of medical students. There was no significant difference in the total GHQ score (> 8) between men and women. Social dysfunction occurred to be the most common mental health disorder in medical students. Somatic symptoms, anxiety, social dysfunction, and depression were observed in 37.5 %, 49 %, 64 %, and 14 % of medical students, respectively. The prevalence of social dysfunction and depression was higher in men than women.Conclusion. It was established that men experienced more significant disturbances in mental health than women during the COVID-19 pandemic.
介绍。2019冠状病毒病大流行及其导致的社交下降对许多人,特别是年轻人的心理健康产生了负面影响。本研究旨在调查新冠肺炎大流行期间苏美州立大学医学生的心理健康状况。该研究于2020年9月至2021年5月进行。材料与方法。苏梅国立大学学术和研究医学研究所的二年级学生参加了这项研究——100名女生和100名男生。学生的平均年龄为18-22岁。采用Goldberg一般健康问卷(GHQ-28)对医学生进行心理健康调查。调查了心理健康、心身症状、焦虑、失眠、社交功能障碍和抑郁的总分。实验数据采用PAST统计软件v4.05进行分析。本研究是在征得所有参与者同意后,按照世界医学会赫尔辛基宣言“涉及人体受试者的医学研究伦理原则”进行的。结果和讨论。结果发现,新冠肺炎大流行导致63.5%的医学生出现精神健康障碍。男女GHQ总分无显著差异(> 8)。社交功能障碍是医学生中最常见的心理健康障碍。躯体症状、焦虑、社交障碍和抑郁分别在37.5%、49%、64%和14%的医学生中出现。社会功能障碍和抑郁的患病率男性高于女性。已经确定,在2019冠状病毒病大流行期间,男性比女性经历了更严重的心理健康障碍。
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引用次数: 0
THERAPY OF PATIENTS WITH ANXIETY DISORDERS AND METABOLIC SYNDROME X 焦虑障碍与代谢综合征患者的治疗
Pub Date : 1900-01-01 DOI: 10.21272/eumj.2021;9(3):262-267
O. V. Kaushanska, O. Zaliavska, O. Nika
Objective of the research: to investigate the efficacy and safety of Afobazole in the treatment of adult patients with anxiety disorders and metabolic syndrome X.The study included 60 adult patients (18–65 years) (36 men, 24 women), whose clinical picture revealed mild and moderate forms of neurotic disorders observed in the therapeutic hospital and outpatient service. The main group (30 people) and control group (30 people) were formed on the basis of representativeness by gender and age (χ2emp <χ2krit, p ≤ 0.01). The sample consisted of patients who signed a written informed consent to participate in the study. The average age of the patients in the control group was 44.81 ± 2.17, in the main group ­– 45.13 ± 2.34 (p < 0.01); the average age of onset of mental disorders in the main group was 33.2 ± 3.1 years; in the control group it was 34.1 ± 3.4 years (p < 0.05); the average duration of psychopathological symptoms in the main group was 5.6 ± 0.6 months, in the control group – 5.8 ± 0.3 months (p < 0.05). The duration of treatment equaled 1 month of active therapy (later, the patients were transferred to maintenance therapy outside this study). Afobazole containing 0.01 g of active substance per tablet was used for treatment. The drug was prescribed 3 times a day (morning, afternoon and evening); the dose of the drug was increased: 1–1–2 (number of tablets per administration).There were changes in psychometric scaling, i.e. a significant decrease in state (by 57.2 and 42.9%; p ≤ 0.001) and trait (by 23.8 and 23.3%; p ≤ 0, 01) anxiety on the Spielberger–Khanin scale in the main and control groups at the end of treatment. In all groups of patients, we noted complete recovery (38.4%) or a significant improvement (37.9%); for most patients with mild manifestations, complete recovery was observed in 92% of cases. Among patients with moderate manifestations, a good response was recorded in 75% of cases; for the rest, moderate and minimal effects were observed, respectively. The changes in the severity as compared with baseline values were significantly positive (p < 0.05) already after 7 days of Afobazole therapy; similar changes were noted in the indicators of the overall effectiveness of therapy. No positive changes after Afobazole therapy were observed in 3.3% of cases, deterioration was registered in 3.3% of cases, while in the control group these values were 6.6% and 3.3%, respectively. The changes in somatic indicators also had positive trends in the control and main groups – SBP reduced by 11.0% and 18.0%, respectively (p ≤ 0.05); DBP – by 4.4% and 14.9% (p ≤ 0.05).The therapeutic effect of Afobazole is the reduction of viscero-vegetative manifestations of anxiety disorders, including relief of breathing, normalization of blood pressure and heart rate, reduction of muscle tension and pain, sweating and dizziness.
研究目的:探讨阿福巴唑治疗成人焦虑症和代谢综合征x的疗效和安全性。研究对象为60例18-65岁的成人患者(男36例,女24例),临床表现为在治疗医院和门诊观察到的轻中度神经性障碍。按性别、年龄的代表性分为主组(30人)和对照组(30人)(χ2emp <χ2krit, p≤0.01)。样本由签署书面知情同意书参加研究的患者组成。对照组患者平均年龄为44.81±2.17岁,主组患者平均年龄为45.13±2.34岁(p < 0.01);主组平均发病年龄为33.2±3.1岁;对照组为34.1±3.4年(p < 0.05);主组精神病理症状的平均持续时间为5.6±0.6个月,对照组为5.8±0.3个月(p < 0.05)。治疗时间相当于1个月的积极治疗(随后,患者转移到本研究外的维持治疗)。治疗方法为每片含0.01 g活性物质的阿福巴唑。每日开3次(早、中、晚);增加给药剂量:1-1-2(每次给药片数)。心理测量量表发生了变化,即状态显著下降(分别下降了57.2%和42.9%;P≤0.001)和性状差异(分别为23.8%和23.3%;p≤0.01)治疗结束时,两组患者在斯皮尔伯格-哈宁量表上的焦虑水平均有显著差异。在所有患者组中,我们注意到完全恢复(38.4%)或显著改善(37.9%);对于大多数表现轻微的患者,92%的病例完全康复。在中度表现的患者中,75%的病例有良好的反应;其余的,分别观察到中度和轻微的影响。阿福巴唑治疗7天后,与基线值相比,严重程度的变化显著为正(p < 0.05);在治疗总体有效性的指标中也注意到类似的变化。3.3%的病例经阿福巴唑治疗后无阳性变化,3.3%的病例病情恶化,而对照组分别为6.6%和3.3%。躯体指标的变化在对照组和主组也有正趋势,收缩压分别降低11.0%和18.0% (p≤0.05);DBP -分别降低4.4%和14.9% (p≤0.05)。阿福巴唑的治疗效果是减少焦虑障碍的内脏-植物性表现,包括呼吸的缓解,血压和心率的正常化,肌肉紧张和疼痛,出汗和头晕的减少。
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引用次数: 0
COMPARATIVE STUDY OF POLYMERIZATION DEPTH OF THREE PHOTOCOMPOSITE DENTAL FILLING MATERIALS FOR BULK FILL RESTORATION 三种光复合牙体修复材料聚合深度的比较研究
Pub Date : 1900-01-01 DOI: 10.21272/eumj.2023;11(2):205-213
I. Noenko, O. Pavlenko, Iurii Mochalov Iurii Mochalov
The objectives of the study was to compare the depth of polymerization of flowable photocomposite dental restorative materials for bulk fill tooth restorations in laboratory.Materials and methods. Three flowable bulk fill photocomposite dental restorative materials – "SDR® Posterior Bulk Fill Flowable Base," "Filtek™ Bulk Fill Flowable" and domestic "Jen-Radiance Molar-FW" – were chosen for the study. For each material, 10 black opaque thin-walled polyvinyl chloride molds with a length of 10.00 mm and a diameter of 3.00 mm were prepared. The molds were air-dried from a compressor and fixed in fluoroplastic retainers perpendicular to the metal opaque surface below and subsequently filled with the investigated restorative material along the entire length, in a contact manner, along the wall. After filling, the material was polymerized with an LED photopolymerizer directly in contact with the surface of the light guide for 40 seconds. Subsequently, the material was removed from the forms and the remains of the unpolymerized mass were removed from the surface of the polymerized cylinder of the composite with a metal dental sickle-shaped carrier (scarification test). The length of the polymerized cylinder was measured using an electronic micrometer.Results. Therefore, the study of the depth of polymerization of flowable bulk fill photocomposites "SDR® Posterior Bulk Fill Flowable Base", "Filtek™ Bulk Fill Flowable" and domestic "Jen-Radiance Molar-FW" showed that signs of polymerization of all three materials were observed in a depth of more than the "declared" four millimeters which may be explained by the improvement of the recipe for the preparation of such materials and the optimization of the transparency of the organic component and inorganic filler, as well as the regular distribution of photoactivators in the mass. "SDR" polymerized to a depth of 7.38 ± 0.17 (M = 7.30) mm, the minimum value was 7.16 mm and the maximum value was 7.71 mm. "Filtek Bulk Fill Flowable" polymerized to a lesser depth – on 6.34 ± 0.14 (М = 6.38) mm, the minimum value was 6.05 mm and the maximum value was 6.55 mm. The domestic analogue "Jen-Radiance Molar‑FW" showed even higher values of polymerization depth – 8.03 ± 0.19 (М = 7.98) mm, the minimum value was equal to 7.75 mm and the maximum value was 8.41 mm. Statistical tests showed probable similarity between "SDR" and "Jen-Radiance Molar-FW" in the depth of polymerization.Conclusions. All three studied flowable bulk fill photocomposite materials were polymerized to a depth greater than 4.00 mm. Domestic "Jen-Radiance Molar-FW" was similar to "SDR" according to the investigated feature.
本研究的目的是比较可流动光复合牙体修复材料在实验室中的聚合深度。材料和方法。三种可流动的散装填充光复合牙科修复材料-“SDR®后牙散装填充流动基板”,“Filtek™散装填充流动基板”和国产“Jen-Radiance Molar-FW”-被选择用于研究。每种材料制备10个黑色不透明薄壁聚氯乙烯模具,模具长10.00 mm,直径3.00 mm。模具从压缩机中风干,固定在垂直于下面金属不透明表面的氟塑料保持器中,随后沿着整个长度,以接触的方式沿着墙壁填充所研究的修复材料。填充后,将材料与LED光聚合剂直接接触光导表面聚合40秒。随后,用金属牙镰刀状载体从复合材料的聚合圆柱体表面移除材料,并将未聚合质量的残留物移除(划伤试验)。用电子千分尺测量了聚合圆柱的长度。因此,研究可流动体填充光复合材料“SDR®后向体填充可流动基”的聚合深度,“Filtek™Bulk Fill Flowable”和国产“Jen-Radiance Molar-FW”显示,在超过“宣布”的4毫米深度的地方观察到所有三种材料的聚合迹象,这可能是由于制备这些材料的配方的改进,有机成分和无机填料的透明度的优化,以及光活化剂在质量中的规则分布。“SDR”的聚合深度为7.38±0.17 (M = 7.30) mm,最小值为7.16 mm,最大值为7.71 mm。“Filtek Bulk Fill Flowable”聚合深度较小,为6.34±0.14 (М = 6.38) mm,最小值为6.05 mm,最大值为6.55 mm。国内类似物“Jen-Radiance Molar - FW”的聚合深度值更高,为8.03±0.19 (М = 7.98) mm,最小值为7.75 mm,最大值为8.41 mm。统计试验表明,“SDR”和“Jen-Radiance Molar-FW”在聚合深度上可能相似。所研究的三种可流动体填充光复合材料的聚合深度均大于4.00 mm。国产“Jen-Radiance Molar-FW”根据所调查的特征与“SDR”相似。
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引用次数: 0
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Eastern Ukrainian Medical Journal
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