Pub Date : 2019-12-29DOI: 10.21272/eumj.2019;7(4):372-376
O. Potapov, O. Kmyta, O. Tsyndrenko, N. Dmytrenko, E. Kolomiets, V. V. Pokhmura, M. P. Khavro, T. V. Bereznyi
Spinal cord tumors include tumors developing from its parenchyma, vessels, roots and membranes. The main theory of the formation of spinal cord tumors is the polyetiological dysontogenetic theory. According to this theory, hereditary factors, dysembriogenesis, trauma, carcinogenic effects, viral infection, intoxication, radiation, etc. play an important role in the development of tumors. Although scientists keep finding out more about genetic and environmental factors influencing the development of many types of tumors, spinal tumors are still a relatively unknown subject. Spinal tumors partially contain pathological genes, but in many cases, researchers don't know what causes these genetic changes. Tumors of the central nervous system (CNS) make up 12% of all tumors, tumors of the spinal cord – 3% of nervous system disorders, in the structure of malignant lesions of the CNS – 1,4-5%, occur mainly at the age of 20-60 years. In children, as well as in elderly and senile persons, these tumors are rare. Most often, they develop not from the brain matter, but from the surrounding tissue, and when they increase in size, they compress the spinal cord. Spinal tumors are usually divided into primary and secondary. The group of primary tumors include tumors, originating from the brain matter (intramedullar tumors), and those that grow from the membranes of the brain, roots, vessels (extramedullar tumors). Extramedullar tumors are much more common (in 80% of all spinal tumors) than intramedullar tumors. Extramedullar tumors can be both subdural and epidural. The majority of extramedullar tumors are subdural. Occasionally there are tumors, some of which are located inside the dural sac, and some – outside the dura mater, they are subdural-epidural tumors, as well as epidural-extrovertebral tumors. Among extramedullar tumors the most commonly diagnosed are meningiomas and neurinomas, among intramedullar the most common are ependymomas, less common are astrocytomas and oligodendroglioma. Glioblastomas of the spinal cord is extremely rare; the most common metastases from the posterior fossa are medulloblastomas. Intracerebral tumors of the spinal cord are characterized by greater biological benignity, than similar brain tumors. Extracerebral spinal cord tumors have no such differences in their biological properties. In general, spinal cord tumors are more common in elderly patients. Neurinomas and meningiomas predominate in adults, and ependymomas and dysgenetic tumors (teratoma, epidermoid cysts) – in children. Peculiarities of etiopathogenetic aspects, clinical course, influence on socio-economic factors encourage further improvement of diagnosis and more detailed study of this type of tumors. Materials and methods. The analysis of medical records of patients with spinal cord tumors, who were hospitalized in neurological departments of the Sumy Regional and 4th City Clinical Hospitals in 2015-2018 was carried out. 69 clinical cases were processed in or
{"title":"LOCALIZATION AND HISTOLOGICAL STRUCTURE OF SPINAL CORD TUMORS IN PATIENTS IN SUMY REGION","authors":"O. Potapov, O. Kmyta, O. Tsyndrenko, N. Dmytrenko, E. Kolomiets, V. V. Pokhmura, M. P. Khavro, T. V. Bereznyi","doi":"10.21272/eumj.2019;7(4):372-376","DOIUrl":"https://doi.org/10.21272/eumj.2019;7(4):372-376","url":null,"abstract":"Spinal cord tumors include tumors developing from its parenchyma, vessels, roots and membranes.\u0000\u0000The main theory of the formation of spinal cord tumors is the polyetiological dysontogenetic theory. According to this theory, hereditary factors, dysembriogenesis, trauma, carcinogenic effects, viral infection, intoxication, radiation, etc. play an important role in the development of tumors.\u0000\u0000Although scientists keep finding out more about genetic and environmental factors influencing the development of many types of tumors, spinal tumors are still a relatively unknown subject. Spinal tumors partially contain pathological genes, but in many cases, researchers don't know what causes these genetic changes.\u0000\u0000Tumors of the central nervous system (CNS) make up 12% of all tumors, tumors of the spinal cord – 3% of nervous system disorders, in the structure of malignant lesions of the CNS – 1,4-5%, occur mainly at the age of 20-60 years. In children, as well as in elderly and senile persons, these tumors are rare. Most often, they develop not from the brain matter, but from the surrounding tissue, and when they increase in size, they compress the spinal cord.\u0000\u0000Spinal tumors are usually divided into primary and secondary. The group of primary tumors include tumors, originating from the brain matter (intramedullar tumors), and those that grow from the membranes of the brain, roots, vessels (extramedullar tumors). Extramedullar tumors are much more common (in 80% of all spinal tumors) than intramedullar tumors.\u0000\u0000Extramedullar tumors can be both subdural and epidural. The majority of extramedullar tumors are subdural. Occasionally there are tumors, some of which are located inside the dural sac, and some – outside the dura mater, they are subdural-epidural tumors, as well as epidural-extrovertebral tumors.\u0000Among extramedullar tumors the most commonly diagnosed are meningiomas and neurinomas, among intramedullar the most common are ependymomas, less common are astrocytomas and oligodendroglioma. Glioblastomas of the spinal cord is extremely rare; the most common metastases from the posterior fossa are medulloblastomas.\u0000Intracerebral tumors of the spinal cord are characterized by greater biological benignity, than similar brain tumors. Extracerebral spinal cord tumors have no such differences in their biological properties.\u0000In general, spinal cord tumors are more common in elderly patients. Neurinomas and meningiomas predominate in adults, and ependymomas and dysgenetic tumors (teratoma, epidermoid cysts) – in children.\u0000Peculiarities of etiopathogenetic aspects, clinical course, influence on socio-economic factors encourage further improvement of diagnosis and more detailed study of this type of tumors.\u0000\u0000Materials and methods. The analysis of medical records of patients with spinal cord tumors, who were hospitalized in neurological departments of the Sumy Regional and 4th City Clinical Hospitals in 2015-2018 was carried out. 69 clinical cases were processed in or","PeriodicalId":315243,"journal":{"name":"Eastern Ukrainian Medical Journal","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115008316","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}
Pub Date : 2019-12-29DOI: 10.21272/eumj.2019;7(4):323-328
V. Psarova
Relevance. The activation of free radical oxidative processes and the development of oxidative stress is one of the most important pathogenetic mechanisms of cardiovascular diseases. Active forms of oxygen can change cellular infiltration of vessels and endothelial function, having an impact on a functional condition of the adhesive molecules intercellular adhesion molecule-1 and vascular cell adhesion molecule-1. Under condition of insulin resistance (IR), the balance in the system of oxidative stress – antioxidant protection is disturbed, the result of which is insufficient resistance to the damaging effect of the LPO products. The aim of the study was to assess the dependence of the activity of the system of oxidative stress – antioxidant protection on insulin resistance (IR) in patients with comorbidity of arterial hypertension and obesity. We examined 200 patients with hypertension and class I–II obesity. The patients were divided into two groups depending on IR: the first group included 80 patients without IR and the second group – 120 patients with IR. As the result of the study, it was established that the presence of IR affects the activity of the system of oxidative stress – antioxidant protection in comorbidity of hypertension and obesity. In the presence of IR, patients with hypertension and concomitant obesity have significantly higher levels of indicators of the system of oxidative stress (malondialdehyde (MDA) and diene conjugates (DC)) compared with patients without IR. In patients with comorbidity of hypertension and obesity, HOMA-IR directly correlated with the indicators of the oxidative stress system (MDA and DC) and inversely correlated with the indicator of total antioxidant protection. In hypertensive patients with obesity and no IR, an increase in HOMA-IR was associated with a decrease in total antioxidant protection, and in patients with IR, an increase in HOMA-IR was associated with an increase in MDA and DC, as well as a decrease in total antioxidant protection.
{"title":"DEPENDENCE OF THE ACTIVITY OF THE SYSTEM OF OXIDATIVE STRESS – ANTIOXIDANT PROTECTION ON INSULIN RESISTANCE IN PATIENTS WITH ESSENTIAL HYPERTENSION AND OBESITY","authors":"V. Psarova","doi":"10.21272/eumj.2019;7(4):323-328","DOIUrl":"https://doi.org/10.21272/eumj.2019;7(4):323-328","url":null,"abstract":"Relevance. The activation of free radical oxidative processes and the development of oxidative stress is one of the most important pathogenetic mechanisms of cardiovascular diseases. Active forms of oxygen can change cellular infiltration of vessels and endothelial function, having an impact on a functional condition of the adhesive molecules intercellular adhesion molecule-1 and vascular cell adhesion molecule-1. Under condition of insulin resistance (IR), the balance in the system of oxidative stress – antioxidant protection is disturbed, the result of which is insufficient resistance to the damaging effect of the LPO products.\u0000The aim of the study was to assess the dependence of the activity of the system of oxidative stress – antioxidant protection on insulin resistance (IR) in patients with comorbidity of arterial hypertension and obesity.\u0000We examined 200 patients with hypertension and class I–II obesity. The patients were divided into two groups depending on IR: the first group included 80 patients without IR and the second group – 120 patients with IR.\u0000As the result of the study, it was established that the presence of IR affects the activity of the system of oxidative stress – antioxidant protection in comorbidity of hypertension and obesity. In the presence of IR, patients with hypertension and concomitant obesity have significantly higher levels of indicators of the system of oxidative stress (malondialdehyde (MDA) and diene conjugates (DC)) compared with patients without IR. In patients with comorbidity of hypertension and obesity, HOMA-IR directly correlated with the indicators of the oxidative stress system (MDA and DC) and inversely correlated with the indicator of total antioxidant protection. In hypertensive patients with obesity and no IR, an increase in HOMA-IR was associated with a decrease in total antioxidant protection, and in patients with IR, an increase in HOMA-IR was associated with an increase in MDA and DC, as well as a decrease in total antioxidant protection.","PeriodicalId":315243,"journal":{"name":"Eastern Ukrainian Medical Journal","volume":"89 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132778675","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}
Pub Date : 2019-09-29DOI: 10.21272/eumj.2019;7(3):190-193
O. Lebid, K. Duda
Introduction: Dental care is one of the most popular types of medical care. At the moment, the state of dental health of the adult and infant population of Ukraine is deteriorating with each passing year. Today, children of school age have an average of 3–4 permanent teeth affected, and at the time of school leaving, every fifth child has one permanent tooth removed. It is possible to change the situation for the better and to improve the health of the younger generation only by methods of primary prevention. Materials and metods. We analyzed the responses of 103 children aged 13–15 years in Ternopil in the questionnaire, which was developed at the Department of Dentistry of the Educational and Research Institute of Postgraduate Education of the State Pedagogical University "I. Horbachevsky Ternopil State Medical University of Ministry of Health of Ukraine". The questionnaire contained a question about the multiplicity of teeth cleaning per day; frequency of toothbrush change; frequency of visits to a dentist; the name of manufacturers of toothpastes and brushes. Discussion. We can state insufficient level of sanitary-hygienic knowledge in most adolescents. Taking into account the low level of medical literacy of the population, which leads to further deterioration of dental health, it is necessary to create differentiated educational programs for children, parents, educators, etc. The lack of awareness of children suggests that educational work among the population is conducted at an unsanitary level, and the schemes of their conduct often do not meet modern requirements.
{"title":"АNALYSIS OF SANITARY-EDUCATIVE ACTIVITIES AMONG CHILDREN OF SCHOOL AGE IN TERNOPIL","authors":"O. Lebid, K. Duda","doi":"10.21272/eumj.2019;7(3):190-193","DOIUrl":"https://doi.org/10.21272/eumj.2019;7(3):190-193","url":null,"abstract":"Introduction: Dental care is one of the most popular types of medical care. At the moment, the state of dental health of the adult and infant population of Ukraine is deteriorating with each passing year. Today, children of school age have an average of 3–4 permanent teeth affected, and at the time of school leaving, every fifth child has one permanent tooth removed. It is possible to change the situation for the better and to improve the health of the younger generation only by methods of primary prevention. \u0000Materials and metods. We analyzed the responses of 103 children aged 13–15 years in Ternopil in the questionnaire, which was developed at the Department of Dentistry of the Educational and Research Institute of Postgraduate Education of the State Pedagogical University \"I. Horbachevsky Ternopil State Medical University of Ministry of Health of Ukraine\". The questionnaire contained a question about the multiplicity of teeth cleaning per day; frequency of toothbrush change; frequency of visits to a dentist; the name of manufacturers of toothpastes and brushes. \u0000Discussion. We can state insufficient level of sanitary-hygienic knowledge in most adolescents. Taking into account the low level of medical literacy of the population, which leads to further deterioration of dental health, it is necessary to create differentiated educational programs for children, parents, educators, etc. The lack of awareness of children suggests that educational work among the population is conducted at an unsanitary level, and the schemes of their conduct often do not meet modern requirements.","PeriodicalId":315243,"journal":{"name":"Eastern Ukrainian Medical Journal","volume":"93 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126194332","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}
Pub Date : 2019-09-29DOI: 10.21272/eumj.2019;7(3):226-232
A. Kuleshov
Mitral valve prolapse plays an important role in cardiovascular pathology in children. The study reveals the condition of the central hemodynamic and echomorphometric parameters in children with mitral valve prolapse (MVP) taking into account mitral regurgitation. Materials and methods. We examined 106 children with MVP. Among them there were 90 children with MVP of 1 st degree and 16 children with the 2 nd degree aged from 13 to 17 years. The presence and absence of mitral regurgitation were included also. Thus, 56 (52.8%) children with MVP of the 1 st degree formed subgroup without mitral regurgitation, and 34 (32.1%) – with regurgitation. MVP of the 2 nd degree formed subgroup which included children both without – 6 (5.6%) and with regurgitation – 10 (9.4%). The control group consisted of 23 almost healthy children of the same age. All patients were clinically examined and consulted by specialists. Common echocardiographic parameters were used for the study. Results. An increase (p<0.05) of E/A parameter in children with MVP was noted, mainly with 1 st degree. It showed the initial manifestations of diastolic dysfunction of the heart. This indicator increases with regurgitation appearance and depends from the MVP degree (r=0.45). Hemodynamics was generally within normal criteria. Conclusions . In children with mitral valve prolapse, regardless to degree, normovolemic and eukinetic type of central hemodynamic was observed. Children with MVP with regurgitation appearance have increased risk of left ventricular diastolic dysfunction. With the progression of mitral valve prolapse, manifestations of diastolic myocardial dysfunction increases. This category of children must have preventive methods to restore echomorphometric parameters for reducing complications occurrence.
{"title":"MITRAL REGURGITATION IN CHILDREN WITH MITRAL VALVE PORLAPSE. FEATURES OF ECHOCARDIOGRAPHIC INDICATORS","authors":"A. Kuleshov","doi":"10.21272/eumj.2019;7(3):226-232","DOIUrl":"https://doi.org/10.21272/eumj.2019;7(3):226-232","url":null,"abstract":"Mitral valve prolapse plays an important role in cardiovascular pathology in children. The study reveals the condition of the central hemodynamic and echomorphometric parameters in children with mitral valve prolapse (MVP) taking into account mitral regurgitation. Materials and methods. We examined 106 children with MVP. Among them there were 90 children with MVP of 1 st degree and 16 children with the 2 nd degree aged from 13 to 17 years. The presence and absence of mitral regurgitation were included also. Thus, 56 (52.8%) children with MVP of the 1 st degree formed subgroup without mitral regurgitation, and 34 (32.1%) – with regurgitation. MVP of the 2 nd degree formed subgroup which included children both without – 6 (5.6%) and with regurgitation – 10 (9.4%). The control group consisted of 23 almost healthy children of the same age. All patients were clinically examined and consulted by specialists. Common echocardiographic parameters were used for the study. Results. An increase (p<0.05) of E/A parameter in children with MVP was noted, mainly with 1 st degree. It showed the initial manifestations of diastolic dysfunction of the heart. This indicator increases with regurgitation appearance and depends from the MVP degree (r=0.45). Hemodynamics was generally within normal criteria. Conclusions . In children with mitral valve prolapse, regardless to degree, normovolemic and eukinetic type of central hemodynamic was observed. Children with MVP with regurgitation appearance have increased risk of left ventricular diastolic dysfunction. With the progression of mitral valve prolapse, manifestations of diastolic myocardial dysfunction increases. This category of children must have preventive methods to restore echomorphometric parameters for reducing complications occurrence.","PeriodicalId":315243,"journal":{"name":"Eastern Ukrainian Medical Journal","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115422953","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}
Pub Date : 2019-09-29DOI: 10.21272/eumj.2019;7(3):267-275
O. Sytnyk, O. Melekhovets, O. Yezhova, D.Voropaiev, S. Abramova, D. Popovych, M. Stetsenko, A. Osadchiy
Introduction. Diabetes is one of the most common chronic diseases in the world. Recently, this disease has been considered as a social problem, which is getting more and more urgent. The increase in the incidence and mortality of type 2 diabetes observed in recent decades requires active influence on risk factors, development of preventive measures, optimization of treatment regimens, active use of physical therapy. Purpose: To investigate the possibility of quality of life improvement in middle-aged people with type 2 diabetes by means of adjustment of physical activity, namely by implementing a specially designed physical therapy program. Materials and methods: survey (WHOQOL-BREF questionnaire), somatometry (height, weight, circumference), pulsometry, tonometry, dynamometry (handgrip), functional tests (static strength endurance, aerobic endurance), perceived exertion (Borg scale). An adequate physiotherapy program for middle-aged people with type 2 diabetes that is suitable for treatment and rehabilitation process was proposed. The program was implemented in the University Clinic of Sumy State University. Discussion: The theoretical part of the paper emphasizes that the use of comprehensive approach only can help normalize carbohydrate metabolism, increase exercise tolerance, reduce body weight, and improve quality of life. During implementation of the experimental part of the study, we contributed to motivation to increase motor activity, implemented a program of physical therapy for middle-aged people with type 2 diabetes and class I-II obesity, which consisted of strength and aerobic exercises of moderate intensity and relaxation exercises. The empirical part of the work proves the program to be the effective. The analysis of the results indicates positive changes in the functional systems of the organism, namely, decrease in waist circumference, hip circumference, neck circumference, significant change in shoulder arc length, increase in ankle circumference, body mass index, waist circumference to hip circumference ratio, significant increase in static strength endurance of abdominal muscles. These changes have a positive effect on a person's quality of life, self-esteem for physical and especially mental health.
{"title":"QUALITY OF LIFE IMPROVEMENT IN MIDDLE-AGED PEOPLE WITH TYPE 2 DIABETES BY MEANS OF PHYSICAL THERAPY","authors":"O. Sytnyk, O. Melekhovets, O. Yezhova, D.Voropaiev, S. Abramova, D. Popovych, M. Stetsenko, A. Osadchiy","doi":"10.21272/eumj.2019;7(3):267-275","DOIUrl":"https://doi.org/10.21272/eumj.2019;7(3):267-275","url":null,"abstract":"Introduction. Diabetes is one of the most common chronic diseases in the world. Recently, this disease has been considered as a social problem, which is getting more and more urgent. The increase in the incidence and mortality of type 2 diabetes observed in recent decades requires active influence on risk factors, development of preventive measures, optimization of treatment regimens, active use of physical therapy. \u0000Purpose: To investigate the possibility of quality of life improvement in middle-aged people with type 2 diabetes by means of adjustment of physical activity, namely by implementing a specially designed physical therapy program. \u0000Materials and methods: survey (WHOQOL-BREF questionnaire), somatometry (height, weight, circumference), pulsometry, tonometry, dynamometry (handgrip), functional tests (static strength endurance, aerobic endurance), perceived exertion (Borg scale). \u0000An adequate physiotherapy program for middle-aged people with type 2 diabetes that is suitable for treatment and rehabilitation process was proposed. The program was implemented in the University Clinic of Sumy State University. \u0000Discussion: The theoretical part of the paper emphasizes that the use of comprehensive approach only can help normalize carbohydrate metabolism, increase exercise tolerance, reduce body weight, and improve quality of life. During implementation of the experimental part of the study, we contributed to motivation to increase motor activity, implemented a program of physical therapy for middle-aged people with type 2 diabetes and class I-II obesity, which consisted of strength and aerobic exercises of moderate intensity and relaxation exercises. The empirical part of the work proves the program to be the effective. The analysis of the results indicates positive changes in the functional systems of the organism, namely, decrease in waist circumference, hip circumference, neck circumference, significant change in shoulder arc length, increase in ankle circumference, body mass index, waist circumference to hip circumference ratio, significant increase in static strength endurance of abdominal muscles. These changes have a positive effect on a person's quality of life, self-esteem for physical and especially mental health.","PeriodicalId":315243,"journal":{"name":"Eastern Ukrainian Medical Journal","volume":"194 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115634005","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}
Pub Date : 2019-09-29DOI: 10.21272/eumj.2019;7(3):208-214
M. Kochuieva, V. Psarova
Relevance. The main component of the metabolic syndrome (MS) is the abdominal obesity (AO) which inevitably leads to insulin resistance (IR). Adiponectin (AN) secreted by the adipocytes protects from the IR development, increases the sensitivity of skeletal muscles to insulin, reduces intake of free fatty acids in a liver and, thus reduces the synthesis of atherogenic lipoproteins. Some investigations prove that the level of the adiponectin in blood plasma correlates back with the mass of the fatty tissue, the waist-hip ratio and IR expressiveness. With obesity, AN secretion decreases, losing its protective role as for the risk of IR development and metabolic violations. It is known that ADIPOQ gene has several polymorphic sites, which influence the production and activity of AN. Allelic options of its polymorphic marker G276T are associated with the development of the AO, IR, and diabetes. The aim of the study was to investigate the association of the genetic polymorphism of the G276T marker of the adiponectin gene with changes in metabolic parameters in patients with arterial hypertension (AH) and concomitant obesity. We examined 300 patients with AH 45 to 55 years old who gave informed written consent to participate in the study and met the inclusion criteria. Group 1 consisted of 200 patients with AH and class I–II obesity, group 2 – 50 patients with AH and normal body weight, group 3 – 50 patients with AH and overweight. The control group consisted of 30 practically healthy individuals, in whom AH and obesity were excluded on the basis of clinical and instrumental examination data. As a result of the study the association of T-allele of the polymorphic marker G276T of the adiponectin gene with the development of comorbidity of AH and obesity was established. It has been proven that adiponectin gene polymorphism influenced changes in metabolic parameters in hypertensive patients with obesity: more pronounced impairment of metabolic parameters in G/T and T/T genotypes as compared to G/G genotype. G/T and T/T genotypes of the polymorphic marker G276T of the adiponectin gene were associated with a significantly higher body mass index, higher triglyceride levels, more pronounced insulin resistance and adipokine imbalance.
{"title":"PARTICULARITIES OF METABOLIC INDICATORS IN PATIENTS WITH ARTERIAL HYPERTENSION AND CONCOMITANT OBESITY DEPENDING ON ADIPONECTIN GENE POLYMORPHISM","authors":"M. Kochuieva, V. Psarova","doi":"10.21272/eumj.2019;7(3):208-214","DOIUrl":"https://doi.org/10.21272/eumj.2019;7(3):208-214","url":null,"abstract":"Relevance. The main component of the metabolic syndrome (MS) is the abdominal obesity (AO) which inevitably leads to insulin resistance (IR). Adiponectin (AN) secreted by the adipocytes protects from the IR development, increases the sensitivity of skeletal muscles to insulin, reduces intake of free fatty acids in a liver and, thus reduces the synthesis of atherogenic lipoproteins. Some investigations prove that the level of the adiponectin in blood plasma correlates back with the mass of the fatty tissue, the waist-hip ratio and IR expressiveness. With obesity, AN secretion decreases, losing its protective role as for the risk of IR development and metabolic violations. \u0000It is known that ADIPOQ gene has several polymorphic sites, which influence the production and activity of AN. Allelic options of its polymorphic marker G276T are associated with the development of the AO, IR, and diabetes. \u0000The aim of the study was to investigate the association of the genetic polymorphism of the G276T marker of the adiponectin gene with changes in metabolic parameters in patients with arterial hypertension (AH) and concomitant obesity. \u0000We examined 300 patients with AH 45 to 55 years old who gave informed written consent to participate in the study and met the inclusion criteria. Group 1 consisted of 200 patients with AH and class I–II obesity, group 2 – 50 patients with AH and normal body weight, group 3 – 50 patients with AH and overweight. The control group consisted of 30 practically healthy individuals, in whom AH and obesity were excluded on the basis of clinical and instrumental examination data. \u0000As a result of the study the association of T-allele of the polymorphic marker G276T of the adiponectin gene with the development of comorbidity of AH and obesity was established. It has been proven that adiponectin gene polymorphism influenced changes in metabolic parameters in hypertensive patients with obesity: more pronounced impairment of metabolic parameters in G/T and T/T genotypes as compared to G/G genotype. G/T and T/T genotypes of the polymorphic marker G276T of the adiponectin gene were associated with a significantly higher body mass index, higher triglyceride levels, more pronounced insulin resistance and adipokine imbalance.","PeriodicalId":315243,"journal":{"name":"Eastern Ukrainian Medical Journal","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131653699","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}
Pub Date : 2019-09-29DOI: 10.21272/eumj.2019;7(3):257-266
О. Kravets, Dnipro Ukraine Vernadsky str.
Introduction. Postoperative pulmonary complications occur in 5–70% of cases in surgical patients and are accompanied by significant short-term and long-term mortality. The purpose is to conduct a comparative analysis of the relationship between the frequency of postoperative pulmonary complications, the degree of surgical risk and the development of interstitial edema in different modes of infusion therapy in patients with moderate and high surgical risk with acute abdominal pathology. Materials and Methods. We examined 200 patients with acute abdominal pathology, operated on urgently by laparatomy access. Patients were divided into groups according to the degree of surgical risk, subgroups were formed taking into account the regimen of infusion therapy. Subgroup 1.1 (n = 50) included patients who received infusion therapy in a liberal regimen; in subgroup 1.2 (n = 50), infusion therapy was performed in a restriction regimen. Subgroup 2.1 (n = 50) consisted of patients who received goal-direct infusion therapy, subgroup 2.2 (n = 50) – restrictive infusion therapy. The non-invasive bioelectric rheography method was used to evaluate the performance of the body's water sectors, sonographically determine the degree of fluid accumulation in the extravascular pulmonary fluid space, postoperative pulmonary complications were verified on the basis of clinical, laboratory and radiological data. In the total cohort of patients we noted 10.5% of postoperative pulmonary complications. In the postoperative period of the liberal regime of infusion therapy was accompanied by an increase of interstitial volume by 146% (p<0.04) and 159% (p<0.02) of norm, a moderate degree of accumulation of fluid within the pulmonary space (R=0,86, p=0.04) and had a strong direct relationship with the development 16% of postoperative pulmonary complications (R=0.79, p=0.002). The absence of interstitial edema on the background of the restrictive regime of infusion therapy, normal sonographic pattern of light when the frequency of postoperative pulmonary complications 6% in the group of moderate surgical risk of 10% in the group of high surgical risk. Goal-direct infusion therapy generates an increase in the volume of interstices on the first day, the accumulation of fluid within the primary space of mild to 3 days and combined with a 10% development of pulmonary complications after surgery.
{"title":"INFLUENCE OF DIFFERENT INFUSION THERAPY MODES ON THE DEVELOPMENT OF POSTOPERATIVE PULMONARY COMPLICATIONS IN PATIENTS WITH MEDIUM AND HIGH SURGICAL RISK WITH ACUTE ABDOMINAL PATHOLOGY","authors":"О. Kravets, Dnipro Ukraine Vernadsky str.","doi":"10.21272/eumj.2019;7(3):257-266","DOIUrl":"https://doi.org/10.21272/eumj.2019;7(3):257-266","url":null,"abstract":"Introduction. Postoperative pulmonary complications occur in 5–70% of cases in surgical patients and are accompanied by significant short-term and long-term mortality. The purpose is to conduct a comparative analysis of the relationship between the frequency of postoperative pulmonary complications, the degree of surgical risk and the development of interstitial edema in different modes of infusion therapy in patients with moderate and high surgical risk with acute abdominal pathology. Materials and Methods. We examined 200 patients with acute abdominal pathology, operated on urgently by laparatomy access. Patients were divided into groups according to the degree of surgical risk, subgroups were formed taking into account the regimen of infusion therapy. Subgroup 1.1 (n = 50) included patients who received infusion therapy in a liberal regimen; in subgroup 1.2 (n = 50), infusion therapy was performed in a restriction regimen. Subgroup 2.1 (n = 50) consisted of patients who received goal-direct infusion therapy, subgroup 2.2 (n = 50) – restrictive infusion therapy. The non-invasive bioelectric rheography method was used to evaluate the performance of the body's water sectors, sonographically determine the degree of fluid accumulation in the extravascular pulmonary fluid space, postoperative pulmonary complications were verified on the basis of clinical, laboratory and radiological data. In the total cohort of patients we noted 10.5% of postoperative pulmonary complications. In the postoperative period of the liberal regime of infusion therapy was accompanied by an increase of interstitial volume by 146% (p<0.04) and 159% (p<0.02) of norm, a moderate degree of accumulation of fluid within the pulmonary space (R=0,86, p=0.04) and had a strong direct relationship with the development 16% of postoperative pulmonary complications (R=0.79, p=0.002). The absence of interstitial edema on the background of the restrictive regime of infusion therapy, normal sonographic pattern of light when the frequency of postoperative pulmonary complications 6% in the group of moderate surgical risk of 10% in the group of high surgical risk. Goal-direct infusion therapy generates an increase in the volume of interstices on the first day, the accumulation of fluid within the primary space of mild to 3 days and combined with a 10% development of pulmonary complications after surgery.","PeriodicalId":315243,"journal":{"name":"Eastern Ukrainian Medical Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132265683","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}
Pub Date : 2019-09-29DOI: 10.21272/eumj.2019;7(3):194-207
V. Ivanov, T. Onyshchuk
This article determines gender- and age-specific peculiarities of left heart changes in patients with stage II hypertension regardless of degree. For this purpose, a complete examination of 160 male and female patients was conducted. The examined cohort was divided into 4 subgroups: the 1st – young men aged 18 to 44 years (n = 40), the 2nd – young women (n = 40), the 3rd – middle-aged men from 45 to 60 years (n = 40) and the 4th – middle-aged women (n = 40). All groups were comparable to age and gender. Verification of the diagnosis was carried out on the basis of existing criteria. All persons who were included in the study underwent general clinical and instrumental methods of examination, which included echocardiography (Echo-CG) conducted by means of ultrasound diagnostic scanner “HI VISION AVINS” (“NITASNI”, Japan) in a one-dimensional (M-mode), two-dimensional (B-mode), by means of Doppler echocardiography and tissue scanning mode according to the generally accepted methodology. The obtained results showed that a significant increase in LA dimensions/volumes and their indices, aortic diameter value, LV, RV, myocardial thickness and its mass, diastolic and systolic stress levels was recorded in young men as compared to women of the same age. The average age of the examined persons, that formed the main group, was marked only by an increase in the absolute/relative dimensions of LA. The most important differences in morphological and functional parameters and the increase in dimensions of LA, LV, aortic diameter, RV, myocardial thickness and its mass, diastolic and systolic stress levels were reported exactly in middle-aged women, as opposed to young women. Of the calculated indices of LP and mass of myocardium of left ventricle, the strongest association with age was shown by the indices calculated for recalculation in grade 2.7. Fundamental differences in the nature of LV structural remodeling were determined in middle-aged men as compared to middle-aged women. A decrease in cases of LV normal geometry and an increase in cases with LV concentric remodeling were recorded. The conducted analysis of the nature of LV structural remodeling with respect to age showed fundamental differences in middle-aged women, as opposed to young women. A significant decrease in cases with concentric remodeling and an increase in cases with concentric hypertrophy was observed.
{"title":"GENDER- AND AGE-SPECIFIC PECULIARITIES OF LEFT HEART REMODELING IN PATIENTS WITH ARTERIAL HYPERTENSION","authors":"V. Ivanov, T. Onyshchuk","doi":"10.21272/eumj.2019;7(3):194-207","DOIUrl":"https://doi.org/10.21272/eumj.2019;7(3):194-207","url":null,"abstract":"This article determines gender- and age-specific peculiarities of left heart changes in patients with stage II hypertension regardless of degree. For this purpose, a complete examination of 160 male and female patients was conducted. The examined cohort was divided into 4 subgroups: the 1st – young men aged 18 to 44 years (n = 40), the 2nd – young women (n = 40), the 3rd – middle-aged men from 45 to 60 years (n = 40) and the 4th – middle-aged women (n = 40). All groups were comparable to age and gender. Verification of the diagnosis was carried out on the basis of existing criteria. All persons who were included in the study underwent general clinical and instrumental methods of examination, which included echocardiography (Echo-CG) conducted by means of ultrasound diagnostic scanner “HI VISION AVINS” (“NITASNI”, Japan) in a one-dimensional (M-mode), two-dimensional (B-mode), by means of Doppler echocardiography and tissue scanning mode according to the generally accepted methodology. \u0000The obtained results showed that a significant increase in LA dimensions/volumes and their indices, aortic diameter value, LV, RV, myocardial thickness and its mass, diastolic and systolic stress levels was recorded in young men as compared to women of the same age. The average age of the examined persons, that formed the main group, was marked only by an increase in the absolute/relative dimensions of LA. The most important differences in morphological and functional parameters and the increase in dimensions of LA, LV, aortic diameter, RV, myocardial thickness and its mass, diastolic and systolic stress levels were reported exactly in middle-aged women, as opposed to young women. Of the calculated indices of LP and mass of myocardium of left ventricle, the strongest association with age was shown by the indices calculated for recalculation in grade 2.7. \u0000Fundamental differences in the nature of LV structural remodeling were determined in middle-aged men as compared to middle-aged women. A decrease in cases of LV normal geometry and an increase in cases with LV concentric remodeling were recorded. The conducted analysis of the nature of LV structural remodeling with respect to age showed fundamental differences in middle-aged women, as opposed to young women. A significant decrease in cases with concentric remodeling and an increase in cases with concentric hypertrophy was observed.","PeriodicalId":315243,"journal":{"name":"Eastern Ukrainian Medical Journal","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115320705","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}
Pub Date : 2019-09-29DOI: 10.21272/eumj.2019;7(3):246-256
V. P. Іvanov, M. Kolesnyk
Introduction. Quality of life (QoL) indicators in case of chronic heart failure (CHF) are associated with a number of clinical and instrumental indicators, which makes it possible to consider its assessment as one of the leading indicators of its severity. From a practical point of view, the identification of QoL indicators as the markers of CHF severity in patients with concomitant iron metabolism disorders, including different variants of latent and manifest iron deficiency (ID)is rather interesting. Purpose. To compare QoL parameters by means of MOS SF-36 and MLHFQ questionnaires in patients with CHF with reduced left ventricular ejection fraction with different iron deficiency types. Materials and Methods. 152 patients with CHF functional class (FC) II-III according to NYHA with reduced left ventricular (LV) ejection fraction (EF) of hypertensive and ischemic etiology with/and without iron deficiency (ID) were examined. All patients were divided into three clinical groups: the first clinical group (which is presented as a comparison group) amounted to 30 (19.7 %) patients with CHF with reduced LV EF without ID, the second one amounted to 60 (39.5 %) patients with CHF with reduced LV EF and latent ID, which included a number of patients with functional and absolute ID and the third clinical group amounted to 62 (40.79 %) patients with I-II severity degree of concomitant iron deficiency anemia (IDA). In order to assess QoL, all patients were interviewed using MOS SF-36 and MLHFQ. The comparison of the obtained findings was carried out among groups of patients with CHF with reduced LV EF without iron metabolism disorders, with functional ID and absolute ID, and among groups of patients with CHF with reduced LV EF without iron metabolism disorders, with I degree of IDA and II degree of IDA. Research findings. It was detected that in comparison with the group of patients without ID, QoL indicators according to MLHFQ questionnaire in patients with functional ID and absolute ID were significantly worse – 49.5 versus 53.5 (p = 0.05) and 60 points (p = 0.009), respectively. Physical health (PH) in these groups was 37.9 (p = 0.033) and 37.2 (p = 0.0068), respectively, which significantly differed from PH value in the comparison group – 41.2 points. In patients with functional ID and absolute ID lower PH values were detected due to significantly worse indicators of physical functioning (PF), role-physical functioning (RP) resulting from physical condition and general health (GH). Similar results were obtained during the analysis of QoL in patients with IDA of different degrees. In patients with mild IDA and moderate IDA as compared to the group of patients without ID, QoL indicators, according to MLHFQ questionnaire, were significantly worse (p = 0.007) and (p < 0.00001) 57 and 62 versus 49.5 points, respectively. In addition, it was detected that PH value according to SF-36 questionnaire results in the groups with IDA was also significantly lower th
{"title":"COMPARATIVE CHARACTERISTICS OF QUALITY OF LIFE INDICATORS IN PATIENTS WITH CHRONIC HEART FAILURE WITH REDUCED LEFT VENTRICULAR EJECTION FRACTION DEPENDING ON IRON DEFICIENCY TYPE","authors":"V. P. Іvanov, M. Kolesnyk","doi":"10.21272/eumj.2019;7(3):246-256","DOIUrl":"https://doi.org/10.21272/eumj.2019;7(3):246-256","url":null,"abstract":"Introduction. Quality of life (QoL) indicators in case of chronic heart failure (CHF) are associated with a number of clinical and instrumental indicators, which makes it possible to consider its assessment as one of the leading indicators of its severity. From a practical point of view, the identification of QoL indicators as the markers of CHF severity in patients with concomitant iron metabolism disorders, including different variants of latent and manifest iron deficiency (ID)is rather interesting. \u0000Purpose. To compare QoL parameters by means of MOS SF-36 and MLHFQ questionnaires in patients with CHF with reduced left ventricular ejection fraction with different iron deficiency types. \u0000Materials and Methods. 152 patients with CHF functional class (FC) II-III according to NYHA with reduced left ventricular (LV) ejection fraction (EF) of hypertensive and ischemic etiology with/and without iron deficiency (ID) were examined. All patients were divided into three clinical groups: the first clinical group (which is presented as a comparison group) amounted to 30 (19.7 %) patients with CHF with reduced LV EF without ID, the second one amounted to 60 (39.5 %) patients with CHF with reduced LV EF and latent ID, which included a number of patients with functional and absolute ID and the third clinical group amounted to 62 (40.79 %) patients with I-II severity degree of concomitant iron deficiency anemia (IDA). In order to assess QoL, all patients were interviewed using MOS SF-36 and MLHFQ. The comparison of the obtained findings was carried out among groups of patients with CHF with reduced LV EF without iron metabolism disorders, with functional ID and absolute ID, and among groups of patients with CHF with reduced LV EF without iron metabolism disorders, with I degree of IDA and II degree of IDA. \u0000Research findings. It was detected that in comparison with the group of patients without ID, QoL indicators according to MLHFQ questionnaire in patients with functional ID and absolute ID were significantly worse – 49.5 versus 53.5 (p = 0.05) and 60 points (p = 0.009), respectively. Physical health (PH) in these groups was 37.9 (p = 0.033) and 37.2 (p = 0.0068), respectively, which significantly differed from PH value in the comparison group – 41.2 points. In patients with functional ID and absolute ID lower PH values were detected due to significantly worse indicators of physical functioning (PF), role-physical functioning (RP) resulting from physical condition and general health (GH). Similar results were obtained during the analysis of QoL in patients with IDA of different degrees. In patients with mild IDA and moderate IDA as compared to the group of patients without ID, QoL indicators, according to MLHFQ questionnaire, were significantly worse (p = 0.007) and (p < 0.00001) 57 and 62 versus 49.5 points, respectively. In addition, it was detected that PH value according to SF-36 questionnaire results in the groups with IDA was also significantly lower th","PeriodicalId":315243,"journal":{"name":"Eastern Ukrainian Medical Journal","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127883209","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}
Pub Date : 2019-09-29DOI: 10.21272/eumj.2019;7(3):177-182
Ye. I. Slynko, O. O. Potapov, Y. Derkach
Introduction. We aimed to evaluate the results of surgical treatment of patients with peripheral nerve sheath tumors with specification of the peculiarities of their structure and extension pattern, and to determine prognostically unfavorable morphological features in tumors of peripheral nerves. Materials and methods. The study is based on a retrospective analysis of the medical records of 65 patients who were operated in our Neurosurgical Department during 2008 to 2018. The indication for the operation was worsening of neurological symptoms as a result of the tumor process in the cervical spine, verified by methods of neuroimaging (spondylography, CT, SCT, MRI). The choice of the surgical access depended on such factors as the tumor location regarding to the dura mater and the nervous structures, bones. Discussion: the expected response to surgical treatment in patients with peripheral nerve sheath tumors depends on many factors: localization, directions of neoplasm extension, radical nature of the treatment and the histological variant of the tumor. The tumors of the spinal nerves are quite common and form up to the 48% of all tumors of the spinal localization. The overwhelming majority of such tumors leads to the compression of the spinal cord and its nerve roots, and to considerable neurological symptomatology. Determining the tactics of surgery and the choice of surgical access is an important component for achieving long remission. The choice of an adequate approach makes it possible to totally remove the tumor, reduces the time of intervention, blood loss, injuries to the nervous structures during removal of the tumor.
{"title":"PECULIARITIES OF TREATMENT OF PATIENTS WITH TUMORS OF CERVICAL SPINAL NERVES WITH PARAVERTEBRAL SPREAD","authors":"Ye. I. Slynko, O. O. Potapov, Y. Derkach","doi":"10.21272/eumj.2019;7(3):177-182","DOIUrl":"https://doi.org/10.21272/eumj.2019;7(3):177-182","url":null,"abstract":"Introduction. We aimed to evaluate the results of surgical treatment of patients with peripheral nerve sheath tumors with specification of the peculiarities of their structure and extension pattern, and to determine prognostically unfavorable morphological features in tumors of peripheral nerves. \u0000Materials and methods. The study is based on a retrospective analysis of the medical records of 65 patients who were operated in our Neurosurgical Department during 2008 to 2018. The indication for the operation was worsening of neurological symptoms as a result of the tumor process in the cervical spine, verified by methods of neuroimaging (spondylography, CT, SCT, MRI). The choice of the surgical access depended on such factors as the tumor location regarding to the dura mater and the nervous structures, bones. \u0000Discussion: the expected response to surgical treatment in patients with peripheral nerve sheath tumors depends on many factors: localization, directions of neoplasm extension, radical nature of the treatment and the histological variant of the tumor. The tumors of the spinal nerves are quite common and form up to the 48% of all tumors of the spinal localization. The overwhelming majority of such tumors leads to the compression of the spinal cord and its nerve roots, and to considerable neurological symptomatology. Determining the tactics of surgery and the choice of surgical access is an important component for achieving long remission. The choice of an adequate approach makes it possible to totally remove the tumor, reduces the time of intervention, blood loss, injuries to the nervous structures during removal of the tumor.","PeriodicalId":315243,"journal":{"name":"Eastern Ukrainian Medical Journal","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116002576","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}
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