Pub Date : 2023-08-04DOI: 10.31612/2616-4868.3(25).2023.01
A.I. Vatsenko, T. Koval
Intriduction: The acute respiratory disease COVID-19 continues to pose a threat to human health worldwide. Identifying new predictors of severe coronavirus disease is necessary to prevent new outbreaks and reduce mortality among the population. The aim of the study was to analyze the prevalence and impact of the angiotensin II type 1 receptor polymorphism (A1166C at1r) on the severity of COVID-19. Materials and methods: We conducted a case-control study involving 151 patients who were diagnosed with COVID-19 and were inpatients at the Municipal Clinical Institution "POKIL" of the OR and the Municipal Clinical Institution "3rd City Hospital of the OR" from April 2020 to March 2021. The diagnosis was made based on the examination of patients by polymerase chain reaction (PCR) and the detection of SARS-CoV-2 virus RNA in the nasopharyngeal scrapings. One of the three genotypes of the at1r gene (rs5186) was identified in each of the patients: AA, AC, and CC. The distribution of genotypes was as follows: AA - 58 people (38.4%), AC - 70 (46.4%), CC - 23 (15.2%). The group of healthy individuals had the following genotype distribution: AA - 42 people (51.2%), AC - 28 people (34.1%) and SS - 12 people (14.7%). In order to determine the impact of the at1r gene polymorphism on the course of COVID-19, patients (n=151) were divided into 2 groups depending on the carriage of the C allele. Results: The combined AS+CC genotype was significantly more common in the group with severe (p=0.011) and severe + critical (p=0.003) course compared to the control group. Patients with combined AC+CC genotype were significantly more likely to be hospitalized with moderate (p=0.016) and severe and critical disease (p=0.016). Patients with the combined AC+CC genotype were significantly more likely to require oxygen therapy (67.7%) compared to patients with the AA genotype (44.8%), p=0.005. They were more likely to be supported with a face mask - 49 (52.7%). Conclusions: the angiotensin II type 1 receptor polymorphism (A1166C at1r) is a factor influencing the severity of COVID-19. Patients with a combined AC+CC genotype are significantly more likely to have a severe course of the disease and require oxygen support.
{"title":"ANGIOTENSIN II TYPE I RECEPTOR POLYMORPHISM (A1166C AT1R) AS A FACTOR COMPLICATING THE COURSE OF COVID-19","authors":"A.I. Vatsenko, T. Koval","doi":"10.31612/2616-4868.3(25).2023.01","DOIUrl":"https://doi.org/10.31612/2616-4868.3(25).2023.01","url":null,"abstract":"Intriduction: The acute respiratory disease COVID-19 continues to pose a threat to human health worldwide. Identifying new predictors of severe coronavirus disease is necessary to prevent new outbreaks and reduce mortality among the population. \u0000The aim of the study was to analyze the prevalence and impact of the angiotensin II type 1 receptor polymorphism (A1166C at1r) on the severity of COVID-19. \u0000Materials and methods: We conducted a case-control study involving 151 patients who were diagnosed with COVID-19 and were inpatients at the Municipal Clinical Institution \"POKIL\" of the OR and the Municipal Clinical Institution \"3rd City Hospital of the OR\" from April 2020 to March 2021. The diagnosis was made based on the examination of patients by polymerase chain reaction (PCR) and the detection of SARS-CoV-2 virus RNA in the nasopharyngeal scrapings. One of the three genotypes of the at1r gene (rs5186) was identified in each of the patients: AA, AC, and CC. The distribution of genotypes was as follows: AA - 58 people (38.4%), AC - 70 (46.4%), CC - 23 (15.2%). \u0000The group of healthy individuals had the following genotype distribution: AA - 42 people (51.2%), AC - 28 people (34.1%) and SS - 12 people (14.7%). In order to determine the impact of the at1r gene polymorphism on the course of COVID-19, patients (n=151) were divided into 2 groups depending on the carriage of the C allele. \u0000Results: The combined AS+CC genotype was significantly more common in the group with severe (p=0.011) and severe + critical (p=0.003) course compared to the control group. Patients with combined AC+CC genotype were significantly more likely to be hospitalized with moderate (p=0.016) and severe and critical disease (p=0.016). Patients with the combined AC+CC genotype were significantly more likely to require oxygen therapy (67.7%) compared to patients with the AA genotype (44.8%), p=0.005. They were more likely to be supported with a face mask - 49 (52.7%). \u0000Conclusions: the angiotensin II type 1 receptor polymorphism (A1166C at1r) is a factor influencing the severity of COVID-19. Patients with a combined AC+CC genotype are significantly more likely to have a severe course of the disease and require oxygen support.","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70042017","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 : 2023-08-04DOI: 10.31612/2616-4868.3(25).2023.11
I. Nezgoda, Y. Demchyshyn
Introduction. In modern hepatology, a special place is occupied by chronic viral hepatitis, including B and C, because today they occupy the leading positions due to their high prevalence, the possibility of severe complications, and also they could lead to death in both adults and children. Specialists should have a comprehensive understanding of the clinical course and laboratory diagnosis of viral hepatitis to facilitate timely diagnosis and effective management of this condition. The aim: to evaluate the clinical and laboratory features of the course of chronic viral hepatitis B and C in children by determining patterns between parametric indexes characterizing the processes of liver fibrosis. Materials and methods. In the process of scientific research, 49 children were examined, including 29 children with diagnosed chronic viral hepatitis B and C (group I) and 20 almost healthy children (group II). The diagnoses of CHB and CHC were confirmed by the PCR method and specific markers detected by ELISA. All examined patients underwent anamnesis collection, general clinical examination, laboratory examination, calculation of CDS, Lok, GUCI, APRI, FIB-4 and "Fibrotest" diagnostic indexes. Statistical data analysis was carried out with "R-Studio" and "Statistica 10.0" software, using the methods of descriptive statistics, correlation analysis. Significance was considered significant at p<0.05. The study was conducted in compliance with the principles of the Declaration of Helsinki. Results. It was established that the levels of ALT, AST, GGT, ALP, indirect bilirubin, international normalized ratio (INR) were significantly higher in the examined patients of the I group. The level of the CDS index was significantly higher in the examined patients of the I group (5,97±0,30), compared with the patients of the II group (4,35±0,28) (p<0,001). A similar trend was noted with the Lok index and FIB-4 (p<0,001). The GUCI and APRI indices were significantly higher in patients of the I group (1,02±0,22; 0,73±0,04), compared to the examined patients of the II group (0,27±0,02; 0,23±0,02) (p<0,01). Conclusions. Implementation of non-invasive indices into clinical practice for the management of children with chronic hepatitis B and C will allow for dynamic monitoring of liver fibrogenesis processes.
{"title":"CLINICAL AND LABORATORY FEATURES OF THE COURSE OF CHRONIC VIRAL HEPATITIS B AND C IN CHILDREN OF PODILSKY REGION: POSSIBILITY FOR MODERN MONITORING","authors":"I. Nezgoda, Y. Demchyshyn","doi":"10.31612/2616-4868.3(25).2023.11","DOIUrl":"https://doi.org/10.31612/2616-4868.3(25).2023.11","url":null,"abstract":"Introduction. In modern hepatology, a special place is occupied by chronic viral hepatitis, including B and C, because today they occupy the leading positions due to their high prevalence, the possibility of severe complications, and also they could lead to death in both adults and children. Specialists should have a comprehensive understanding of the clinical course and laboratory diagnosis of viral hepatitis to facilitate timely diagnosis and effective management of this condition. \u0000The aim: to evaluate the clinical and laboratory features of the course of chronic viral hepatitis B and C in children by determining patterns between parametric indexes characterizing the processes of liver fibrosis. \u0000Materials and methods. In the process of scientific research, 49 children were examined, including 29 children with diagnosed chronic viral hepatitis B and C (group I) and 20 almost healthy children (group II). The diagnoses of CHB and CHC were confirmed by the PCR method and specific markers detected by ELISA. All examined patients underwent anamnesis collection, general clinical examination, laboratory examination, calculation of CDS, Lok, GUCI, APRI, FIB-4 and \"Fibrotest\" diagnostic indexes. Statistical data analysis was carried out with \"R-Studio\" and \"Statistica 10.0\" software, using the methods of descriptive statistics, correlation analysis. Significance was considered significant at p<0.05. The study was conducted in compliance with the principles of the Declaration of Helsinki. \u0000Results. It was established that the levels of ALT, AST, GGT, ALP, indirect bilirubin, international normalized ratio (INR) were significantly higher in the examined patients of the I group. The level of the CDS index was significantly higher in the examined patients of the I group (5,97±0,30), compared with the patients of the II group (4,35±0,28) (p<0,001). A similar trend was noted with the Lok index and FIB-4 (p<0,001). The GUCI and APRI indices were significantly higher in patients of the I group (1,02±0,22; 0,73±0,04), compared to the examined patients of the II group (0,27±0,02; 0,23±0,02) (p<0,01). \u0000Conclusions. Implementation of non-invasive indices into clinical practice for the management of children with chronic hepatitis B and C will allow for dynamic monitoring of liver fibrogenesis processes.","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47712929","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 : 2023-08-04DOI: 10.31612/2616-4868.3(25).2023.12
A. Nabok, B. Palamar
The article discusses current issues of providing oncology medical care at the present time. Current legislation has been studied and modern approaches to the structure and features of the organization of providing medical care for malignant neoplasms during the war in Ukraine have been analyzed. Introduction. The war as a result of the Russian attack made it difficult for patients to access necessary medical services and medicines. The most problematic in the organization of cancer control in the regions are the timely detection of patients, adequate staging of the malignant process, registration of deaths, as well as the system of dispensary observation of cancer patients, without the establishment of which it is impossible to achieve success in increasing the survival rate of cancer patients. High levels of neglect of visual malignant neoplasms in many regions indicate that dental, gynecological and other services of the general hospital network of these regions do not take an active part in solving the problem of timely cancer diagnosis [1, 2, 4]. During the war, the Medical Guarantee Program continues to operate, and cancer patients can receive government-provided treatment free of charge. Guarantees cover medical care at every stage of treatment: diagnosis, chemotherapy and radiological treatment, support in outpatient or inpatient settings, surgery, rehabilitation, palliative care. A patient can receive medical assistance free of charge upon a doctor's referral [2, 11]. An analysis of the onco-epidemiological situation in Ukraine in recent years revealed a significant decrease in the number of both patients and deaths from cancer compared to previous years. The quantitative characteristics of morbidity were obviously affected by the epidemic of COVID-19 and the war in the country, which changed the organization of the diagnostic process and the patient's ability to get to a specialized oncology care facility [4]. The purpose of the work is to study the organization of medical care for oncological diseases during the period of martial law. Research materials and methods. An analysis of the legal framework was carried out. The following methods were used: content analysis, systematic approach and analysis.
{"title":"INFLUENCE OF THE WAR ON THE ORGANIZATION OF MEDICAL ASSISTANCE FOR ONCOLOGICAL DISEASES","authors":"A. Nabok, B. Palamar","doi":"10.31612/2616-4868.3(25).2023.12","DOIUrl":"https://doi.org/10.31612/2616-4868.3(25).2023.12","url":null,"abstract":"The article discusses current issues of providing oncology medical care at the present time. Current legislation has been studied and modern approaches to the structure and features of the organization of providing medical care for malignant neoplasms during the war in Ukraine have been analyzed. \u0000Introduction. The war as a result of the Russian attack made it difficult for patients to access necessary medical services and medicines. The most problematic in the organization of cancer control in the regions are the timely detection of patients, adequate staging of the malignant process, registration of deaths, as well as the system of dispensary observation of cancer patients, without the establishment of which it is impossible to achieve success in increasing the survival rate of cancer patients. High levels of neglect of visual malignant neoplasms in many regions indicate that dental, gynecological and other services of the general hospital network of these regions do not take an active part in solving the problem of timely cancer diagnosis [1, 2, 4]. \u0000During the war, the Medical Guarantee Program continues to operate, and cancer patients can receive government-provided treatment free of charge. Guarantees cover medical care at every stage of treatment: diagnosis, chemotherapy and radiological treatment, support in outpatient or inpatient settings, surgery, rehabilitation, palliative care. A patient can receive medical assistance free of charge upon a doctor's referral [2, 11]. \u0000An analysis of the onco-epidemiological situation in Ukraine in recent years revealed a significant decrease in the number of both patients and deaths from cancer compared to previous years. The quantitative characteristics of morbidity were obviously affected by the epidemic of COVID-19 and the war in the country, which changed the organization of the diagnostic process and the patient's ability to get to a specialized oncology care facility [4]. \u0000The purpose of the work is to study the organization of medical care for oncological diseases during the period of martial law. \u0000Research materials and methods. An analysis of the legal framework was carried out. The following methods were used: content analysis, systematic approach and analysis.","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70041654","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 : 2023-08-04DOI: 10.31612/2616-4868.3(25).2023.08
A. Payenok, A. Kulyk
The aim. The primary aim of this study is to assess the variance in substance P concentration, taking into account pain intensity and the presence of a neuropathic component, among patients experiencing acute and chronic vertebral lumbosacral pain syndromes. Materials. Measurement of substance P concentration in serum blood, evaluation of pain syndrome using the VAS scale, and assessment of pain according to the DN4 questionnaire were performed in patients receiving comprehensive treatment. A total of 125 patients were included in the study, comprising 65 patients with acute pain and 60 patients with chronic pain syndrome. Results. Pain ratings according to the Visual Analog Scale (VAS) among patients from the acute pain group was 7.15±1.07 on the VAS scale, while patients in the chronic pain group rated it at 6.09±0.96. On the 7th day of treatment, patients in the acute pain group reported a pain rating of 4.46±0.73, whereas those in the chronic pain group reported a rating of 4.22±0.97. The level of substance p(SP) in serum blood on the first day of treatment was 13.96±1.93 ng/mL in the acute pain group and 10.34±2.92 ng/mL in the chronic pain group. By the 7th day of treatment, the level decreased to 7.72±1.90 ng/mL in the acute pain group and 8.03±2.14 ng/mL in the chronic pain group. According to the DN4 questionnaire, neuropathic component was ascertained in 38% of patients with acute pain syndrome and 56% of participants with chronic pain. The average DN4 score in the acute pain group was 2.26±1.01, while in the chronic pain group, it was 4.53±1.02. In the group of patients with chronic pain syndrome and the presence of a neuropathic component, the level of SP was 10.89±1.78 ng/mL. In contrast, without the presence of a neuropathic component, it was 6.51±1.94 ng/mL. Conclusions. The trajectory of acute and chronic pain syndromes in patients with lumbosacral vertebral pain syndromes exhibits dissimilarities. Patients experiencing acute pain displayed a more favorable trend characterized by a reduction in pain intensity and a decrease in pain-related neurotransmitter concentration in the bloodstream.
{"title":"COMPARATIVE CHARACTERISTICS OF SUBSTANCE P CONCENTRATION AND NEUROPATHIC PAIN COMPONENT IN PATIENTS WITH ACUTE AND CHRONIC COURSES OF VERTEBROGENIC LUMBAR-SACRAL PAIN SYNDROMES","authors":"A. Payenok, A. Kulyk","doi":"10.31612/2616-4868.3(25).2023.08","DOIUrl":"https://doi.org/10.31612/2616-4868.3(25).2023.08","url":null,"abstract":"The aim. The primary aim of this study is to assess the variance in substance P concentration, taking into account pain intensity and the presence of a neuropathic component, among patients experiencing acute and chronic vertebral lumbosacral pain syndromes. \u0000Materials. Measurement of substance P concentration in serum blood, evaluation of pain syndrome using the VAS scale, and assessment of pain according to the DN4 questionnaire were performed in patients receiving comprehensive treatment. A total of 125 patients were included in the study, comprising 65 patients with acute pain and 60 patients with chronic pain syndrome. \u0000Results. Pain ratings according to the Visual Analog Scale (VAS) among patients from the acute pain group was 7.15±1.07 on the VAS scale, while patients in the chronic pain group rated it at 6.09±0.96. On the 7th day of treatment, patients in the acute pain group reported a pain rating of 4.46±0.73, whereas those in the chronic pain group reported a rating of 4.22±0.97. The level of substance p(SP) in serum blood on the first day of treatment was 13.96±1.93 ng/mL in the acute pain group and 10.34±2.92 ng/mL in the chronic pain group. By the 7th day of treatment, the level decreased to 7.72±1.90 ng/mL in the acute pain group and 8.03±2.14 ng/mL in the chronic pain group. According to the DN4 questionnaire, neuropathic component was ascertained in 38% of patients with acute pain syndrome and 56% of participants with chronic pain. The average DN4 score in the acute pain group was 2.26±1.01, while in the chronic pain group, it was 4.53±1.02. In the group of patients with chronic pain syndrome and the presence of a neuropathic component, the level of SP was 10.89±1.78 ng/mL. In contrast, without the presence of a neuropathic component, it was 6.51±1.94 ng/mL. \u0000Conclusions. The trajectory of acute and chronic pain syndromes in patients with lumbosacral vertebral pain syndromes exhibits dissimilarities. Patients experiencing acute pain displayed a more favorable trend characterized by a reduction in pain intensity and a decrease in pain-related neurotransmitter concentration in the bloodstream.","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70041585","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 : 2023-08-04DOI: 10.31612/2616-4868.3(25).2023.06
K. Usychenko
Modern antiviral therapy regimens for patients with chronic viral hepatitis aim to achieve either long-term suppression of pathogen replication (e.g., nucleoside analogs in chronic hepatitis B) or complete elimination of the virus (such as direct-acting antiviral drugs in chronic hepatitis C). However, antiviral agents do not have a significant impact on the complete restoration of biochemical processes or the prevention of further progression of morphological changes in the liver. These limitations emphasize the ongoing need for new therapeutic strategies that target the processes of fibrogenesis. The aim of the work is to assess the possibility of the effect of the drug "Bicyclol" on fibrotic changes in patients with chronic hepatitis B+C using a non-invasive scale of the rate of fibrosis. Materials and methods An analysis of the dynamics of 62 patients with chronic hepatitis B and C (HCV+C) was conducted. All patients received long-term antiviral therapy consisting of pegylated interferon for 48 weeks. In the main group (Group I), patients with chronic hepatitis B and C were prescribed the drug "Bicyclol" after completing antiviral treatment with interferon. The control group (Group II) followed the principles of proper nutrition and took traditional hepatoprotectors. Based on the identified correlations, a non-invasive scale was proposed to assess the individual risk of liver fibrosis progression. Research results Against the background of the use of an antiviral treatment regimen, the normalization of cytolysis indicators was observed in most patients with CHB+C, but in some patients it was short-lived. Treatment with the drug "Bicyclol" contributed to a further decrease in cytolysis indicators, in the vast majority of patients with CHB+C, the activity of ALT and AST reached the upper limit of the norm. In patients with CHB+C who received only basic treatment without an antifibrotic component, a tendency to maintain an elevated level of transaminases was observed. Conclusions. Thus, the use of the hepatoprotector "Bicyclol" for 12 months ensures a decrease in cytolysis in the liver, is accompanied by a decrease in the severity of fibrosis, and in some patients - its reverse development. The use of the proposed prognostic scale makes it possible to assess the need for early appointment of antifibrotic therapy.
{"title":"RESULTS OF ANTIFIBROTIC THERAPY IN PATIENTS WITH CHRONIC HEPATITIS B+C","authors":"K. Usychenko","doi":"10.31612/2616-4868.3(25).2023.06","DOIUrl":"https://doi.org/10.31612/2616-4868.3(25).2023.06","url":null,"abstract":"Modern antiviral therapy regimens for patients with chronic viral hepatitis aim to achieve either long-term suppression of pathogen replication (e.g., nucleoside analogs in chronic hepatitis B) or complete elimination of the virus (such as direct-acting antiviral drugs in chronic hepatitis C). However, antiviral agents do not have a significant impact on the complete restoration of biochemical processes or the prevention of further progression of morphological changes in the liver. These limitations emphasize the ongoing need for new therapeutic strategies that target the processes of fibrogenesis. \u0000The aim of the work is to assess the possibility of the effect of the drug \"Bicyclol\" on fibrotic changes in patients with chronic hepatitis B+C using a non-invasive scale of the rate of fibrosis. \u0000Materials and methods \u0000An analysis of the dynamics of 62 patients with chronic hepatitis B and C (HCV+C) was conducted. All patients received long-term antiviral therapy consisting of pegylated interferon for 48 weeks. In the main group (Group I), patients with chronic hepatitis B and C were prescribed the drug \"Bicyclol\" after completing antiviral treatment with interferon. The control group (Group II) followed the principles of proper nutrition and took traditional hepatoprotectors. Based on the identified correlations, a non-invasive scale was proposed to assess the individual risk of liver fibrosis progression. \u0000Research results \u0000Against the background of the use of an antiviral treatment regimen, the normalization of cytolysis indicators was observed in most patients with CHB+C, but in some patients it was short-lived. Treatment with the drug \"Bicyclol\" contributed to a further decrease in cytolysis indicators, in the vast majority of patients with CHB+C, the activity of ALT and AST reached the upper limit of the norm. In patients with CHB+C who received only basic treatment without an antifibrotic component, a tendency to maintain an elevated level of transaminases was observed. \u0000Conclusions. \u0000Thus, the use of the hepatoprotector \"Bicyclol\" for 12 months ensures a decrease in cytolysis in the liver, is accompanied by a decrease in the severity of fibrosis, and in some patients - its reverse development. The use of the proposed prognostic scale makes it possible to assess the need for early appointment of antifibrotic therapy.","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47049924","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 : 2023-08-04DOI: 10.31612/2616-4868.3(25).2023.14
T. Cherniy, V. Cherniy, D.V. Svitlytska
Introduction. Chronic cerebral ischemia (CCI) is considered a syndrome that develops as a result of a slowly progressive reduction in cerebral blood flow. This reduction occurs due to the gradual accumulation of ischemic and secondary degenerative changes in the brain, which are caused by repeated ischemic episodes resulting from the development of atherosclerosis and arterial hypertension. These changes lead to impairment of brain functions, manifested by progressive neurological, neuropsychological, and mental disorders. The aim. To analyze the problems of pathogenesis, diagnosis, and treatment of CCI from the sources of modern literature in order to optimize the treatment of this group of patients. Materials and methods. Bibliosemantic, comparative and method of system analysis. Results. The pathogenetic mechanisms underlying CCI remain controversial due to the heterogeneity of causes and the complexity of the neuropathology associated with the disease. However, one common reason that can be named is dysregulation of cerebral blood flow, that results in chronic cerebral hypoperfusion, which can lead to the development of vascular cognitive impairment and dementia. Detection of biological markers in the patients' blood in combination with neuropsychological testing, neurophysiological (CEP P300, EEG) and neuroimaging (CT, MRI, Doppler Ultrasound of the head and neck) methods, which confirms the morphological substrate of vascular disease (leukoareosis, focal changes, multi-infarct condition, cerebral atrophy) and provides the possibility of choosing an effective pathogenetically-justified treatment. Conclusions. The rating of effectiveness of treatment in CCI is complicated considering difficulties in the selection of the efficiency criteria due to the significant differences in the methodology and research formats, as well as problem of a significant medication-related burden in the case of comorbidities. In this regard, the main direction in therapy is combined neuroprotection, which allows to optimize the possibilities of this strategy and to increase its clinical significance in angioneurology.
{"title":"CHRONIC CEREBRAL ISCHEMIA. MODERN VIEW OF THE PROBLEM","authors":"T. Cherniy, V. Cherniy, D.V. Svitlytska","doi":"10.31612/2616-4868.3(25).2023.14","DOIUrl":"https://doi.org/10.31612/2616-4868.3(25).2023.14","url":null,"abstract":"Introduction. Chronic cerebral ischemia (CCI) is considered a syndrome that develops as a result of a slowly progressive reduction in cerebral blood flow. This reduction occurs due to the gradual accumulation of ischemic and secondary degenerative changes in the brain, which are caused by repeated ischemic episodes resulting from the development of atherosclerosis and arterial hypertension. These changes lead to impairment of brain functions, manifested by progressive neurological, neuropsychological, and mental disorders. \u0000The aim. To analyze the problems of pathogenesis, diagnosis, and treatment of CCI from the sources of modern literature in order to optimize the treatment of this group of patients. \u0000 Materials and methods. Bibliosemantic, comparative and method of system analysis. \u0000 Results. The pathogenetic mechanisms underlying CCI remain controversial due to the heterogeneity of causes and the complexity of the neuropathology associated with the disease. However, one common reason that can be named is dysregulation of cerebral blood flow, that results in chronic cerebral hypoperfusion, which can lead to the development of vascular cognitive impairment and dementia. Detection of biological markers in the patients' blood in combination with neuropsychological testing, neurophysiological (CEP P300, EEG) and neuroimaging (CT, MRI, Doppler Ultrasound of the head and neck) methods, which confirms the morphological substrate of vascular disease (leukoareosis, focal changes, multi-infarct condition, cerebral atrophy) and provides the possibility of choosing an effective pathogenetically-justified treatment. \u0000Conclusions. The rating of effectiveness of treatment in CCI is complicated considering difficulties in the selection of the efficiency criteria due to the significant differences in the methodology and research formats, as well as problem of a significant medication-related burden in the case of comorbidities. In this regard, the main direction in therapy is combined neuroprotection, which allows to optimize the possibilities of this strategy and to increase its clinical significance in angioneurology.","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48640023","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 : 2023-08-04DOI: 10.31612/2616-4868.3(25).2023.09
N.G. Pylypenko
The aim. To provide an analysis of the theoretical foundations and practical approaches to addressing the issue of psychological safety for specialists involved in the organization and provision of psychological assistance in war conditions. Materials and methods. The research employed the bibliographic method, method of analysis, and synthesis of scientific materials from academic sources. Results and discussion. A detailed analysis of several scientific studies revealed that among the main prerequisites for the emergence of emotional burnout in helping professionals, two directions are traditionally identified: the characteristics of professional activities and the psychological characteristics of the specialist. In the context of the question about the psychological changes that can occur in professionals during their professional activities, we have examined the phenomenon of secondary trauma or secondary traumatic stress, which refers to the trauma experienced by a professional while providing psychological assistance. In the literature on crisis psychology, the phenomenon of burnout is often equated with the phenomenon of secondary trauma due to the following reasons: 1) both states tend to accumulate over time, and 2) they have similar consequences (insomnia, depressed mood, impaired communication with social environment and family).However, a detailed analysis of these phenomena indicates the presence of differences, primarily in the characteristics of their emergence. Conclusion. The main safety rules for assisting specialists, compliance with which is necessary to maintain their professional well-being, include: awareness of one's abilities and the limits of one's competence;having an understanding of one's vulnerabilities and assessing one's capabilities and risks when working with cases that involve heightened emotional sensitivity; tracking changes in one's emotional and physical state, as well as changes in behavior; seeking help from superiors when needed;when dealing with challenging crisis events and their aftermath, working better in pairs with colleagues. This is necessary for maintaining emotional balance for each specialist working in a pair and for the ability to rely on each other during consultations or group psychological work;participating periodically in supervision groups or receiving supervision.Following these rules is essential for preserving the emotional well-being of each specialist and enables them to rely on support systems such as working in pairs and seeking supervision or consultation when needed.
{"title":"The psychological safety of specialists involved in the organization and provision of psychological assistance in war conditions","authors":"N.G. Pylypenko","doi":"10.31612/2616-4868.3(25).2023.09","DOIUrl":"https://doi.org/10.31612/2616-4868.3(25).2023.09","url":null,"abstract":"The aim. To provide an analysis of the theoretical foundations and practical approaches to addressing the issue of psychological safety for specialists involved in the organization and provision of psychological assistance in war conditions. \u0000Materials and methods. The research employed the bibliographic method, method of analysis, and synthesis of scientific materials from academic sources. \u0000Results and discussion. A detailed analysis of several scientific studies revealed that among the main prerequisites for the emergence of emotional burnout in helping professionals, two directions are traditionally identified: the characteristics of professional activities and the psychological characteristics of the specialist. \u0000In the context of the question about the psychological changes that can occur in professionals during their professional activities, we have examined the phenomenon of secondary trauma or secondary traumatic stress, which refers to the trauma experienced by a professional while providing psychological assistance. In the literature on crisis psychology, the phenomenon of burnout is often equated with the phenomenon of secondary trauma due to the following reasons: 1) both states tend to accumulate over time, and 2) they have similar consequences (insomnia, depressed mood, impaired communication with social environment and family).However, a detailed analysis of these phenomena indicates the presence of differences, primarily in the characteristics of their emergence. \u0000Conclusion. \u0000The main safety rules for assisting specialists, compliance with which is necessary to maintain their professional well-being, include: awareness of one's abilities and the limits of one's competence;having an understanding of one's vulnerabilities and assessing one's capabilities and risks when working with cases that involve heightened emotional sensitivity; tracking changes in one's emotional and physical state, as well as changes in behavior; seeking help from superiors when needed;when dealing with challenging crisis events and their aftermath, working better in pairs with colleagues. This is necessary for maintaining emotional balance for each specialist working in a pair and for the ability to rely on each other during consultations or group psychological work;participating periodically in supervision groups or receiving supervision.Following these rules is essential for preserving the emotional well-being of each specialist and enables them to rely on support systems such as working in pairs and seeking supervision or consultation when needed.","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70041638","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 : 2023-08-04DOI: 10.31612/2616-4868.3(25).2023.04
Yu. G. Shevchuk, Y. Dieieva
The aim. To assess the correlation between subjective measurements and objective volume of palatine tonsils in adults, and to test the effect of oropharyngeal anatomy, body mass index, age, and OSA severity on actual tonsil volume. In addition, we evaluated the effect of tonsil size on the development of OSA in adults. Materials and methods. A prospective study of 130 patients with rhonchopathy and obstructive sleep apnea syndrome was conducted. Patients underwent a physical examination, nocturnal polysomnography, Epworth Sleepiness Scale, body mass index (BMI, kg/m²), and a subjective assessment of snoring on an analog scale from 1 (not important) to 10 (worst possible). Results: pharyngeal tissues are also found to be proportional to body size in both patients with rhonchopathy and patients with OSA, which indicates a secondary role of anatomy in the pathogenesis of OSA development. Tonsil volume (p = 0.053) tended to correlate with the degree of severity OSA There were no significant differences in the mean apnea-hypopnea index (AHI) between patients with grade I (30.5), II (29.6), or III (38.2) tonsil hypertrophy. Patients with grade IV tonsil hypertrophy had a higher AHI (mean 103.2) than patients with grade I (p = 0.01), II (p = 0.01) or III (p = 0.03) hypertrophy. Conclusions: In adult patients with rhonchopathy and OSA, there is a reliable correlation between the clinical degree of tonsil hypertrophy and the objective volume of the tonsils. Possible changes in pharyngeal geometry associated with OSA do not affect the clinical ability to determine tonsil volume. Although tonsil volume correlates with AHI, clinically only grade IV tonsils are predictive of severe OSA. Pharyngeal tissue volume likely reflects body mass index rather than OSA.
{"title":"THE RELATIONSHIP BETWEEN THE ANATOMY FEATURES OF THE STRUCTURES OF THE PHARYNX AND THE DEVELOPMENT OF OBSTRUCTIVE SLEEP APNOEA SYNDROME IN ADULTS.","authors":"Yu. G. Shevchuk, Y. Dieieva","doi":"10.31612/2616-4868.3(25).2023.04","DOIUrl":"https://doi.org/10.31612/2616-4868.3(25).2023.04","url":null,"abstract":"The aim. To assess the correlation between subjective measurements and objective volume of palatine tonsils in adults, and to test the effect of oropharyngeal anatomy, body mass index, age, and OSA severity on actual tonsil volume. In addition, we evaluated the effect of tonsil size on the development of OSA in adults. \u0000Materials and methods. A prospective study of 130 patients with rhonchopathy and obstructive sleep apnea syndrome was conducted. Patients underwent a physical examination, nocturnal polysomnography, Epworth Sleepiness Scale, body mass index (BMI, kg/m²), and a subjective assessment of snoring on an analog scale from 1 (not important) to 10 (worst possible). \u0000Results: pharyngeal tissues are also found to be proportional to body size in both patients with rhonchopathy and patients with OSA, which indicates a secondary role of anatomy in the pathogenesis of OSA development. Tonsil volume (p = 0.053) tended to correlate with the degree of severity OSA There were no significant differences in the mean apnea-hypopnea index (AHI) between patients with grade I (30.5), II (29.6), or III (38.2) tonsil hypertrophy. Patients with grade IV tonsil hypertrophy had a higher AHI (mean 103.2) than patients with grade I (p = 0.01), II (p = 0.01) or III (p = 0.03) hypertrophy. \u0000Conclusions: In adult patients with rhonchopathy and OSA, there is a reliable correlation between the clinical degree of tonsil hypertrophy and the objective volume of the tonsils. Possible changes in pharyngeal geometry associated with OSA do not affect the clinical ability to determine tonsil volume. Although tonsil volume correlates with AHI, clinically only grade IV tonsils are predictive of severe OSA. Pharyngeal tissue volume likely reflects body mass index rather than OSA.","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70041571","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 : 2023-08-04DOI: 10.31612/2616-4868.3(25).2023.15
O. Lytvak, V. Shaprynskyi, M.V. Markova
Introduction. Penis enlargement procedures are becoming increasingly common among men seeking to achieve more desirable aesthetics of their male organ. This paper reviews the literature to identify and analyze scientific studies on the use of hyaluronic acid in andrology to increase penis size. The aim. To evaluate the effectiveness and safety of the procedure of injectable penis enlargement using hyaluronic acid filler. Materials and Methods. We evaluated the current scientific evidence on all available injectable penis enlargement methods to assess their effectiveness. To achieve this goal, we conducted a systematic search for scientific medical information in English-language databases such as MEDLINE, Embase, AMED (Allied and Complementary Medicine) and HMIC (Health Management Information Consortium). We analyzed all articles that met the specified search parameters. In addition, we manually searched for relevant references in the found texts. Results. The analysis of the literature shows that the use of hyaluronic acid to increase penile girth is a fairly effective method. The injection of hyaluronic acid demonstrates safety and effectiveness in practice, contributing to an increase in penis circumference. The results of studies confirm the long-term success and satisfaction of patients using this method, in particular in long-term follow-up. Conclusions. The use of hyaluronic acid as a filler to increase the size of the penis is effective and has several advantages. This minimally invasive method has fast and noticeable effect, increasing both the volume and length of the penis. This can improve patients' self-esteem and quality of life in the area of sexual relations. In addition, the procedure does not require complex surgical interventions and has a minimal recovery time, because hyaluronic acid is injectable. In general, the use of hyaluronic acid for penis enlargement is a convenient and effective option that allows patients to quickly achieve the desired result and improve the quality of their intimate life.
{"title":"EFFECTIVENESS OF HYALURONIC ACID INJECTIONS FOR PENIS ENLARGEMENT","authors":"O. Lytvak, V. Shaprynskyi, M.V. Markova","doi":"10.31612/2616-4868.3(25).2023.15","DOIUrl":"https://doi.org/10.31612/2616-4868.3(25).2023.15","url":null,"abstract":"Introduction. Penis enlargement procedures are becoming increasingly common among men seeking to achieve more desirable aesthetics of their male organ. This paper reviews the literature to identify and analyze scientific studies on the use of hyaluronic acid in andrology to increase penis size. \u0000The aim. To evaluate the effectiveness and safety of the procedure of injectable penis enlargement using hyaluronic acid filler. \u0000Materials and Methods. We evaluated the current scientific evidence on all available injectable penis enlargement methods to assess their effectiveness. To achieve this goal, we conducted a systematic search for scientific medical information in English-language databases such as MEDLINE, Embase, AMED (Allied and Complementary Medicine) and HMIC (Health Management Information Consortium). We analyzed all articles that met the specified search parameters. In addition, we manually searched for relevant references in the found texts. \u0000Results. The analysis of the literature shows that the use of hyaluronic acid to increase penile girth is a fairly effective method. The injection of hyaluronic acid demonstrates safety and effectiveness in practice, contributing to an increase in penis circumference. The results of studies confirm the long-term success and satisfaction of patients using this method, in particular in long-term follow-up. \u0000Conclusions. The use of hyaluronic acid as a filler to increase the size of the penis is effective and has several advantages. This minimally invasive method has fast and noticeable effect, increasing both the volume and length of the penis. This can improve patients' self-esteem and quality of life in the area of sexual relations. In addition, the procedure does not require complex surgical interventions and has a minimal recovery time, because hyaluronic acid is injectable. In general, the use of hyaluronic acid for penis enlargement is a convenient and effective option that allows patients to quickly achieve the desired result and improve the quality of their intimate life.","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70042342","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 : 2023-08-04DOI: 10.31612/2616-4868.3(25).2023.13
A. Kravchenko
The aim. To conduct an analysis and generalize scientific publications on the influence of war factors on morbidity indicators and the clinical course of arterial hypertension. Materials and methods. An analysis and generalization of scientific research and publications on the specifics of morbidity among military personnel and the population affected by war has been conducted. The following methods were utilized: a systematic approach, bibliosemantic analysis, and analytical methods. Results: The article focuses on the influence of war factors on the incidence rates and clinical course of arterial hypertension in both military personnel and the civilian population. Through a review of historical data and modern scientific sources, the study examines the long-term effects of stress factors on the development of hypertension, the peculiarities of its clinical manifestations, and the potential for predicting complications in individuals affected by military operations. The impact of nervous tension is particularly evident among frontline soldiers, as hypertension is observed, on average, 3-4 times more frequently compared to soldiers in the rear. The article emphasizes the clear correlation between the frequency of arterial hypertension in servicemen and the duration of their frontline deployment. Conclusion. Severe mental trauma and negative emotions, experienced by both military personnel and the civilian population during war, can not only contribute to an increased incidence of hypertension but also lead to a significant rise in the occurrence of the disease in young individuals, with severe clinical manifestations expected.
{"title":"ARTERIAL HYPERTENSION AND WAR, WHAT TO EXPECT?","authors":"A. Kravchenko","doi":"10.31612/2616-4868.3(25).2023.13","DOIUrl":"https://doi.org/10.31612/2616-4868.3(25).2023.13","url":null,"abstract":"The aim. To conduct an analysis and generalize scientific publications on the influence of war factors on morbidity indicators and the clinical course of arterial hypertension. \u0000Materials and methods. An analysis and generalization of scientific research and publications on the specifics of morbidity among military personnel and the population affected by war has been conducted. The following methods were utilized: a systematic approach, bibliosemantic analysis, and analytical methods. \u0000Results: The article focuses on the influence of war factors on the incidence rates and clinical course of arterial hypertension in both military personnel and the civilian population. Through a review of historical data and modern scientific sources, the study examines the long-term effects of stress factors on the development of hypertension, the peculiarities of its clinical manifestations, and the potential for predicting complications in individuals affected by military operations. The impact of nervous tension is particularly evident among frontline soldiers, as hypertension is observed, on average, 3-4 times more frequently compared to soldiers in the rear. The article emphasizes the clear correlation between the frequency of arterial hypertension in servicemen and the duration of their frontline deployment. \u0000Conclusion. Severe mental trauma and negative emotions, experienced by both military personnel and the civilian population during war, can not only contribute to an increased incidence of hypertension but also lead to a significant rise in the occurrence of the disease in young individuals, with severe clinical manifestations expected.","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70042330","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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