Pub Date : 2019-09-29DOI: 10.21272/eumj.2019;7(3):215-225
V. Krasivska, O. Stasyshyn, M. Semerak, O. Tushnytskyi, V. Novak
Background: In order to control the treatment of haemophilia patients, classical coagulation methods (APTT, FVIII (IX)) and global tests are used. One of the tests for a comprehensive coagulation assessment is thromboelastography (TEG), which can provide immediate results and reflect the hemostatic status of the patient during therapy. Some of the parameters obtained from the TEG can be compared with the coagulation tests since they describe similar processes of coagulation. Purpose: To carry out a correlation analysis of TEG parameters with coagulation test parameters to determine the role of TEG in the control of prophylactic treatment and the development of inhibitors in patients with severe haemophilia A. Materials and methods: 9 haemophilia A patients were treated with 45 ± 5 IU/kg of FVIII of body weight twice a week prophylactically an incremental recovery test (IR) at a dose of 60 ± 5 IU/kg body weight was performed. Prior to and after administration, TEG was performed and the PT, APTT, fibrinogen, FVIII, FVIII:Ag, vWF:Ag and the platelet count were measured. The possible dependencies of 10 TEG parameters (R, K, α-Angle, MA, TMA, SI, SP, G, LY30, TPI/c) and coagulation tests results were analyzed. Results: Significant direct correlation of the R and SP on the PT and APTT was found (r > 0.71) prior to the administration of the FVIII concentrate. The negative average correlation between R and FVIII:Ag (r = ‑0.56) was established. The elongation of the PT and APTT and the decrease in the activity of FVIII:Ag causes a decrease in the total hemostatic potential of the SI in the direction of hypocoagulation (r = 0.75). Prior to administration of the calculated dose, the concentration of MA, TMA and α-Angel inclination strongly and directly depends on the level of vWF:Ag and platelet count (in all cases r > 0.7). After administration of the FVIII concentrate in haemophilia A patients, a significant positive correlation between the response time R and the APTT (r = 0.64) was found. The growth of the CІ coagulation index is associated with an increase in the level of FVIII: Ag (r = 0.75) and a shortening of the APTT (r = -0.76). Other dependencies between TEG parameters and hemostatic tests have not been established. Conclusion: Correlation of TEG parameters and results of traditional coagulation tests characterized similar processes of coagulation and was revealed in haemophilia A patients on prophylactic treatment. For R, SI, SP depending on the values of the PT, APTT, FVIII: Ag, the end point is coagulation. MA, TMA, α-Angel depend on the level of vWF: Ag and platelet count which reflects the initiation of haemostasis and the strength of clot. TEG fully reflects the changes in hemostasis, so thromboelastography can be successfully applied to control the treatment and the development of FVIII (IX) inhibitors in hemophilia patients.
{"title":"CORRELATION OF THE PARAMETERS OF THROMBO-ELASTOGRAM WITH THE RESULTS OF COAGULATIOIN TESTS IN HAEMOPHILIA A PATIENTS DURING PROPHYLAXIS","authors":"V. Krasivska, O. Stasyshyn, M. Semerak, O. Tushnytskyi, V. Novak","doi":"10.21272/eumj.2019;7(3):215-225","DOIUrl":"https://doi.org/10.21272/eumj.2019;7(3):215-225","url":null,"abstract":"Background: In order to control the treatment of haemophilia patients, classical coagulation methods (APTT, FVIII (IX)) and global tests are used. One of the tests for a comprehensive coagulation assessment is thromboelastography (TEG), which can provide immediate results and reflect the hemostatic status of the patient during therapy. Some of the parameters obtained from the TEG can be compared with the coagulation tests since they describe similar processes of coagulation. \u0000Purpose: To carry out a correlation analysis of TEG parameters with coagulation test parameters to determine the role of TEG in the control of prophylactic treatment and the development of inhibitors in patients with severe haemophilia A. \u0000Materials and methods: 9 haemophilia A patients were treated with 45 ± 5 IU/kg of FVIII of body weight twice a week prophylactically an incremental recovery test (IR) at a dose of 60 ± 5 IU/kg body weight was performed. Prior to and after administration, TEG was performed and the PT, APTT, fibrinogen, FVIII, FVIII:Ag, vWF:Ag and the platelet count were measured. The possible dependencies of 10 TEG parameters (R, K, α-Angle, MA, TMA, SI, SP, G, LY30, TPI/c) and coagulation tests results were analyzed. \u0000Results: Significant direct correlation of the R and SP on the PT and APTT was found (r > 0.71) prior to the administration of the FVIII concentrate. The negative average correlation between R and FVIII:Ag (r = ‑0.56) was established. The elongation of the PT and APTT and the decrease in the activity of FVIII:Ag causes a decrease in the total hemostatic potential of the SI in the direction of hypocoagulation (r = 0.75). Prior to administration of the calculated dose, the concentration of MA, TMA and α-Angel inclination strongly and directly depends on the level of vWF:Ag and platelet count (in all cases r > 0.7). After administration of the FVIII concentrate in haemophilia A patients, a significant positive correlation between the response time R and the APTT (r = 0.64) was found. The growth of the CІ coagulation index is associated with an increase in the level of FVIII: Ag (r = 0.75) and a shortening of the APTT (r = -0.76). Other dependencies between TEG parameters and hemostatic tests have not been established. \u0000Conclusion: Correlation of TEG parameters and results of traditional coagulation tests characterized similar processes of coagulation and was revealed in haemophilia A patients on prophylactic treatment. For R, SI, SP depending on the values of the PT, APTT, FVIII: Ag, the end point is coagulation. MA, TMA, α-Angel depend on the level of vWF: Ag and platelet count which reflects the initiation of haemostasis and the strength of clot. TEG fully reflects the changes in hemostasis, so thromboelastography can be successfully applied to control the treatment and the development of FVIII (IX) inhibitors in hemophilia patients.","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":"129888892","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):183-189
S. Yermolenko
In the XXI century, the problem of overweight and obesity affects the formation of cardiovascular risk becomes increasingly relevant. Arterial hypertension (AH) combined with common risk factors such as dyslipidemia, obesity, hypodynamia, smoking, diabetes mellitus (DM) causes at least 70–75% of stroke, 80–90% of myocardial infarctions, leading to premature disability and mortality of patients. The aim of the study was to study the relationship between the daily profile of blood pressure with BMI in patients with hypertension in stage 2. Materials and methods. 120 persons with AH stage II were screened and divided into 2 groups according to body mass index (BMI). 60 patients with BMI 18–25 kg/m 2 belonged to the Ist group and 60 patients with BMI ≥ 25 kg/m 2 belonged to the IInd group. All patients had general-clinical, anthropometric studies with measurements of height, body weight, body mass index (BMI), daily blood pressure monitoring. Results and discussion. According to the daily profile of blood pressure, among the patients of both groups revealed: "dippers" – 43 (35.8%), non-dippers – 71 (59.2%), "over-dippers" – 2 men (1.7 %), "night-payers" – 4 people (3.3%). In the group with BMI 18– 25 kg/m 2 , 53.3% of the patients had a physiological rhythm, 43.3% of patients had the phenomenon of "non-dippers". At the same time, among 80% of patients in the BMI group ≥ 25 kg/m 2 had an adverse profile of non-dippers (73.3%) and 6.7% had night-hypertension “night-peakers”. Determination of the time index of hypertension showed that, the average daily level of systolic blood pressure (SBP) in group II is 1.3 times as much as in group I (p <0.05). It is important that the increase in the daily level of diastolic blood pressure (DBP) in group II was 1.6 times higher than that of group I, and also significantly exceeded the level of SBP in group II (p <0.05). And it was also found that patients in group II had significantly increased the speed of morning rise of SBP and DBP in comparison with the Ist group of patients (p <0,05). Conclusions. In patients with hypertension in stage 2 and BMI > 25 kg/m 2 , 73.3% of non-dippers were found, and 6.7% of those with night-hypertension were night-peakers. This significantly exceeds the rates of patients with hypertension in stage 2 without excess weight. Patients with stage 2 of hypertension and obesity had significantly higher values of
{"title":"THE DEPENDENCE OF THE PARAMETERS OF DAILY BLOOD PRESSURE MONITORING ON BODY MASS INDEX IN PATIENTS WITH ARTERIAL HYPERTENSION","authors":"S. Yermolenko","doi":"10.21272/eumj.2019;7(3):183-189","DOIUrl":"https://doi.org/10.21272/eumj.2019;7(3):183-189","url":null,"abstract":"In the XXI century, the problem of overweight and obesity affects the formation of cardiovascular risk becomes increasingly relevant. Arterial hypertension (AH) combined with common risk factors such as dyslipidemia, obesity, hypodynamia, smoking, diabetes mellitus (DM) causes at least 70–75% of stroke, 80–90% of myocardial infarctions, leading to premature disability and mortality of patients. The aim of the study was to study the relationship between the daily profile of blood pressure with BMI in patients with hypertension in stage 2. Materials and methods. 120 persons with AH stage II were screened and divided into 2 groups according to body mass index (BMI). 60 patients with BMI 18–25 kg/m 2 belonged to the Ist group and 60 patients with BMI ≥ 25 kg/m 2 belonged to the IInd group. All patients had general-clinical, anthropometric studies with measurements of height, body weight, body mass index (BMI), daily blood pressure monitoring. Results and discussion. According to the daily profile of blood pressure, among the patients of both groups revealed: \"dippers\" – 43 (35.8%), non-dippers – 71 (59.2%), \"over-dippers\" – 2 men (1.7 %), \"night-payers\" – 4 people (3.3%). In the group with BMI 18– 25 kg/m 2 , 53.3% of the patients had a physiological rhythm, 43.3% of patients had the phenomenon of \"non-dippers\". At the same time, among 80% of patients in the BMI group ≥ 25 kg/m 2 had an adverse profile of non-dippers (73.3%) and 6.7% had night-hypertension “night-peakers”. Determination of the time index of hypertension showed that, the average daily level of systolic blood pressure (SBP) in group II is 1.3 times as much as in group I (p <0.05). It is important that the increase in the daily level of diastolic blood pressure (DBP) in group II was 1.6 times higher than that of group I, and also significantly exceeded the level of SBP in group II (p <0.05). And it was also found that patients in group II had significantly increased the speed of morning rise of SBP and DBP in comparison with the Ist group of patients (p <0,05). Conclusions. In patients with hypertension in stage 2 and BMI > 25 kg/m 2 , 73.3% of non-dippers were found, and 6.7% of those with night-hypertension were night-peakers. This significantly exceeds the rates of patients with hypertension in stage 2 without excess weight. Patients with stage 2 of hypertension and obesity had significantly higher values of","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":"130411691","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):233-245
R. Sabadosh, V. A. Reshetylo, N. M. Rizyuk, A. V. Reshetylo
Introduction. Critical limb ischemia is a serious threat, and even after surgery for revascularization, only 45% of those operated on retain both extremities within 1 year. During this time, unfortunately, in 30% of cases, the affected limbs are amputated, and the remaining 25% of critical ischemia cases result in death. Purpose. In order to improve the treatment outcomes of patients with peripheral arterial disease (PAD), the relationship between hemocoagulation-related gene polymorphism and the risk of shunt thrombosis after reconstructive arterial disease has been studied. Materials and Methods. The study included 40 patients who had previously undergone open reconstructive surgery for peripheral arterial disease, who were divided into two groups. The main criterion for inclusion of the patient in the main group was thrombosis of the shunt at any time after reconstructive surgery, and in the comparison group – the absence of thrombosis after peripheral arterial bypass at least 1 year after reconstructive surgery. All patients with polymerase chain reaction were analyzed for the presence of the following hereditary thrombophilia: Leiden factor G1691A, prothrombin G20210A, FGB G (-455) A, ITGA2 C807T, ITGB3 T1565C, PAI-1 5G (-675) 4G and MTHFR. Discussion. The study found a relationship between FGB G (-455) A, ITGA2 C807T and ITGB3 T1565C gene mutations and thrombosis after peripheral arterial bypass. It has been statistically proven that when there is at least one of the thrombophilia such as FGB G (-455) A, ITGA2 C807T and ITGB3 T1565C present in a patient with peripheral arterial disease, the risk of shunt thrombosis will increase in the future. A prospective direction for further research is the study of the question of how differentiated additional prevention of thrombosis of arterial shunts in patients with PLEAD depending on the detected hereditary thrombophilia will affect the frequency of thrombosis of these shunts. The study found that in patients with peripheral arterial disease who are planning to undergo surgery on peripheral arteries, it is advisable to study the presence or absence of thrombophilia bypass as FGB G (-455) A, ITGA2 C807T and ITGB3 T1565C. If these patients have at least one of these thrombophilia, the risk of bypass thrombosis in them is statistically significant in the future. A promising direction for further research may be to investigate how differentiated additional prevention of arterial bypass thrombosis in patients with PAD, depending on the hereditary thrombophilia detected, will affect the frequency of thrombosis of these pass and bypass.
介绍。严重的肢体缺血是严重的威胁，即使在手术重建后，只有45%的手术患者在1年内保留了四肢。不幸的是，在这段时间里，30%的病例受影响的肢体被截肢，其余25%的严重缺血病例导致死亡。目的。为了提高外周动脉疾病(PAD)患者的治疗效果，研究了血液凝固相关基因多态性与动脉重建疾病后分流血栓形成风险的关系。材料与方法。该研究包括40名之前接受过外周动脉疾病开放重建手术的患者，他们被分为两组。将患者纳入主组的主要标准是重建手术后任何时间分流器血栓形成，对照组的主要标准是重建手术后至少1年外周动脉旁路后无血栓形成。分析所有聚合酶链反应患者是否存在以下遗传性血栓形成:莱顿因子G1691A、凝血酶原G20210A、FGB G (-455) A、ITGA2 C807T、ITGB3 T1565C、PAI-1 5G (-675) 4G和MTHFR。讨论。本研究发现FGB G (-455) a、ITGA2 C807T、ITGB3 T1565C基因突变与外周动脉搭桥术后血栓形成相关。有统计证明，当外周动脉疾病患者存在至少一种血栓性疾病如FGB G (-455) A、ITGA2 C807T和ITGB3 T1565C时，未来发生分流血栓形成的风险会增加。进一步研究的一个前瞻性方向是，根据检测到的遗传性血栓倾向，对患者动脉分流的血栓形成进行差异化的额外预防，将如何影响这些分流的血栓形成频率。研究发现，计划行外周动脉手术的外周动脉疾病患者，宜研究是否存在血栓性旁路:FGB G (-455) A、ITGA2 C807T、ITGB3 T1565C。如果这些患者至少有其中一种血栓形成，他们将来发生搭桥血栓的风险在统计学上是显著的。进一步研究的一个有希望的方向可能是，根据检测到的遗传性血栓倾向，研究PAD患者动脉旁路血栓形成的差异化额外预防如何影响这些通道和旁路血栓形成的频率。
{"title":"STUDY OF THE GENETIC ASPECTS OF THE RISK OF SHUNT THROMBOSIS AFTER OPERATIONS IN THE LOWER LIMBS ARTERIES","authors":"R. Sabadosh, V. A. Reshetylo, N. M. Rizyuk, A. V. Reshetylo","doi":"10.21272/eumj.2019;7(3):233-245","DOIUrl":"https://doi.org/10.21272/eumj.2019;7(3):233-245","url":null,"abstract":"Introduction. Critical limb ischemia is a serious threat, and even after surgery for revascularization, only 45% of those operated on retain both extremities within 1 year. During this time, unfortunately, in 30% of cases, the affected limbs are amputated, and the remaining 25% of critical ischemia cases result in death. \u0000Purpose. In order to improve the treatment outcomes of patients with peripheral arterial disease (PAD), the relationship between hemocoagulation-related gene polymorphism and the risk of shunt thrombosis after reconstructive arterial disease has been studied. \u0000Materials and Methods. The study included 40 patients who had previously undergone open reconstructive surgery for peripheral arterial disease, who were divided into two groups. The main criterion for inclusion of the patient in the main group was thrombosis of the shunt at any time after reconstructive surgery, and in the comparison group – the absence of thrombosis after peripheral arterial bypass at least 1 year after reconstructive surgery. All patients with polymerase chain reaction were analyzed for the presence of the following hereditary thrombophilia: Leiden factor G1691A, prothrombin G20210A, FGB G (-455) A, ITGA2 C807T, ITGB3 T1565C, PAI-1 5G (-675) 4G and MTHFR. \u0000Discussion. The study found a relationship between FGB G (-455) A, ITGA2 C807T and ITGB3 T1565C gene mutations and thrombosis after peripheral arterial bypass. It has been statistically proven that when there is at least one of the thrombophilia such as FGB G (-455) A, ITGA2 C807T and ITGB3 T1565C present in a patient with peripheral arterial disease, the risk of shunt thrombosis will increase in the future. \u0000A prospective direction for further research is the study of the question of how differentiated additional prevention of thrombosis of arterial shunts in patients with PLEAD depending on the detected hereditary thrombophilia will affect the frequency of thrombosis of these shunts. The study found that in patients with peripheral arterial disease who are planning to undergo surgery on peripheral arteries, it is advisable to study the presence or absence of thrombophilia bypass as FGB G (-455) A, ITGA2 C807T and ITGB3 T1565C. If these patients have at least one of these thrombophilia, the risk of bypass thrombosis in them is statistically significant in the future. \u0000A promising direction for further research may be to investigate how differentiated additional prevention of arterial bypass thrombosis in patients with PAD, depending on the hereditary thrombophilia detected, will affect the frequency of thrombosis of these pass and bypass.","PeriodicalId":315243,"journal":{"name":"Eastern Ukrainian Medical Journal","volume":"47 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":"130810941","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 : 2019-06-28DOI: 10.21272/EUMJ.2019;7(2):136-141
N. Kovalenko, T. M. Zamazii, I. V. Novikova, G. Taranenko
Actuality: Purulent-inflammatory diseases of the respiratory tract are more often induced (under the influence of different triggers) by endogenous microflora. One of the factors that determine the appropriateness of the choice of antibiotics and, therefore, the beneficial outcome of the disease is the microbial spectrum of causative agents of infection. At the present time, there is increasing information on changes in the composition of human microbiota at various diseases and its role in the pathogenesis of various disorders, including respiratory diseases. Objective: Studying the species composition of the microflora in non-hospital pneumonia and the determination of the participation of different species in the structure of microbiocenosis. Materials and methods: Bacteriological research of various clinical materials from 336 patients with pneumonia is conducted. Microbiological examination included an isolation of pathogens, identification by morphological, cultural and biochemical properties. An ecological analysis of the microflora of clinical material was carried out by studying its structure and functional characteristics using indicators such as the index of constancy, the Berger-Parker domination index. Results and discussion: During the study of micro-ecological indicators of microflora of patients with pneumonia, the distribution of endogenous microorganisms of nasopharynx in the biocenosis of lungs was revealed, which was confirmed by the indices of constancy and the dominance of Berger-Parker. In the etiological spectrum of infectious factors, fungi of the genus Candida and streptococci of viridans group, which had a high colonization level, were prevailed. Microorganisms were isolated in both a monocultural and associative form, which contained two to five species. Combinations of bacteria and fungi of the genus Candida were the most common, which were registered at 80.7 % (152/187). The associations included not only autochthonous bacteria but also non-specific habitats such as K. pneumoniae, P. aeruginosa, E. coli, E. cloacae, E. aerogenes, E. faecalis, E. faecium, P. vulgaris, P. mirabilis, C. xerosis and A. baumonii. Conclusion: The obtained data have shown that the lungs of patients with pneumonia are actively colonized by the representatives of the microflora of the nasopharynx with certain qualitative and quantitative changes of microbiocenosis. This is manifested in the emergence of transient and random opportunistic microorganisms against the background of reduced domination of the autochthonous microflora of the nasopharynx. Fungi of the genus Candida and streptococci of the viridans group were predominant among the other isolated opportunistic microorganisms and characterized by high colonization levels.
{"title":"ECOLOGICAL ANALYSIS OF OPPORTUNISTIC MICROFLORA IN PNEUMONIA","authors":"N. Kovalenko, T. M. Zamazii, I. V. Novikova, G. Taranenko","doi":"10.21272/EUMJ.2019;7(2):136-141","DOIUrl":"https://doi.org/10.21272/EUMJ.2019;7(2):136-141","url":null,"abstract":"Actuality: Purulent-inflammatory diseases of the respiratory tract are more often induced (under the influence of different triggers) by endogenous microflora. One of the factors that determine the appropriateness of the choice of antibiotics and, therefore, the beneficial outcome of the disease is the microbial spectrum of causative agents of infection. At the present time, there is increasing information on changes in the composition of human microbiota at various diseases and its role in the pathogenesis of various disorders, including respiratory diseases. \u0000Objective: Studying the species composition of the microflora in non-hospital pneumonia and the determination of the participation of different species in the structure of microbiocenosis. \u0000Materials and methods: Bacteriological research of various clinical materials from 336 patients with pneumonia is conducted. Microbiological examination included an isolation of pathogens, identification by morphological, cultural and biochemical properties. \u0000An ecological analysis of the microflora of clinical material was carried out by studying its structure and functional characteristics using indicators such as the index of constancy, the Berger-Parker domination index. \u0000Results and discussion: During the study of micro-ecological indicators of microflora of patients with pneumonia, the distribution of endogenous microorganisms of nasopharynx in the biocenosis of lungs was revealed, which was confirmed by the indices of constancy and the dominance of Berger-Parker. In the etiological spectrum of infectious factors, fungi of the genus Candida and streptococci of viridans group, which had a high colonization level, were prevailed. Microorganisms were isolated in both a monocultural and associative form, which contained two to five species. Combinations of bacteria and fungi of the genus Candida were the most common, which were registered at 80.7 % (152/187). The associations included not only autochthonous bacteria but also non-specific habitats such as K. pneumoniae, P. aeruginosa, E. coli, E. cloacae, E. aerogenes, E. faecalis, E. faecium, P. vulgaris, P. mirabilis, C. xerosis and A. baumonii. \u0000Conclusion: The obtained data have shown that the lungs of patients with pneumonia are actively colonized by the representatives of the microflora of the nasopharynx with certain qualitative and quantitative changes of microbiocenosis. This is manifested in the emergence of transient and random opportunistic microorganisms against the background of reduced domination of the autochthonous microflora of the nasopharynx. Fungi of the genus Candida and streptococci of the viridans group were predominant among the other isolated opportunistic microorganisms and characterized by high colonization levels.","PeriodicalId":315243,"journal":{"name":"Eastern Ukrainian Medical Journal","volume":"121 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129751050","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 : 2019-06-28DOI: 10.21272/EUMJ.2019;7(2):166-170
O. Potapov, O. Kmyta, O. Tsyndrenko, N. Dmytrenko, I. G. Dudka, A. Prokopchuk
Brain tumors are a heterogeneous group of various intracranial tumors, benign or malignant, primary and secondary, which develop due to the launch of the process of abnormal uncontrolled division of cells. In the structure of the total cancer incidence, brain tumors account for 0.7-1.5 % cases. The distribution of primary brain tumors in the population ranges 4 to 14 (more often 5-7) per 100 thousand population. Whereby, in Ukraine the incidence of brain tumors in men is 10.2 per 100 thousand population, and among women 7.6 per 100 thousand population. The mortality rate ranks 3rd among all causes of death. Most often, the detection of this pathology is observed at the age of 20 to 50 years. A sample analysis of 37 medical records of patients with brain tumors of different localization, who were having inpatient treatment in neurological departments of the Municipal Institution of the Sumy Regional Council "Sumy Regional Clinical Hospital" and the Municipal Non-profit Enterprise "Clinical Hospital No. 4" of the Sumy City Council in 2015-2017, was carried out. Among the patients there were 14 (37.8 %) women and 23 (62.2 %) men. The mean age was 45.5 ± 3.8 years. Instrumental examination was carried out over time using magnetic resonance imaging (1.5 T) and computer tomography with intravenous contrast enhancement over time (before and after surgery). The condition of the brain tissues was evaluated before and after surgical intervention, the localization and the presence/absence of secondary swelling of the brain tissue was determined. The pathohistological study was conducted in the conditions of the certified laboratory of the Regional Municipal Institution of Sumy Regional Clinical Oncological Dispensary. Processing of statistical data was carried out using the licensed version of IBM SPSS Statistics 17 program. Purpose and objectives of the study: to analyze topographic, histological and clinical peculiarities of brain tumors. Our study established that space occupying lesions of the brain significantly more often were localized in the temporal lobes (16 patients – 43.2 %), most often was diagnosed astrocytoma, localized in the frontal areas (7 patients – 18.9 %). During the analysis of the results of neurological examination of patients it was found that focal syndrome was significantly predominant in 20 (54.1 %) patients, among whom astrocytoma was verified in 18 (48.6 %) of the examined. We have not found the dependence of the development of leading focal or hypertensive syndromes on the localization of brain tumors (р ˃ 0.5). Secondary edema of peripheral brain tissues was diagnosed in 21 (56.8 %) patients. Astrocytoma – 11 (52.4% of the total number of patients with edema), was significantly more aggressive in terms of development of the studied complication.
{"title":"FEATURES OF LOCALIZATION OF BRAIN TUMORS WITH DIFFERENT HISTOLOGICAL STRUCTURE","authors":"O. Potapov, O. Kmyta, O. Tsyndrenko, N. Dmytrenko, I. G. Dudka, A. Prokopchuk","doi":"10.21272/EUMJ.2019;7(2):166-170","DOIUrl":"https://doi.org/10.21272/EUMJ.2019;7(2):166-170","url":null,"abstract":"Brain tumors are a heterogeneous group of various intracranial tumors, benign or malignant, primary and secondary, which develop due to the launch of the process of abnormal uncontrolled division of cells. \u0000In the structure of the total cancer incidence, brain tumors account for 0.7-1.5 % cases. The distribution of primary brain tumors in the population ranges 4 to 14 (more often 5-7) per 100 thousand population. Whereby, in Ukraine the incidence of brain tumors in men is 10.2 per 100 thousand population, and among women 7.6 per 100 thousand population. The mortality rate ranks 3rd among all causes of death. Most often, the detection of this pathology is observed at the age of 20 to 50 years. \u0000A sample analysis of 37 medical records of patients with brain tumors of different localization, who were having inpatient treatment in neurological departments of the Municipal Institution of the Sumy Regional Council \"Sumy Regional Clinical Hospital\" and the Municipal Non-profit Enterprise \"Clinical Hospital No. 4\" of the Sumy City Council in 2015-2017, was carried out. \u0000Among the patients there were 14 (37.8 %) women and 23 (62.2 %) men. The mean age was 45.5 ± 3.8 years. \u0000Instrumental examination was carried out over time using magnetic resonance imaging (1.5 T) and computer tomography with intravenous contrast enhancement over time (before and after surgery). The condition of the brain tissues was evaluated before and after surgical intervention, the localization and the presence/absence of secondary swelling of the brain tissue was determined. \u0000The pathohistological study was conducted in the conditions of the certified laboratory of the Regional Municipal Institution of Sumy Regional Clinical Oncological Dispensary. \u0000Processing of statistical data was carried out using the licensed version of IBM SPSS Statistics 17 program. \u0000Purpose and objectives of the study: to analyze topographic, histological and clinical peculiarities of brain tumors. \u0000Our study established that space occupying lesions of the brain significantly more often were localized in the temporal lobes (16 patients – 43.2 %), most often was diagnosed astrocytoma, localized in the frontal areas (7 patients – 18.9 %). \u0000During the analysis of the results of neurological examination of patients it was found that focal syndrome was significantly predominant in 20 (54.1 %) patients, among whom astrocytoma was verified in 18 (48.6 %) of the examined. \u0000We have not found the dependence of the development of leading focal or hypertensive syndromes on the localization of brain tumors (р ˃ 0.5). \u0000Secondary edema of peripheral brain tissues was diagnosed in 21 (56.8 %) patients. Astrocytoma – 11 (52.4% of the total number of patients with edema), was significantly more aggressive in terms of development of the studied complication.","PeriodicalId":315243,"journal":{"name":"Eastern Ukrainian Medical Journal","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121847737","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 : 2019-06-28DOI: 10.21272/EUMJ.2019;7(2):159-165
A. Rusanov
{"title":"THE ROLE OF VEGFA GENE POLYMORPHISM IN DIABETIC FOOT SYNDROME DEVELOPMEN","authors":"A. Rusanov","doi":"10.21272/EUMJ.2019;7(2):159-165","DOIUrl":"https://doi.org/10.21272/EUMJ.2019;7(2):159-165","url":null,"abstract":"","PeriodicalId":315243,"journal":{"name":"Eastern Ukrainian Medical Journal","volume":"29 3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132338265","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 : 2019-06-28DOI: 10.21272/EUMJ.2019;7(2):126-135
V. Kondratyuk, M. S. Yehorova
Cerebrovascular diseases is one of the most important causes of morbidity and mortality in the adult population. Objective: to conduct a comparative analysis of the morpho-functional changes of the heart, intracardiac and systemic hemodynamics in elderly patients with cerebral atherosclerosis (CA) of 1–3 degree. Materials and methods: 229 patients with cerebral atherosclerosis of 2–3 degree took part in a comprehensive study. The patients were divided into 4 groups: Group 1 – patients with ischemic stroke (IS) in the right hemisphere (RH), Group 2 – with IS in the left hemisphere (LH), Group 3 – with cerebral atherosclerosis of 1–2 degree (no IS – comparison group) and Group 4 – a general group of patients who have IS. Design: simple, prospective, non-randomized, with the consistent inclusion of patients. Results and discussion: The compared groups differed statistically significantly by the LA diameter index (ILA), the LV diastolic index (LVIDd), the LV systolic index (LVIDs) and the wall thickness of the left ventricle (LV). Thus, the highest ILA value was observed in patients with CA (1.1 times more than in patients with IS), the highest values of LVIDd and LVIDs – in the group of patients with left-hemispheric localization of IS (1.14 and 1.18 times more, accordingly, than in patients with CA without IS). The minimal thickness of the interventricular septum (IVS) and the posterior wall of the LV was in the group of patients with CA (1.18 and 1.17 times less, respectively, compared with the group of patients with AI, without taking into account the hemispheric localization of IS). Interhemispheric differences were observed only in the assessment of LVIDd, LVIDs, and the thickness of the IVS. So, in patients with left hemispheric localization of IF LVIDd, it was 1.09 times greater, and LVIDs was 1.16 times greater than in patients with right hemispheric IF, while the IVS was 1.15 times thicker in the IS group with the right hemisphere than with left hemispheric localization of IF. In the compared groups, we also observed statistically significant differences in the assessment of the parameters of systemic and intracardiac hemodynamics. So, in patients with CA, the index of the end-diastolic volume (iEDV) was 1.14 times higher and the index of the end-systolic volume (iESV) was 1.09 times less than in patients with IS, while in patients with left-hemispheric localization of IS the lowest ejection fraction and iEDV were observed compared with the group of patients with CA (1.02 and 1.15 times, respectively). Interhemispheric differences were recorded only in terms of the magnitude of the stroke index (SI). Thus, patients with IS in LН SI was 1.2 times more than in patients with IS in RH. In the group of patients with CA and IS, non-dilatational eccentric and concentric hypertrophy of LV (LVH) was most common (37.4 % and 48.1 %–26.0 % and 61.6 %, respectively), but type III was 1.44 times more common in patients with CA, and type V – 1.28 ti
{"title":"PECULIARITIES OF THE STRUCTURAL AND FUNCTIONAL STATE OF THE HEART IN PATIENTS AT DIFFERENT STAGES OF CEREBRAL ATHEROSCLEROSIS","authors":"V. Kondratyuk, M. S. Yehorova","doi":"10.21272/EUMJ.2019;7(2):126-135","DOIUrl":"https://doi.org/10.21272/EUMJ.2019;7(2):126-135","url":null,"abstract":"Cerebrovascular diseases is one of the most important causes of morbidity and mortality in the adult population. \u0000Objective: to conduct a comparative analysis of the morpho-functional changes of the heart, intracardiac and systemic hemodynamics in elderly patients with cerebral atherosclerosis (CA) of 1–3 degree. \u0000Materials and methods: 229 patients with cerebral atherosclerosis of 2–3 degree took part in a comprehensive study. The patients were divided into 4 groups: Group 1 – patients with ischemic stroke (IS) in the right hemisphere (RH), Group 2 – with IS in the left hemisphere (LH), Group 3 – with cerebral atherosclerosis of 1–2 degree (no IS – comparison group) and Group 4 – a general group of patients who have IS. Design: simple, prospective, non-randomized, with the consistent inclusion of patients. \u0000Results and discussion: The compared groups differed statistically significantly by the LA diameter index (ILA), the LV diastolic index (LVIDd), the LV systolic index (LVIDs) and the wall thickness of the left ventricle (LV). Thus, the highest ILA value was observed in patients with CA (1.1 times more than in patients with IS), the highest values of LVIDd and LVIDs – in the group of patients with left-hemispheric localization of IS (1.14 and 1.18 times more, accordingly, than in patients with CA without IS). The minimal thickness of the interventricular septum (IVS) and the posterior wall of the LV was in the group of patients with CA (1.18 and 1.17 times less, respectively, compared with the group of patients with AI, without taking into account the hemispheric localization of IS). Interhemispheric differences were observed only in the assessment of LVIDd, LVIDs, and the thickness of the IVS. So, in patients with left hemispheric localization of IF LVIDd, it was 1.09 times greater, and LVIDs was 1.16 times greater than in patients with right hemispheric IF, while the IVS was 1.15 times thicker in the IS group with the right hemisphere than with left hemispheric localization of IF. In the compared groups, we also observed statistically significant differences in the assessment of the parameters of systemic and intracardiac hemodynamics. So, in patients with CA, the index of the end-diastolic volume (iEDV) was 1.14 times higher and the index of the end-systolic volume (iESV) was 1.09 times less than in patients with IS, while in patients with left-hemispheric localization of IS the lowest ejection fraction and iEDV were observed compared with the group of patients with CA (1.02 and 1.15 times, respectively). Interhemispheric differences were recorded only in terms of the magnitude of the stroke index (SI). Thus, patients with IS in LН SI was 1.2 times more than in patients with IS in RH. In the group of patients with CA and IS, non-dilatational eccentric and concentric hypertrophy of LV (LVH) was most common (37.4 % and 48.1 %–26.0 % and 61.6 %, respectively), but type III was 1.44 times more common in patients with CA, and type V – 1.28 ti","PeriodicalId":315243,"journal":{"name":"Eastern Ukrainian Medical Journal","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134336339","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 : 2019-06-28DOI: 10.21272/EUMJ.2019;7(2):171-176
S. O. Huriev, I. Duzhyi, Y. Shkatula, Y. Badion
The purpose of the work is to analyze the structure and characteristics of injuries resulting from traffic accidents, which will undoubtedly contribute to the development of pathogenetically grounded treatment measures and will reduce the level of negative consequences. Materials and methods. The severity of road accidents in Ukraine and the Sumy region was investigated by determining the F't factor, calculated as the ratio of the number of casualties and deaths to the total number of accidents. In order to assess the severity of injuries suffered by the victims, a standardized PTS-Hannover Damage Assessment System was used. To determine the causes and nature of the traffic accident, there was carried out an inspection and an anonymous non-personal survey of 124 traumatized patients who were undergoing treatment in the medical institutions of the Sumy region. Results. The reasons and circumstances under which traffic accidents occurred, with 124 people being injured, the structure and character of the damage they received have been analyzed. It has been established that the integral ten-year value of F't in Ukraine is (0.23 ± 0.004), and in the Sumy region it is (0.41 ± 0.013). The trend is determined to increase the severity of accidents both in the Sumy region and in Ukraine as a whole. The main causes of road accidents were violations of the road safety rules by the drivers (54.03 %) and driving in the state of alcoholic intoxication (16.94 %). In most cases, the victims suffered multiple and combined injuries. Most often there was a combination of skeletal and craniocerebral trauma (18.55 %), and skeletal trauma connected to the craniocerebral injury and trauma of the chest (11.29 %). When studying the variety of lesions, the changes in nosological structure of characteristic and specific road traffic injuries were noted. Conclusions. The main causes of the road accident occurrence were the violations of traffic safety rules by the drivers and driving in a state of intoxication. Most often, the victims had a combination of skeletal and craniocerebral trauma, and a skeletal trauma connected to the craniocerebral injury and trauma of the chest. Over the past 10 years there have been changes in the structure of specific and typical road traffic injuries, which, in our opinion, are due to the constructive features of a modern motor transport vehicle, means of internal and external passive safety.
{"title":"PATHOGENETIC PARTICULARITIES OF THE ROAD TRAFFIC INJURIES OF THE PRESENT","authors":"S. O. Huriev, I. Duzhyi, Y. Shkatula, Y. Badion","doi":"10.21272/EUMJ.2019;7(2):171-176","DOIUrl":"https://doi.org/10.21272/EUMJ.2019;7(2):171-176","url":null,"abstract":"The purpose of the work is to analyze the structure and characteristics of injuries resulting from traffic accidents, which will undoubtedly contribute to the development of pathogenetically grounded treatment measures and will reduce the level of negative consequences. \u0000Materials and methods. The severity of road accidents in Ukraine and the Sumy region was investigated by determining the F't factor, calculated as the ratio of the number of casualties and deaths to the total number of accidents. In order to assess the severity of injuries suffered by the victims, a standardized PTS-Hannover Damage Assessment System was used. To determine the causes and nature of the traffic accident, there was carried out an inspection and an anonymous non-personal survey of 124 traumatized patients who were undergoing treatment in the medical institutions of the Sumy region. \u0000Results. The reasons and circumstances under which traffic accidents occurred, with 124 people being injured, the structure and character of the damage they received have been analyzed. It has been established that the integral ten-year value of F't in Ukraine is (0.23 ± 0.004), and in the Sumy region it is (0.41 ± 0.013). The trend is determined to increase the severity of accidents both in the Sumy region and in Ukraine as a whole. The main causes of road accidents were violations of the road safety rules by the drivers (54.03 %) and driving in the state of alcoholic intoxication (16.94 %). In most cases, the victims suffered multiple and combined injuries. Most often there was a combination of skeletal and craniocerebral trauma (18.55 %), and skeletal trauma connected to the craniocerebral injury and trauma of the chest (11.29 %). When studying the variety of lesions, the changes in nosological structure of characteristic and specific road traffic injuries were noted. \u0000Conclusions. The main causes of the road accident occurrence were the violations of traffic safety rules by the drivers and driving in a state of intoxication. Most often, the victims had a combination of skeletal and craniocerebral trauma, and a skeletal trauma connected to the craniocerebral injury and trauma of the chest. Over the past 10 years there have been changes in the structure of specific and typical road traffic injuries, which, in our opinion, are due to the constructive features of a modern motor transport vehicle, means of internal and external passive safety.","PeriodicalId":315243,"journal":{"name":"Eastern Ukrainian Medical Journal","volume":"518 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116335325","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 : 2019-06-28DOI: 10.21272/EUMJ.2019;7(2):109-115
O. Khukhlina
combining NAFLD with CKD, progressing with CKD stage, degree of
NAFLD合并CKD，随CKD分期、程度进展
{"title":"DEVELOPMENT DEGREE AND THE ROLE OF ENDOTHELIAL DYSFUNCTION IN THE DEVELOPMENT AND PROGRESSION OF NON-ALCOHOL FATTY LIVER DISEASE AND CHRONIC KIDNEY DISEASE IN PATIENTS WITH OBESITY","authors":"O. Khukhlina","doi":"10.21272/EUMJ.2019;7(2):109-115","DOIUrl":"https://doi.org/10.21272/EUMJ.2019;7(2):109-115","url":null,"abstract":"combining NAFLD with CKD, progressing with CKD stage, degree of","PeriodicalId":315243,"journal":{"name":"Eastern Ukrainian Medical Journal","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114589219","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 : 2019-06-28DOI: 10.21272/eumj.2019;7(2):121-125
A. Volkogon
{"title":"ASSOCIATION OF MALAT1 RS3200401 GENE POLYMORPHISM WITH KIDNEY CANCER IN UKRAINIAN POPULATION","authors":"A. Volkogon","doi":"10.21272/eumj.2019;7(2):121-125","DOIUrl":"https://doi.org/10.21272/eumj.2019;7(2):121-125","url":null,"abstract":"","PeriodicalId":315243,"journal":{"name":"Eastern Ukrainian Medical Journal","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126712454","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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