Pub Date : 2022-05-19DOI: 10.31612/2616-4868.2(20).2022.11
L. Kriachkova, V. Krotova, L.O. Krotova, M.I. Zayarsky
The aim of the study is to find out awareness about the presence of high blood pressure (BP), to investigate the autonomy in medical decision-making and to determine the factors influencing the situation on the example of people with hypertension. Material and methods. The study was made on the basis of data obtained during the project "May measurement month" of the International Society of Hypertension (2017-2019), which involved employees and students of the Dnipro State Medical University. A cross-sectional study of blood pressure was made among 757 adult residents of Dnipro. The presence of hypertension was determined according to the approaches of this project. General information, data on risk factors and health behaviors were determined based on the results of the survey. Data processing was performed using standard statistical tools. Results. The study involved 476 (62.9%) women and 281 (37.1%) men aged 18 to 90 years. Hypertension was detected in 31.8% (95% CI 28.5 % - 35.3%). Hypertension was more common in the elderly. Among the controlled risk factors in the respondents were the most common – high BMI, smoking, alcohol consumption. More than two-thirds of people with high blood pressure were unaware of their condition and did not receive appropriate treatment, while almost half of patients did not achieve blood pressure control even while taking medication. Only 17.4% (95% CI 14.8% - 20.3%) of persons received appropriate antihypertensive treatment, which corresponds to 54.8% of detected cases of hypertension. The use of these antihypertensive drugs, which is a manifestation of patients' autonomy, their conscious decision to adhere to the prescribed treatment, according to the study depends on the age of patients and the presence of aggravating factors: increased BMI, myocardial infarction and/or stroke. Conclusions. According to the study, the facts were revealed that people with hypertension are poorly informed about their own health and low propensity to make decisions about its support. This justifies the need for more thorough involvement of the population in the process of health care with increasing their awareness and autonomy, including awareness of opportunities in making medical decisions about their own health.
{"title":"STUDY OF PATIENT AWARENESS AND AUTONOMY FOR PUBLIC HEALTH NEEDS (ON THE EXAMPLE OF A CROSS-SECTIONAL STUDY OF PEOPLE WITH HYPERTENSION IN DNIPRO)","authors":"L. Kriachkova, V. Krotova, L.O. Krotova, M.I. Zayarsky","doi":"10.31612/2616-4868.2(20).2022.11","DOIUrl":"https://doi.org/10.31612/2616-4868.2(20).2022.11","url":null,"abstract":"The aim of the study is to find out awareness about the presence of high blood pressure (BP), to investigate the autonomy in medical decision-making and to determine the factors influencing the situation on the example of people with hypertension. \u0000Material and methods. The study was made on the basis of data obtained during the project \"May measurement month\" of the International Society of Hypertension (2017-2019), which involved employees and students of the Dnipro State Medical University. A cross-sectional study of blood pressure was made among 757 adult residents of Dnipro. The presence of hypertension was determined according to the approaches of this project. General information, data on risk factors and health behaviors were determined based on the results of the survey. Data processing was performed using standard statistical tools. \u0000Results. The study involved 476 (62.9%) women and 281 (37.1%) men aged 18 to 90 years. Hypertension was detected in 31.8% (95% CI 28.5 % - 35.3%). Hypertension was more common in the elderly. Among the controlled risk factors in the respondents were the most common – high BMI, smoking, alcohol consumption. More than two-thirds of people with high blood pressure were unaware of their condition and did not receive appropriate treatment, while almost half of patients did not achieve blood pressure control even while taking medication. Only 17.4% (95% CI 14.8% - 20.3%) of persons received appropriate antihypertensive treatment, which corresponds to 54.8% of detected cases of hypertension. \u0000The use of these antihypertensive drugs, which is a manifestation of patients' autonomy, their conscious decision to adhere to the prescribed treatment, according to the study depends on the age of patients and the presence of aggravating factors: increased BMI, myocardial infarction and/or stroke. \u0000Conclusions. According to the study, the facts were revealed that people with hypertension are poorly informed about their own health and low propensity to make decisions about its support. This justifies the need for more thorough involvement of the population in the process of health care with increasing their awareness and autonomy, including awareness of opportunities in making medical decisions about their own health.","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47480742","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 : 2022-05-19DOI: 10.31612/2616-4868.2(20).2022.01
T. Gruzieva
The aim of the work is to study the processes of development of the Kyiv Social and Hygienic Scientific School during the period of Ukraine’s independency, it’s contribution to the development of medical and social research and development of the health care system. Materials and methods. Published scientific papers and reports were used like sources of information. The methodology was based on the using of historical-bibliographic and information-analytical methods. Results. Since 1991, a new stage of development of the Kyiv Social and Hygiene Scientific School has been started, closely connected with the state-forming processes in the country. Important scientific tasks of the representatives of this school were the scientific substantiation of the new national health care system, preparation of modern specialists in the sphere of social medicine and health care organization, optimization of organization and management of medical services, development of public health system, etc. Department of Social Medicine and Health Care of Bogomolets National Medical University later was transformed into the Department of Social Medicine and Public Health and continue the traditions according previous years in the development of scientific and educational direction in social medicine and health care organization, filled it with modern content. Members of the school became developers of a number of important strategic and program documents on development of the field, including concepts, state programs, national plans. They actively worked on forming the regulatory and legal base of health care. The department, as a scientific and methodological center of educational process implementation in medical and social direction, has carried out development of new modern educational programs on social medicine, public health and their educational and methodical support. The staff members of the department are developers of educational standards and programs. The pedagogical staff of the department headed the work on writing and publishing a number of new national editions and educational manuals to provide teaching of specialized educational disciplines. Over time, the Department’s graduates have joined to the groups of other scientific and educational institutions, which contributed to the expansion and progressive development of the Kyiv Social and Hygiene Scientific School. Active preparation of new personnel of social workers for scientific and educational institutions and practical health care was carried out. International cooperation, cooperation of school representatives with WHO, WHO/Europe and other international healthcare organizations have been strong developed. Conclusion. The repairing of Ukraine's independence marked the beginning of a new stage in the development of the Kyiv Social and Hygienic Scientific School, which continues nowadays. It is characterized by active transformation and internationalization of medical, social, scientific and e
{"title":"DEVELOPMENT OF KYIV SOCIAL AND HYGIENIC SCIENTIFIC SCHOOL IN INDEPENDENT UKRAINE","authors":"T. Gruzieva","doi":"10.31612/2616-4868.2(20).2022.01","DOIUrl":"https://doi.org/10.31612/2616-4868.2(20).2022.01","url":null,"abstract":"The aim of the work is to study the processes of development of the Kyiv Social and Hygienic Scientific School during the period of Ukraine’s independency, it’s contribution to the development of medical and social research and development of the health care system. \u0000Materials and methods. Published scientific papers and reports were used like sources of information. The methodology was based on the using of historical-bibliographic and information-analytical methods. \u0000Results. Since 1991, a new stage of development of the Kyiv Social and Hygiene Scientific School has been started, closely connected with the state-forming processes in the country. Important scientific tasks of the representatives of this school were the scientific substantiation of the new national health care system, preparation of modern specialists in the sphere of social medicine and health care organization, optimization of organization and management of medical services, development of public health system, etc. Department of Social Medicine and Health Care of Bogomolets National Medical University later was transformed into the Department of Social Medicine and Public Health and continue the traditions according previous years in the development of scientific and educational direction in social medicine and health care organization, filled it with modern content. Members of the school became developers of a number of important strategic and program documents on development of the field, including concepts, state programs, national plans. They actively worked on forming the regulatory and legal base of health care. The department, as a scientific and methodological center of educational process implementation in medical and social direction, has carried out development of new modern educational programs on social medicine, public health and their educational and methodical support. The staff members of the department are developers of educational standards and programs. \u0000The pedagogical staff of the department headed the work on writing and publishing a number of new national editions and educational manuals to provide teaching of specialized educational disciplines. Over time, the Department’s graduates have joined to the groups of other scientific and educational institutions, which contributed to the expansion and progressive development of the Kyiv Social and Hygiene Scientific School. Active preparation of new personnel of social workers for scientific and educational institutions and practical health care was carried out. International cooperation, cooperation of school representatives with WHO, WHO/Europe and other international healthcare organizations have been strong developed. \u0000Conclusion. The repairing of Ukraine's independence marked the beginning of a new stage in the development of the Kyiv Social and Hygienic Scientific School, which continues nowadays. It is characterized by active transformation and internationalization of medical, social, scientific and e","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48324293","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 : 2022-05-19DOI: 10.31612/2616-4868.2(20).2022.10
L. Lytvynova, N. V. Hrechyshkina, O. Donik, L. Artemchuk, O. Tonkovyd
Aim. Analyze changes in the performance of specialized institutions providing medical care to infectious patients in the context of the Covid-19 pandemic, compare them with the “pre-Covid” period (2015–2019) and suggest ways to improve the activities of the infectious service. Material and methods. The materials of the study were the official statistical data of the reports of the Center for Medical Statistics of the Ministry of Health of Ukraine "Medical personnel and the network of healthcare institutions of the system of the Ministry of Health of Ukraine" for 2015-2020. Results. The dynamics of providing medical care to infectious patients is analyzed. A decrease in the provision of the population with doctors and infectious beds against the background of a decrease in the incidence of certain infectious diseases was determined. The inefficient use of beds with an infectious profile was established. The main reasons for the problems of organizing an infectious disease service have been established, taking into account the experience of medical institutions in the context of the Covid-19 pandemic. Conclusions. Possible ways of optimizing medical care for infectious patients are identified: improving the epidemiological monitoring of infectious morbidity and calculating the needs of medical support, taking into account regional characteristics, improving the training of family doctors in the diagnosis and treatment of infectious diseases.
{"title":"ORGANIZATION OF MEDICAL CARE FOR INFECTIOUS PATIENTS IN UKRAINE: THE PRIMARY ISSUES OF THE CURRENT TIME","authors":"L. Lytvynova, N. V. Hrechyshkina, O. Donik, L. Artemchuk, O. Tonkovyd","doi":"10.31612/2616-4868.2(20).2022.10","DOIUrl":"https://doi.org/10.31612/2616-4868.2(20).2022.10","url":null,"abstract":"Aim. Analyze changes in the performance of specialized institutions providing medical care to infectious patients in the context of the Covid-19 pandemic, compare them with the “pre-Covid” period (2015–2019) and suggest ways to improve the activities of the infectious service. \u0000Material and methods. The materials of the study were the official statistical data of the reports of the Center for Medical Statistics of the Ministry of Health of Ukraine \"Medical personnel and the network of healthcare institutions of the system of the Ministry of Health of Ukraine\" for 2015-2020. \u0000Results. The dynamics of providing medical care to infectious patients is analyzed. A decrease in the provision of the population with doctors and infectious beds against the background of a decrease in the incidence of certain infectious diseases was determined. The inefficient use of beds with an infectious profile was established. The main reasons for the problems of organizing an infectious disease service have been established, taking into account the experience of medical institutions in the context of the Covid-19 pandemic. \u0000Conclusions. Possible ways of optimizing medical care for infectious patients are identified: improving the epidemiological monitoring of infectious morbidity and calculating the needs of medical support, taking into account regional characteristics, improving the training of family doctors in the diagnosis and treatment of infectious diseases.","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70041241","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 : 2022-02-14DOI: 10.31612/2616-4868.1(19).2022.03
O. Kovalenko, N. Prityko
Relevance: The problem of treatment of cerebrovascular diseases is one of the leading in modern medicine. The combination of this nosology in patients with emotional and volitional disorders acquires a special shade. Features of neurochemical transmission of impulses in different hemispheres of the brain provide greater opportunities for improving the treatment of patients with chronic cerebral venous dysfunction syndrome (SCVD). Objective: To study the features of hemispheric lateralization of the brain in patients with SCVD and indicators of anxiety on the Spielberger-Khanin scale and depression on the Beck scale. Materials and methods: 153 patients tested on the scale of reactive (RT) and personal (LT) anxiety Spielberger-YL Khanin and Beck depression. 125 people with signs of SCCVD and various levels of BP. Mean age of patients: 53.60 ± 10.27 years, 115 women, 38 men. All underwent clinical and neurological examination, testing to determine hemispheric dominance on the scale of NP Rebrova and MP Chernysheva. Statistics were calculated using the Medstat program. The comparison was performed according to the criterion of W. Kruskal-A. Wallis, the criterion of J. Dunn and the chi-square. Results: It was found that the presence of SCCVD did not depend on hemispheric dominance. In patients with SCVD with left hemisphere lateralization, there was a statistically significant increase in personal anxiety on the Spielberger-Khanin scale (p<0.001). The patients with SCVD and right-hemispheric lateralization had a statistically significant increase in depression on the Beck scale (p <0.001). Patients of the control group did not show a statistically significant relationship between the types of hemispheric dominance and indicators of personal anxiety and depression.
相关性:脑血管病的治疗问题是现代医学的主要问题之一。在情绪和意志障碍患者中，这种分类学的结合获得了特殊的阴影。脑不同半球脉冲神经化学传递的特征为改善慢性脑静脉功能障碍综合征(SCVD)患者的治疗提供了更大的机会。目的:探讨SCVD患者的大脑半球偏侧特征及斯皮尔伯格-哈宁量表焦虑和贝克量表抑郁指标。材料与方法:对153例患者进行反应性焦虑(RT)和个人焦虑(LT)量表的测试。125人有SCCVD的症状和不同水平的血压。患者平均年龄:53.60±10.27岁，女性115例，男性38例。所有患者均接受了临床和神经学检查，并在NP Rebrova和MP Chernysheva量表上进行了半球优势测试。使用Medstat程序计算统计数据。根据W. Kruskal-A标准进行比较。Wallis, J. Dunn准则和卡方。结果:发现SCCVD的存在不依赖于半球优势。在伴有左半球偏侧的SCVD患者中，Spielberger-Khanin量表上的个人焦虑有统计学意义的增加(p<0.001)。SCVD合并右半球偏侧的患者在贝克量表上抑郁程度有统计学意义的增加(p <0.001)。对照组患者的半球优势类型与个人焦虑和抑郁指标之间没有统计学上的显著关系。
{"title":"HEMISPHERE LATERALIZATION IN PATIENTS WITH CHRONIC VENOUS CEREBRAL DYSFUNCTION SYNDROME AND EMOTIONAL-VOLUNTARY DISORDERS.","authors":"O. Kovalenko, N. Prityko","doi":"10.31612/2616-4868.1(19).2022.03","DOIUrl":"https://doi.org/10.31612/2616-4868.1(19).2022.03","url":null,"abstract":"Relevance: The problem of treatment of cerebrovascular diseases is one of the leading in modern medicine. The combination of this nosology in patients with emotional and volitional disorders acquires a special shade. Features of neurochemical transmission of impulses in different hemispheres of the brain provide greater opportunities for improving the treatment of patients with chronic cerebral venous dysfunction syndrome (SCVD). \u0000Objective: To study the features of hemispheric lateralization of the brain in patients with SCVD and indicators of anxiety on the Spielberger-Khanin scale and depression on the Beck scale. Materials and methods: 153 patients tested on the scale of reactive (RT) and personal (LT) anxiety Spielberger-YL Khanin and Beck depression. 125 people with signs of SCCVD and various levels of BP. Mean age of patients: 53.60 ± 10.27 years, 115 women, 38 men. All underwent clinical and neurological examination, testing to determine hemispheric dominance on the scale of NP Rebrova and MP Chernysheva. Statistics were calculated using the Medstat program. The comparison was performed according to the criterion of W. Kruskal-A. Wallis, the criterion of J. Dunn and the chi-square. Results: It was found that the presence of SCCVD did not depend on hemispheric dominance. In patients with SCVD with left hemisphere lateralization, there was a statistically significant increase in personal anxiety on the Spielberger-Khanin scale (p<0.001). The patients with SCVD and right-hemispheric lateralization had a statistically significant increase in depression on the Beck scale (p <0.001). Patients of the control group did not show a statistically significant relationship between the types of hemispheric dominance and indicators of personal anxiety and depression.","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70040053","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 : 2022-02-14DOI: 10.31612/2616-4868.1(19).2022.06
U.M. Petrova, Y. Garmash, O. Klimenko, V.V. Bedny, O.G. Mylnikova, V.M. Eagle
The aim of our article is to shed light on the problem of the development of Guillain-Barre syndrome after COVID-19 infection Materials and methods The main research methods we used were scientific research and the actual description of our own clinical case. Laboratory research methods, magnetic resonance imaging, and electromyography were used to confirm the diagnosis and perform differential diagnostics. Results. In 2021, the Center for Acute Neurology and Pain Treatment treated 12 patients with Guillain-Barre syndrome. Guillain-Barre syndrome (GBS) is an acute autoimmune inflammatory polyradiculoneuropathy. The clinical picture of GBS includes progressive motor and sensory disorders in the extremities and pain. We bring to your attention a clinical case of GBS in patient B., who was treated at the clinical hospital "Feofania". Patient B., 32 years old, was hospitalized in the Feofania Clinical Hospital with complaints of weakness in her arms and legs, inability to walk, foreign body sensation in the throat, difficulty swallowing, chest discomfort, and difficulty breathing. A few weeks before the disease, the patient was treated for a mild SARS-CoV-2 infection. The patient's condition gradually deteriorated by day 25 of the disease, despite plasmapheresis, intravenous immunoglobulin and glucocorticoid therapy. However, from day 29, the condition gradually improved and on re-examination after 2 months, the patient remained mild distal paresis of the leg muscles (up to 4 points), decreased tendon reflexes from the lower extremities. Disorders of sensitivity and function of the pelvic organs were not observed. Conclusion. In our article, we present a case of COVID-19-associated GBS with a classic clinical picture, increased peripheral paresis, stabilization, and gradual recovery of all functions (respiration, pelvic function, motor, sensory, and reflex) through pathogenetic treatment and follow-up rehabilitation measures.
{"title":"CLINICAL CASE OF COVID-ASSOCIATED GUILLAIN-BARRE SYNDROME","authors":"U.M. Petrova, Y. Garmash, O. Klimenko, V.V. Bedny, O.G. Mylnikova, V.M. Eagle","doi":"10.31612/2616-4868.1(19).2022.06","DOIUrl":"https://doi.org/10.31612/2616-4868.1(19).2022.06","url":null,"abstract":"The aim of our article is to shed light on the problem of the development of Guillain-Barre syndrome after COVID-19 infection \u0000Materials and methods \u0000The main research methods we used were scientific research and the actual description of our own clinical case. Laboratory research methods, magnetic resonance imaging, and electromyography were used to confirm the diagnosis and perform differential diagnostics. \u0000Results. \u0000In 2021, the Center for Acute Neurology and Pain Treatment treated 12 patients with Guillain-Barre syndrome. Guillain-Barre syndrome (GBS) is an acute autoimmune inflammatory polyradiculoneuropathy. The clinical picture of GBS includes progressive motor and sensory disorders in the extremities and pain. \u0000We bring to your attention a clinical case of GBS in patient B., who was treated at the clinical hospital \"Feofania\". Patient B., 32 years old, was hospitalized in the Feofania Clinical Hospital with complaints of weakness in her arms and legs, inability to walk, foreign body sensation in the throat, difficulty swallowing, chest discomfort, and difficulty breathing. A few weeks before the disease, the patient was treated for a mild SARS-CoV-2 infection. The patient's condition gradually deteriorated by day 25 of the disease, despite plasmapheresis, intravenous immunoglobulin and glucocorticoid therapy. However, from day 29, the condition gradually improved and on re-examination after 2 months, the patient remained mild distal paresis of the leg muscles (up to 4 points), decreased tendon reflexes from the lower extremities. Disorders of sensitivity and function of the pelvic organs were not observed. \u0000Conclusion. \u0000In our article, we present a case of COVID-19-associated GBS with a classic clinical picture, increased peripheral paresis, stabilization, and gradual recovery of all functions (respiration, pelvic function, motor, sensory, and reflex) through pathogenetic treatment and follow-up rehabilitation measures.","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70040108","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 : 2022-02-14DOI: 10.31612/2616-4868.1(19).2022.07
V. Dunaevska, O.M. Savluk
Sclerosing lichen (SL) of the external genitalia is a chronic slowly progressive disease with pronounced focal atrophy of the skin of the perineum and visible mucous membranes of the vulva and has two main peaks of clinical manifestations: childhood and perimenopausal age. It is associated with an increased risk of developing vulvar cancer, even though it is not a malignancy in itself. The true precursor of SL-associated cancer is intraepithelial vulvar neoplasia (VIN). The diagnosis is usually clinical, but in some cases a biopsy may be performed, especially to rule out VIN or cancer. In this study, 180 patients with SL vulva were examined on the basis of two clinical bases (National Cancer Institute, MC "Verum"). After examining the patients, the diagnosis was made on the basis of examination, complaints, advanced biochemical blood test, detailed blood test, hormonal examination and ultrasound. In most cases, the diagnosis of SL vulva is clinical. As a result of a number of examinations of patients of reproductive age in patients with SL vulva, it was found that SL vulva is a consequence of thyroid disease (82.2%) of different types compared with patients in the control group (32.7%). The diagnosis of SL vulva was established in young patients mainly with AIT (48.6%) and with AIT accompanied by hypothyroidism or nodular thyroid disease (27%). When comparing the diagnostic findings of thyroid disease in patients with SL vulva and the control group, no significant differences were found. Therefore, timely detection of latent forms of AIT, hypothyroidism, nodular goiter, adequate treatment of thyroid dysfunction will allow to normalize changes in the reproductive system and prevent the formation of pathological lesions of the reproductive organs of women.
{"title":"THE INFLUENCE OF THE THYROID GLAND ON THE DEVELOPMENT OF THE SCLEROSING HULL OF THE VULVA IN WOMEN OF REPRODUCTIVE AGE","authors":"V. Dunaevska, O.M. Savluk","doi":"10.31612/2616-4868.1(19).2022.07","DOIUrl":"https://doi.org/10.31612/2616-4868.1(19).2022.07","url":null,"abstract":"Sclerosing lichen (SL) of the external genitalia is a chronic slowly progressive disease with pronounced focal atrophy of the skin of the perineum and visible mucous membranes of the vulva and has two main peaks of clinical manifestations: childhood and perimenopausal age. It is associated with an increased risk of developing vulvar cancer, even though it is not a malignancy in itself. The true precursor of SL-associated cancer is intraepithelial vulvar neoplasia (VIN). The diagnosis is usually clinical, but in some cases a biopsy may be performed, especially to rule out VIN or cancer. In this study, 180 patients with SL vulva were examined on the basis of two clinical bases (National Cancer Institute, MC \"Verum\"). After examining the patients, the diagnosis was made on the basis of examination, complaints, advanced biochemical blood test, detailed blood test, hormonal examination and ultrasound. In most cases, the diagnosis of SL vulva is clinical. As a result of a number of examinations of patients of reproductive age in patients with SL vulva, it was found that SL vulva is a consequence of thyroid disease (82.2%) of different types compared with patients in the control group (32.7%). The diagnosis of SL vulva was established in young patients mainly with AIT (48.6%) and with AIT accompanied by hypothyroidism or nodular thyroid disease (27%). When comparing the diagnostic findings of thyroid disease in patients with SL vulva and the control group, no significant differences were found. Therefore, timely detection of latent forms of AIT, hypothyroidism, nodular goiter, adequate treatment of thyroid dysfunction will allow to normalize changes in the reproductive system and prevent the formation of pathological lesions of the reproductive organs of women.","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49412248","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 : 2022-02-14DOI: 10.31612/2616-4868.1(19).2022.05
K. Serikov, L. M. Smyrnova
The aim of the work was to develop criteria for the severity of ischemic cerebral stroke (ICS) and the use of personalized intensive therapy (IT) technologies in the acute and acute periods of the disease. The clinical study included 108 patients with IMI (mean age 73,47±0,48 years). Based on the severity of energy structural disorders and personalized IT methods, all patients were divided into 4 groups. The first group consisted of patients with eubiotic energy structural status (ESST), who received personalized IT with homeostasis technologies. The following three groups consisted of patients with hypoergic ESST disorders: hypoergic dysfunction, in which energy protection was used, hypoergic damage, in which energy resuscitation was used, and hypoergic insufficiency, in which energy-correction technologies of personalized IT were used. Conclusions. 1. The conducted clinical study made it possible to develop additional technologies of personalized IT, which were used depending on the severity of energy-structural disorders in patients with ICS. The use of personalized IT technologies in patients with eubiotic and hypoergic ESST made it possible to reduce mortality, the number of complications and the time spent in intensive therapy units for patients with ICS. Traditional standard IT does not allow to prevent the development of the late form of multiple organ failure syndrome in patients with ICS.
{"title":"PERSONIFICATION OF INTENSIVE THERAPY FOR ISCHEMIC CEREBRAL STROKE DEPENDING ON THE SEVERITY OF ENERGY STRUCTURAL DISORDERS","authors":"K. Serikov, L. M. Smyrnova","doi":"10.31612/2616-4868.1(19).2022.05","DOIUrl":"https://doi.org/10.31612/2616-4868.1(19).2022.05","url":null,"abstract":"The aim of the work was to develop criteria for the severity of ischemic cerebral stroke (ICS) and the use of personalized intensive therapy (IT) technologies in the acute and acute periods of the disease. \u0000The clinical study included 108 patients with IMI (mean age 73,47±0,48 years). Based on the severity of energy structural disorders and personalized IT methods, all patients were divided into 4 groups. The first group consisted of patients with eubiotic energy structural status (ESST), who received personalized IT with homeostasis technologies. \u0000The following three groups consisted of patients with hypoergic ESST disorders: hypoergic dysfunction, in which energy protection was used, hypoergic damage, in which energy resuscitation was used, and hypoergic insufficiency, in which energy-correction technologies of personalized IT were used. \u0000Conclusions. 1. The conducted clinical study made it possible to develop additional technologies of personalized IT, which were used depending on the severity of energy-structural disorders in patients with ICS. \u0000 \u0000The use of personalized IT technologies in patients with eubiotic and hypoergic ESST made it possible to reduce mortality, the number of complications and the time spent in intensive therapy units for patients with ICS. \u0000Traditional standard IT does not allow to prevent the development of the late form of multiple organ failure syndrome in patients with ICS. \u0000","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70040072","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 : 2022-02-14DOI: 10.31612/2616-4868.1(19).2022.08
O. Sydorenko
Introduction. Strict performance requirements applied to civil servants, a high level of mental stress and of responsibility at the workplace can be considered as risk factors leading to the formation of a wide range of maladaptive reactions and states among civil servants - starting with specific mosaic domains and ending with nosologically defined mental disorders of neurotic genesis or psychosomatic illnesses, resulting in a state of psychological maladaptation. The purpose. Develop a program of psychological correction based on the detection of states of psychological maladaptation in civil servants. Materials and methods of the research. The main group consisted of 78 civil servants with the domain of psychological maladaptation, the experimental group consisted of 81 civil servants, among whose members no domain of psychological maladaptation was detected. Results. States of psychological maladaptation among civil servants were conceptualized as a holistic clinical and psychological, and socio-psychological phenomenon that has a multicomponent origin of biopsychosocial nature. We have identified the peculiarities of professional deformation and the psychoemotional state among the civil servants, and have determined the specifics of their mutual influence and the role of each parameter in the origin of the development of psychological maladaptation among the persons concerned. Conclusions. The study found that the essential factor in the formation of states of psychological maladaptation is the disparity between the level of stress caused by the working environment of a civil servant and his personal and adaptive resource base.
{"title":"PSYCHOCORRECTION OF PSYCHOLOGICAL MALADAPTATION AMONG CIVIL SERVANTS","authors":"O. Sydorenko","doi":"10.31612/2616-4868.1(19).2022.08","DOIUrl":"https://doi.org/10.31612/2616-4868.1(19).2022.08","url":null,"abstract":"Introduction. Strict performance requirements applied to civil servants, a high level of mental stress and of responsibility at the workplace can be considered as risk factors leading to the formation of a wide range of maladaptive reactions and states among civil servants - starting with specific mosaic domains and ending with nosologically defined mental disorders of neurotic genesis or psychosomatic illnesses, resulting in a state of psychological maladaptation. \u0000The purpose. Develop a program of psychological correction based on the detection of states of psychological maladaptation in civil servants. \u0000Materials and methods of the research. The main group consisted of 78 civil servants with the domain of psychological maladaptation, the experimental group consisted of 81 civil servants, among whose members no domain of psychological maladaptation was detected. \u0000Results. States of psychological maladaptation among civil servants were conceptualized as a holistic clinical and psychological, and socio-psychological phenomenon that has a multicomponent origin of biopsychosocial nature. We have identified the peculiarities of professional deformation and the psychoemotional state among the civil servants, and have determined the specifics of their mutual influence and the role of each parameter in the origin of the development of psychological maladaptation among the persons concerned. \u0000Conclusions. The study found that the essential factor in the formation of states of psychological maladaptation is the disparity between the level of stress caused by the working environment of a civil servant and his personal and adaptive resource base.","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70040122","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 : 2022-02-14DOI: 10.31612/2616-4868.1(19).2022.01
T. Lasytsia, G. Moroz, I. Hidzynska
Objective: to evaluate current approaches to the training of physicians on comorbidity and multimorbidity and to develop and implement a training module “Comorbidity in patients with coronary artery disease: current approaches to treatment” in the Training Center "Institute of Postgraduate Education" of the State Institution of Sciences “Research and Practical Center of Preventive and Clinical Medicine” State Administrative Department (SIS “RPC PCM” SAD). Material and methods. We carried out an analysis and generalization of recent publications on the topic of the management challenges in patients with coronary artery disease and comorbidities and review the literature focusing on postgraduate training of medical doctors in the area of multimorbidity After the implementation of the training module we made a survey of 60 physicians on their assessment of the information provided. Results and discussion: Current scientific research substantiates the feasibility of introducing both face-to-face trainings and master classes, as well as distance learning to optimize the training programmes for doctors in managing patients with multimorbidity and comorbidity. We developed and implemented a training module “Comorbidity in patients with coronary artery disease: current approaches to treatment” in the Training Center "Institute of Postgraduate Education" of SIS “RPC PCM” SAD. We identified major theoretical issues and practical skills that should be acquired by the physician, we worked out the methodology for presenting information during full-time and distance learning. The educational process includes lectures (including the use of distance learning), and a workshop format and master classes with the analysis of specific clinical cases. Conclusions: 97.1% of respondents rated positively the implementation of continuing medical education on the topic of coronary artery disease management in patients with comorbidities with the use of distance learning and the appliance of master classes with the analysis of clinical cases. Optimal educational format is a significant issue which needs further research. Any training on the management of multimorbidity in practice must be outcome-oriented, in order to change practice and improve clinical outcomes for complex patients.
{"title":"IMPLEMENTATION OF CONTINUING MEDICAL EDUCATION OF PHYSICIANS ON THE TREATMENT OF PATIENTS WITH CORONARY ARTERY DISEASE AND COMORBIDITIES","authors":"T. Lasytsia, G. Moroz, I. Hidzynska","doi":"10.31612/2616-4868.1(19).2022.01","DOIUrl":"https://doi.org/10.31612/2616-4868.1(19).2022.01","url":null,"abstract":"Objective: to evaluate current approaches to the training of physicians on comorbidity and multimorbidity and to develop and implement a training module “Comorbidity in patients with coronary artery disease: current approaches to treatment” in the Training Center \"Institute of Postgraduate Education\" of the State Institution of Sciences “Research and Practical Center of Preventive and Clinical Medicine” State Administrative Department (SIS “RPC PCM” SAD). \u0000Material and methods. We carried out an analysis and generalization of recent publications on the topic of the management challenges in patients with coronary artery disease and comorbidities and review the literature focusing on postgraduate training of medical doctors in the area of multimorbidity After the implementation of the training module we made a survey of 60 physicians on their assessment of the information provided. \u0000Results and discussion: Current scientific research substantiates the feasibility of introducing both face-to-face trainings and master classes, as well as distance learning to optimize the training programmes for doctors in managing patients with multimorbidity and comorbidity. We developed and implemented a training module “Comorbidity in patients with coronary artery disease: current approaches to treatment” in the Training Center \"Institute of Postgraduate Education\" of SIS “RPC PCM” SAD. We identified major theoretical issues and practical skills that should be acquired by the physician, we worked out the methodology for presenting information during full-time and distance learning. The educational process includes lectures (including the use of distance learning), and a workshop format and master classes with the analysis of specific clinical cases. \u0000Conclusions: 97.1% of respondents rated positively the implementation of continuing medical education on the topic of coronary artery disease management in patients with comorbidities with the use of distance learning and the appliance of master classes with the analysis of clinical cases. Optimal educational format is a significant issue which needs further research. Any training on the management of multimorbidity in practice must be outcome-oriented, in order to change practice and improve clinical outcomes for complex patients.","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70040477","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 : 2022-02-14DOI: 10.31612/2616-4868.1(19).2022.09
V. Cherniy, Y. Kurylenko
Introduction. Coronary heart disease is the leading cause of death and disability worldwide. For patients with three or more coronary arteries lesion, revascularization with coronary artery bypass grafting (CABG) is the best treatment. 10% of all patients require re-hospitalization within 30 days of discharge, the most common cause being heart failure. The most formidable complication after CABG surgery with cardiopulmonary bypass (CPB) is the development of acute left ventricular failure (ALVF). The aim. To analyze the problems of correction of ALVF after CABG with CPB from the sources of modern literature to optimize the management of the perioperative period in this group of patients. Materials and methods. Bibliosemantic, comparative and method of system analysis. The proposed recommendations are based on the analysis of modern literature, the results of randomized trials and meta-analyzes to study the problem of correction of ALVF after CABG with CPB. Results. Inotropic support for ALVF after CABG with CPB is prescribed based on the presence of a number of factors. Adrenomimetics, phosphodiesterase inhibitors and calcium sensitizers are prescribed for the correction of ALVF. In addition to inotropics, the myocardium has a positive effect on metabolic drugs: levocarnitine and arginine. When medical treatments are exhausted, resort to the use of hardware treatments: intra-aortic balloon pump, left ventricle assist device, Impella, extracorporeal membrane oxygenation. Conclusions. Given the variety of classes of drugs and their active components, dobutamine remains the most affordable, safe and effective drug for the treatment of ALVF after CABG with CPB. The combination of L-carnitine and arginine has a number of effects that have a stabilizing effect on the operated myocardium. For the treatment of ALVF after CABG with CPB, in order to achieve a stabilizing effect on the myocardium, it is advisable to investigate the combined use of dobutamine with L-carnitine and arginine to combine the positive effects of drugs.
{"title":"MODERN APPROACHES TO TREATMENT OF ACUTE LEFT VENTRICULAR INSUFFICIENCY IN PATIENTS AFTER AORTO-CORONARY SCANNING SURGERY IN CONDITIONS IN CONDITIONS","authors":"V. Cherniy, Y. Kurylenko","doi":"10.31612/2616-4868.1(19).2022.09","DOIUrl":"https://doi.org/10.31612/2616-4868.1(19).2022.09","url":null,"abstract":"Introduction. Coronary heart disease is the leading cause of death and disability worldwide. For patients with three or more coronary arteries lesion, revascularization with coronary artery bypass grafting (CABG) is the best treatment. 10% of all patients require re-hospitalization within 30 days of discharge, the most common cause being heart failure. The most formidable complication after CABG surgery with cardiopulmonary bypass (CPB) is the development of acute left ventricular failure (ALVF). \u0000The aim. To analyze the problems of correction of ALVF after CABG with CPB from the sources of modern literature to optimize the management of the perioperative period in this group of patients. \u0000Materials and methods. Bibliosemantic, comparative and method of system analysis. The proposed recommendations are based on the analysis of modern literature, the results of randomized trials and meta-analyzes to study the problem of correction of ALVF after CABG with CPB. \u0000Results. Inotropic support for ALVF after CABG with CPB is prescribed based on the presence of a number of factors. Adrenomimetics, phosphodiesterase inhibitors and calcium sensitizers are prescribed for the correction of ALVF. In addition to inotropics, the myocardium has a positive effect on metabolic drugs: levocarnitine and arginine. When medical treatments are exhausted, resort to the use of hardware treatments: intra-aortic balloon pump, left ventricle assist device, Impella, extracorporeal membrane oxygenation. \u0000Conclusions. Given the variety of classes of drugs and their active components, dobutamine remains the most affordable, safe and effective drug for the treatment of ALVF after CABG with CPB. The combination of L-carnitine and arginine has a number of effects that have a stabilizing effect on the operated myocardium. For the treatment of ALVF after CABG with CPB, in order to achieve a stabilizing effect on the myocardium, it is advisable to investigate the combined use of dobutamine with L-carnitine and arginine to combine the positive effects of drugs.","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70040253","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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