Pub Date : 2023-06-05DOI: 10.31612/2616-4868.2(24).2023.07
V. Zub
Introduction. Malignant tumors are the second most common cause of death in the population of Ukraine. Breast cancer is the most common cancer among women, and lung cancer among men. At the same time, there is a negative trend towards an increase in new cases of prostate cancer among the male population. In turn, gastric cancer is among the most common types of tumors in both male and female population of Ukraine. The aim. Comparison of indicators of the quality of life of patients with breast cancer, prostate cancer, lung cancer, gastric cancer and identification of the main problems in their quality of life in order to optimize the medical care system for them. Materials and methods. A questionnaire was conducted among patients with lung cancer (n=411), prostate cancer (n=408), breast cancer (n=400) and gastric cancer (n=404) on stage of their inpatient treatment in oncological institutions in nine regions of Ukraine, using the EORTC QLQ-C30 questionnaire. Results and discussion. The best indicator of Global Health Status/QoL was found in patients with breast cancer (53,22 points on a 100-point scale), while the lowest was found in patients with lung cancer (49,12 points). Breast cancer patients are also characterized by the best results in all items of the functional scale and the QLQ-C30 symptom scale. In turn, patients with gastric cancer recorded the worst indicators both on the functional scale and on the QLQ-С30 symptom scale. Conclusions. Based on the low quality of life indicators of cancer patients, it is important to create socio-psychological support for cancer patients and their family members, which will include the development and implementation of standardized psychological assistance and mental health care at all stages of diagnosis, treatment and rehabilitation.
{"title":"COMPARATIVE ANALYSIS FOR QUALITY OF LIFE OF PATIENTS WITH LUNG, PROSTATE, BREAST AND GASTRIC CANCER IN UKRAINE ACCORDING TO THE EORTC QLQ-C30 QUESTIONNAIRE","authors":"V. Zub","doi":"10.31612/2616-4868.2(24).2023.07","DOIUrl":"https://doi.org/10.31612/2616-4868.2(24).2023.07","url":null,"abstract":"Introduction. Malignant tumors are the second most common cause of death in the population of Ukraine. Breast cancer is the most common cancer among women, and lung cancer among men. At the same time, there is a negative trend towards an increase in new cases of prostate cancer among the male population. In turn, gastric cancer is among the most common types of tumors in both male and female population of Ukraine. \u0000The aim. Comparison of indicators of the quality of life of patients with breast cancer, prostate cancer, lung cancer, gastric cancer and identification of the main problems in their quality of life in order to optimize the medical care system for them. \u0000Materials and methods. A questionnaire was conducted among patients with lung cancer (n=411), prostate cancer (n=408), breast cancer (n=400) and gastric cancer (n=404) on stage of their inpatient treatment in oncological institutions in nine regions of Ukraine, using the EORTC QLQ-C30 questionnaire. \u0000Results and discussion. The best indicator of Global Health Status/QoL was found in patients with breast cancer (53,22 points on a 100-point scale), while the lowest was found in patients with lung cancer (49,12 points). Breast cancer patients are also characterized by the best results in all items of the functional scale and the QLQ-C30 symptom scale. In turn, patients with gastric cancer recorded the worst indicators both on the functional scale and on the QLQ-С30 symptom scale. \u0000Conclusions. Based on the low quality of life indicators of cancer patients, it is important to create socio-psychological support for cancer patients and their family members, which will include the development and implementation of standardized psychological assistance and mental health care at all stages of diagnosis, treatment and rehabilitation.","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70041513","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 : 2023-06-05DOI: 10.31612/2616-4868.2(24).2023.12
O. Klymenyuk, O. Ocheredko, V. P. Klymenyuk, A. A. Rudenko
Objective of the study. To evaluate the state of surgical services for patients with uterine fibroids and/or ovarian cysts in hospitals in Vinnytsia by the correspondence of the balance values of costs, quality, and comfort of medical services depending on the patient's medical education. Materials and methods. The analysis, design, and program of the study are based on the econometric model of D. Dranov and M. Satterthwaite, which relates the balance values of costs, quality, and comfort of health care services to individualized elasticities of demand. The model is empirically specified for the purposes of the study in a proper structural form. On this theoretical basis, we studied the state of the provision of surgical services to patients with uterine fibroids and/or ovarian cysts by a combined (retrospective + prospective) study of the main array, namely, 150 medical records of inpatients of gynecological departments from three medical diagnostic institutions of Vinnytsia hospitalized over a six-year period. Results. The behavior of the balance values of costs, quality, and comfort of medical services depending on the patient's medical education was analyzed. Conclusions. The hypothesis of the existence of responsiveness, namely, a decrease in the individualized elasticity of demand for price, quality, and comfort due to lack of patient awareness leads to a reduction in the balance values of costs, quality, and comfort, has been previously confirmed. In our opinion, the insufficient reliability of the effects is due solely to the small amount of data. The presence of properly oriented shifts in balance sheet values indicates the organization of inpatient obstetric and gynecological care for the nosologies under consideration that is congruent with the market environment. At the same time, the organization of inpatient obstetric and gynecological care for the considered nosologies meets the conditions of optimization, on the basis of which a theoretical model and a system of structural dependencies were developed, and therefore, they offer marketable and cost-effective solutions.
{"title":"ANALYSIS OF THE BEHAVIOR OF BALANCE VALUES OF COSTS, QUALITY AND COMFORT OF MEDICAL SERVICES DEPENDING ON THE PATIENT'S MEDICAL EDUCATION","authors":"O. Klymenyuk, O. Ocheredko, V. P. Klymenyuk, A. A. Rudenko","doi":"10.31612/2616-4868.2(24).2023.12","DOIUrl":"https://doi.org/10.31612/2616-4868.2(24).2023.12","url":null,"abstract":"Objective of the study. To evaluate the state of surgical services for patients with uterine fibroids and/or ovarian cysts in hospitals in Vinnytsia by the correspondence of the balance values of costs, quality, and comfort of medical services depending on the patient's medical education. \u0000Materials and methods. The analysis, design, and program of the study are based on the econometric model of D. Dranov and M. Satterthwaite, which relates the balance values of costs, quality, and comfort of health care services to individualized elasticities of demand. The model is empirically specified for the purposes of the study in a proper structural form. On this theoretical basis, we studied the state of the provision of surgical services to patients with uterine fibroids and/or ovarian cysts by a combined (retrospective + prospective) study of the main array, namely, 150 medical records of inpatients of gynecological departments from three medical diagnostic institutions of Vinnytsia hospitalized over a six-year period. \u0000Results. The behavior of the balance values of costs, quality, and comfort of medical services depending on the patient's medical education was analyzed. \u0000Conclusions. The hypothesis of the existence of responsiveness, namely, a decrease in the individualized elasticity of demand for price, quality, and comfort due to lack of patient awareness leads to a reduction in the balance values of costs, quality, and comfort, has been previously confirmed. In our opinion, the insufficient reliability of the effects is due solely to the small amount of data. The presence of properly oriented shifts in balance sheet values indicates the organization of inpatient obstetric and gynecological care for the nosologies under consideration that is congruent with the market environment. At the same time, the organization of inpatient obstetric and gynecological care for the considered nosologies meets the conditions of optimization, on the basis of which a theoretical model and a system of structural dependencies were developed, and therefore, they offer marketable and cost-effective solutions.","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70041859","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 : 2023-06-05DOI: 10.31612/2616-4868.2(24).2023.06
T. Gutor, N. Timchenko
The aim. Substantiation of the prognostic component in the process of developing the model of prevention of miscarriage among the female population of Ukraine. Materials and methods. A retrospective epidemiological analysis of the miscarriage dynamics among the female population of Ukraine and Lviv region for the period of 2014-2021 was performed, and prognosis of the indicators of this pathology until 2026 was established. The work uses the methods of a systemic approach and structural-logical analysis, medical-statistical analysis , prognostic methodology using exponential smoothing according to the two-parameter Holt method. Results and discussion. Over the analyzed period from 2014 to 2021, an increase in the index of the ratio of the total rate of miscarriage to the total number of pregnancies (cases of miscarriage per 100 pregnancies) from 5.50 in 2014 to 6.22 in 2021 in Ukraine and from 3.57 to 4.72 in Lviv region, respectively, was noted. In order to predict the ratio of miscarriages to the total number of pregnancies we have chosen the exponential smoothing method according to the two-parameter Holt method. In our opinion, this indicator will be the least dependent on the impact of war and COVID-19 pandemic. All other conditions remaining unchanged, the prognosis results predict that in 2026, the ratio of miscarriage to the total number of pregnancies in Ukraine will amount to 6.37 cases of miscarriage per 100 pregnancies, and 5.38 cases of miscarriage per 100 pregnancies in Lviv region. Conclusions. Analysis of the dynamic indicators of the ratio of stillbirths to the total number of pregnancies over the analyzed 8-year period both in Ukraine and in Lviv region showed a trend towards annual growth of this index. A worsening of the demographic situation according to the results of the study, as well as the likely development of a demographic crisis in connection with the state of war in Ukraine and the mass migration of the female population provoked by the war, requires searching for all possible ways to prevent miscarriage and take into account this prognostic-negative trend in the development of preventive programs.
{"title":"EPIDEMIOLOGICAL ANALYSIS AND PROGNOSIS OF MISCARRIAGE IN UKRAINE AND LVIV REGION","authors":"T. Gutor, N. Timchenko","doi":"10.31612/2616-4868.2(24).2023.06","DOIUrl":"https://doi.org/10.31612/2616-4868.2(24).2023.06","url":null,"abstract":"The aim. Substantiation of the prognostic component in the process of developing the model of prevention of miscarriage among the female population of Ukraine. \u0000Materials and methods. A retrospective epidemiological analysis of the miscarriage dynamics among the female population of Ukraine and Lviv region for the period of 2014-2021 was performed, and prognosis of the indicators of this pathology until 2026 was established. The work uses the methods of a systemic approach and structural-logical analysis, medical-statistical analysis , prognostic methodology using exponential smoothing according to the two-parameter Holt method. \u0000Results and discussion. Over the analyzed period from 2014 to 2021, an increase in the index of the ratio of the total rate of miscarriage to the total number of pregnancies (cases of miscarriage per 100 pregnancies) from 5.50 in 2014 to 6.22 in 2021 in Ukraine and from 3.57 to 4.72 in Lviv region, respectively, was noted. In order to predict the ratio of miscarriages to the total number of pregnancies we have chosen the exponential smoothing method according to the two-parameter Holt method. In our opinion, this indicator will be the least dependent on the impact of war and COVID-19 pandemic. \u0000All other conditions remaining unchanged, the prognosis results predict that in 2026, the ratio of miscarriage to the total number of pregnancies in Ukraine will amount to 6.37 cases of miscarriage per 100 pregnancies, and 5.38 cases of miscarriage per 100 pregnancies in Lviv region. \u0000Conclusions. \u0000Analysis of the dynamic indicators of the ratio of stillbirths to the total number of pregnancies over the analyzed 8-year period both in Ukraine and in Lviv region showed a trend towards annual growth of this index. \u0000A worsening of the demographic situation according to the results of the study, as well as the likely development of a demographic crisis in connection with the state of war in Ukraine and the mass migration of the female population provoked by the war, requires searching for all possible ways to prevent miscarriage and take into account this prognostic-negative trend in the development of preventive programs.","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70041454","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 : 2023-02-26DOI: 10.31612/2616-4868.1(23).2023.07
O. Kovalenko, N. G. Prytiko
Aim: to investigate the features of CS DDC in patients with CCVDS in comparison with patients without clinical signs of chronic venous cerebral dysgemia, to substantiate comorbidity. Material and methods. In compliance with ethical norms, 2 groups of patients were examined: 125 patients have CCVDS and different levels of blood pressure (98 women, 27 men, average age 53.60±10.27ys), 28 similar patients, but without CCVDS (17 women and 11 men, 52.54±10.03 years old). General clinical and clinicalneurological examination, clinical assessment of the hypoglossal veins condition, MRI of the cervical spine, X-ray functional tests, MedStat programs. Results. The main group patients had a mixed headache, stiffness, limitation of movements and pain in the CS, irradiation in the upper limb aggravated by movements and forced positions; paresthesias and arm pain, which were significantly different from the control group except for tension headache. A significant difference in cerebral complaints – dizziness, transient visual and hearing impairments (<0.001). Limitation of mobility in the CS up to 30-45 degrees, tension, compaction and tenderness of the paravertebral muscles during palpation, usually asymmetric, expansion and fullness of the sublingual veins of patients in the main group were significantly different from the indicators of the control group (<0.001). According to the MRI and X-ray spondylography, the patients of the main group had structural changes in the spinal cord significantly worse than the control group (<0.001). Conclusions. Patients with CCVDS had significantly worse clinical, structural and dynamic changes in the cervical spine, which were significantly different from the indicators of patients without chronic brain venous dyshemia (<0.001). DDC of the cervical spine should be considered a significant comorbid factor of chronic cerebral venous blood flow disorders, which can be explained by anatomical and physiological dependences.
{"title":"CHRONIC CEREBRAL VENOUS DYSFUNCTION SYNDROME AND DEGENERATIVE-DYSTROPHIC CHANGES OF THE CERVICAL SPINE: ANATOMO-PHYSIOLOGICAL UNDERSTANDING OF COMORBIDITY","authors":"O. Kovalenko, N. G. Prytiko","doi":"10.31612/2616-4868.1(23).2023.07","DOIUrl":"https://doi.org/10.31612/2616-4868.1(23).2023.07","url":null,"abstract":"Aim: to investigate the features of CS DDC in patients with CCVDS in comparison with patients without clinical signs of chronic venous cerebral dysgemia, to substantiate comorbidity. \u0000Material and methods. In compliance with ethical norms, 2 groups of patients were examined: 125 patients have CCVDS and different levels of blood pressure (98 women, 27 men, average age 53.60±10.27ys), 28 similar patients, but without CCVDS (17 women and 11 men, 52.54±10.03 years old). General clinical and clinicalneurological examination, clinical assessment of the hypoglossal veins condition, MRI of the cervical spine, X-ray functional tests, MedStat programs. \u0000Results. The main group patients had a mixed headache, stiffness, limitation of movements and pain in the CS, irradiation in the upper limb aggravated by movements and forced positions; paresthesias and arm pain, which were significantly different from the control group except for tension headache. A significant difference in cerebral complaints – dizziness, transient visual and hearing impairments (<0.001). Limitation of mobility in the CS up to 30-45 degrees, tension, compaction and tenderness of the paravertebral muscles during palpation, usually asymmetric, expansion and fullness of the sublingual veins of patients in the main group were significantly different from the indicators of the control group (<0.001). According to the MRI and X-ray spondylography, the patients of the main group had structural changes in the spinal cord significantly worse than the control group (<0.001). \u0000Conclusions. Patients with CCVDS had significantly worse clinical, structural and dynamic changes in the cervical spine, which were significantly different from the indicators of patients without chronic brain venous dyshemia (<0.001). DDC of the cervical spine should be considered a significant comorbid factor of chronic cerebral venous blood flow disorders, which can be explained by anatomical and physiological dependences.","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49045201","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 : 2023-02-26DOI: 10.31612/2616-4868.1(23).2023.05
N. Pokrovska, E. Sklyarov
Introduction. Adropin is a new secretory hormone that takes part in the regulation of energy homeostasis. Hormone is known to have positive effects on endothelial cell proliferation and prevention of atherosclerosis, and low adropin level may be a risk factor and potential predictor of atherosclerosis. Arterial hypertension (AH), which remains one of the most common somatic pathologies among middle-aged and older people, plays an important role in predicting cardiovascular morbidity and mortality. A number of medications that are used as antihypertensive therapy contribute to an increase in the content of adropin. At the same time there are not enough studies on the effect of statins on the content of adropin. Aim of the study.To investigate the effects of statins on adropin level in patients with AH. Material and methods. 70 patients with hypertension aged 62,1 ± 9,9 years were examined. They were divided into 2 groups: 1 group – patients with AH, overweight and obesity who did not take statins (n=40); group 2 – persons with AH, overweight and obesity who took statins (n=30). All individuals underwent determination of basic indicators of biochemical blood analysis, lipid profile (total cholesterol (TC), low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), triglycerides (TG), atherogenicity ratio). The level of adropin was determined by enzyme immunoassay (Finetest Elisa Kit) in blood serum. Results. Systolic blood pressure (BP) was significantly higher in group 1 individuals (p<0.05), while diastolic BP remained unchanged (p>0.05). Among patients who took statins, a significantly lower level of TC, LDL, atherogenicity ratio (p<0.01), HDL (p<0.05) was found, while the level of TG remained unchanged. Taking statins and achieving the target level of LDL improves the prognosis of patients with cardiovascular pathology, as evidenced by a significant increase in the content of adropin in blood serum in patients of the 2nd group. In women who took statins, a direct correlation was found between the level of adropin and HDL (r=0.609; p<0.05). Conclusions. Taking statins is associated with significantly higher levels of adropin in patients with AH compared to individuals who did not take these drugs. A direct correlation was noted between the level of adropin and HDL in women who took statins. Statins effectively reduce atherogenic fractions of cholesterol and help to increase the concentration of adropin in blood serum.
{"title":"Beneficial effects of statins on adropin level in patients with arterial hypertension","authors":"N. Pokrovska, E. Sklyarov","doi":"10.31612/2616-4868.1(23).2023.05","DOIUrl":"https://doi.org/10.31612/2616-4868.1(23).2023.05","url":null,"abstract":"Introduction. Adropin is a new secretory hormone that takes part in the regulation of energy homeostasis. Hormone is known to have positive effects on endothelial cell proliferation and prevention of atherosclerosis, and low adropin level may be a risk factor and potential predictor of atherosclerosis. Arterial hypertension (AH), which remains one of the most common somatic pathologies among middle-aged and older people, plays an important role in predicting cardiovascular morbidity and mortality. A number of medications that are used as antihypertensive therapy contribute to an increase in the content of adropin. At the same time there are not enough studies on the effect of statins on the content of adropin. \u0000Aim of the study.To investigate the effects of statins on adropin level in patients with AH. \u0000Material and methods. 70 patients with hypertension aged 62,1 ± 9,9 years were examined. They were divided into 2 groups: 1 group – patients with AH, overweight and obesity who did not take statins (n=40); group 2 – persons with AH, overweight and obesity who took statins (n=30). All individuals underwent determination of basic indicators of biochemical blood analysis, lipid profile (total cholesterol (TC), low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), triglycerides (TG), atherogenicity ratio). The level of adropin was determined by enzyme immunoassay (Finetest Elisa Kit) in blood serum. \u0000Results. Systolic blood pressure (BP) was significantly higher in group 1 individuals (p<0.05), while diastolic BP remained unchanged (p>0.05). Among patients who took statins, a significantly lower level of TC, LDL, atherogenicity ratio (p<0.01), HDL (p<0.05) was found, while the level of TG remained unchanged. \u0000Taking statins and achieving the target level of LDL improves the prognosis of patients with cardiovascular pathology, as evidenced by a significant increase in the content of adropin in blood serum in patients of the 2nd group. In women who took statins, a direct correlation was found between the level of adropin and HDL (r=0.609; p<0.05). \u0000Conclusions. Taking statins is associated with significantly higher levels of adropin in patients with AH compared to individuals who did not take these drugs. A direct correlation was noted between the level of adropin and HDL in women who took statins. Statins effectively reduce atherogenic fractions of cholesterol and help to increase the concentration of adropin in blood serum.","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70040685","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 : 2023-02-26DOI: 10.31612/2616-4868.1(23).2023.04
K. A. Malyarchuk, A. Ganul, B. O. Borysyuk, L. Bororov, A. Shevchenko, V. Sovenko
Treatment of STAGE III A NSCLC is an extremely difficult problem for modern oncology, since the one-year survival rate from the moment of diagnosis according to the National Cancer Registry is up to 58%. At the same time, there is a situation of uncertainty in the clinical approach to the treatment of this pathology – neither NCCN nor other world scientific literature sources contain information regarding a specific treatment method. The advantage of none of the possible methods of treatment of stage III NSCLC (HCT, NHLT, HCT + adjuvant PT) is not proven in relation to others. The conducted study is devoted to comparing these methods in relation to each other and overall and relapse-free survival. According to the results of previous studies, the highest results of both general and relapse-free survival were shown by patients from the NHLT group. But an important aspect of treatment is the ratio of benefit and risk, that is, the number and severity of complications. The study and analysis of complications of treatment with the methods of NXT, NHLT and NXT + adjuvant PT was the task of the work. Goal. To investigate and determine the number of complications in groups with NCRT, NCT and NCT + adjuvant LT. Materials and methods. The study included 3 groups of patients – patients who received NHLT, NHT and NHT + adjuvant PT, a total of 304 people. All patients had the same chemotherapy regimen- Cisplatin / Docetaxel or Carboplatin / Paclitaxel, patients receiving radiation therapy received it in a total dosage of 30 Gy in both neoadjuvant and adjuvant regimens. The irradiation was carried out on the chest and mediastinum area. Patients underwent radical surgery in the form of lobectomy, bilobectomy or pneumonectomy. In early works on this topic, an analysis of survival on the Kaplan and Mayer scale was carried out. The article describes the conduct and study of treatment complications that were recorded during the stay of patients in the hospital both during chemotherapy, radiation therapy and in the postoperative period.
{"title":"COMPARISON OF EARLY TREATMENT- EMERGENT COMPLICATIONS OF STAGE III A NON-SMALL CELL CARCINOMA (NSCLC STAGE III A) IN PATIENTS TREATED WITH NEOADJUVANT CHEMORADIOTHERAPY (NHLT), (NCHT), AND NEOADJUVANT CHEMOTHERAPY AND ADJUVANT RADIATION THERAPY","authors":"K. A. Malyarchuk, A. Ganul, B. O. Borysyuk, L. Bororov, A. Shevchenko, V. Sovenko","doi":"10.31612/2616-4868.1(23).2023.04","DOIUrl":"https://doi.org/10.31612/2616-4868.1(23).2023.04","url":null,"abstract":"Treatment of STAGE III A NSCLC is an extremely difficult problem for modern oncology, since the one-year survival rate from the moment of diagnosis according to the National Cancer Registry is up to 58%. At the same time, there is a situation of uncertainty in the clinical approach to the treatment of this pathology – neither NCCN nor other world scientific literature sources contain information regarding a specific treatment method. The advantage of none of the possible methods of treatment of stage III NSCLC (HCT, NHLT, HCT + adjuvant PT) is not proven in relation to others. The conducted study is devoted to comparing these methods in relation to each other and overall and relapse-free survival. According to the results of previous studies, the highest results of both general and relapse-free survival were shown by patients from the NHLT group. But an important aspect of treatment is the ratio of benefit and risk, that is, the number and severity of complications. The study and analysis of complications of treatment with the methods of NXT, NHLT and NXT + adjuvant PT was the task of the work. Goal. To investigate and determine the number of complications in groups with NCRT, NCT and NCT + adjuvant LT. Materials and methods. The study included 3 groups of patients – patients who received NHLT, NHT and NHT + adjuvant PT, a total of 304 people. All patients had the same chemotherapy regimen- Cisplatin / Docetaxel or Carboplatin / Paclitaxel, patients receiving radiation therapy received it in a total dosage of 30 Gy in both neoadjuvant and adjuvant regimens. The irradiation was carried out on the chest and mediastinum area. Patients underwent radical surgery in the form of lobectomy, bilobectomy or pneumonectomy. In early works on this topic, an analysis of survival on the Kaplan and Mayer scale was carried out. The article describes the conduct and study of treatment complications that were recorded during the stay of patients in the hospital both during chemotherapy, radiation therapy and in the postoperative period.","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47532008","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 : 2023-02-26DOI: 10.31612/2616-4868.1(23).2023.06
V. Shaprynskyi, N. Semenenko
Abstract. Treatment results of primary varicose disorders has been shown in article. The experience of using of thermal (endovenous laser ablation, radiofrequency ablation) and non-thermal methods (endovenous mechanochemical ablation, echo-controlled introduction of bioglue) in treatment of stage C2-С6 chronic venous is shown. The purpose of this work is to evaluate the efficiency of endovenous ablation techniques. The treatment of 218 patients was analyzed. In the group of patients who underwent EVLA, reflux was detected in 2 cases at the follow-up after week. In our opinion, this is due to insufficient exposure of the laser irradiation using a single-ring type of light guide. To correct the detected reflux, a single injection of foam scleroterapy. Foam form (3%) was used. In the group of patients after RFA, inflow reflux was detected in 1 patient (5.2%), in other cases complete obliteration was observed (17 patients - 89.4%). In the group of patients with mechanochemical obliteration, recanalization was determined in 5 patients (19.2%) with control ultrasound after 1 month. It was corrected by carrying out the procedure of foam scleroobliteration. In the group of patients with the cyanoacrylate obliteration, inflow reflux was detected in 2 patients (14.2%) on examination after 1 month. The received results lead to conclusion, that endovenous laser coagulation of affected veins is a more reliable method of threatment and the gold standard. The advantage of non-thermal methods is the absence of thermal effects on the paravenous structures, respectively, patients have no pain during the procedure, increases comfort, and there is no risk of damage to the paravenous nerves. Another advantage of non-thermal techniques is no need to use of tumescent anesthesia, since only one puncture is required for the operation, which is comfortable for patients. The use of adhesive vein obliteration is justified in patients with signs of a short reflux duration and has an advantage for the patient due to the absence of the need for compression in the postoperative period. In our study, foam sclerotherapy was the method of choice for treatment correction, if necessary.
{"title":"Puncture miniinvasive methods of surgical treatment of primary varicoses of the superficial veins of the lower extremities c2-c6s","authors":"V. Shaprynskyi, N. Semenenko","doi":"10.31612/2616-4868.1(23).2023.06","DOIUrl":"https://doi.org/10.31612/2616-4868.1(23).2023.06","url":null,"abstract":"Abstract. Treatment results of primary varicose disorders has been shown in article. The experience of using of thermal (endovenous laser ablation, radiofrequency ablation) and non-thermal methods (endovenous mechanochemical ablation, echo-controlled introduction of bioglue) in treatment of stage C2-С6 chronic venous is shown. The purpose of this work is to evaluate the efficiency of endovenous ablation techniques. The treatment of 218 patients was analyzed. In the group of patients who underwent EVLA, reflux was detected in 2 cases at the follow-up after week. In our opinion, this is due to insufficient exposure of the laser irradiation using a single-ring type of light guide. To correct the detected reflux, a single injection of foam scleroterapy. Foam form (3%) was used. In the group of patients after RFA, inflow reflux was detected in 1 patient (5.2%), in other cases complete obliteration was observed (17 patients - 89.4%). In the group of patients with mechanochemical obliteration, recanalization was determined in 5 patients (19.2%) with control ultrasound after 1 month. It was corrected by carrying out the procedure of foam scleroobliteration. In the group of patients with the cyanoacrylate obliteration, inflow reflux was detected in 2 patients (14.2%) on examination after 1 month. The received results lead to conclusion, that endovenous laser coagulation of affected veins is a more reliable method of threatment and the gold standard. The advantage of non-thermal methods is the absence of thermal effects on the paravenous structures, respectively, patients have no pain during the procedure, increases comfort, and there is no risk of damage to the paravenous nerves. Another advantage of non-thermal techniques is no need to use of tumescent anesthesia, since only one puncture is required for the operation, which is comfortable for patients. The use of adhesive vein obliteration is justified in patients with signs of a short reflux duration and has an advantage for the patient due to the absence of the need for compression in the postoperative period. In our study, foam sclerotherapy was the method of choice for treatment correction, if necessary.","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47680756","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 : 2023-02-26DOI: 10.31612/2616-4868.1(23).2023.09
S. K. Nazhar Saleh, S. V. Seleznyova, O. Kozynskyi, Ali-Kyzy Mamedalieva Sevinj, Singh Hira Harpreet
Introduction: the relevance of determining the effectiveness of early rehabilitation of patients after an ischemic stroke is high, as it solves a number of important medical and social problems of society. The aim: to determine the possibilities and effectiveness of early rehabilitation of patients after an ischemic stroke according to the data of literary sources. Materials and methods: the research was conducted based on the results of the analysis of the world results of scientific research and the existing mechanisms and documents of international societies for determining the possibilities and effectiveness of early rehabilitation of patients after an ischemic stroke. The search for scientific information was performed using domestic and foreign Internet resources of Google Scholar, PubMed, Medscape, Scopus and Web of Science databases, etc. The results of the study: It was determined that the primary and quite effective measure in the treatment of patients after an ischemic stroke is the early start of rehabilitation measures, which improves the survival of brain cells due to an increase in cerebral blood flow, which reduces ischemic necrosis of neurons and revitalizes part of neurons and significantly reduces the post-stroke level disability of patients. It was established that a significant yet undetermined issue in early rehabilitation is the effectiveness of early mobilization and its intensity, and the effectiveness of the rehabilitation strategy is entirely based on the correct combination of the time from the onset of the stroke and the intensity of mobilization Conclusions: the study determined that early rehabilitation intervention in ischemic stroke is significantly effective and economically feasible, and the effectiveness and feasibility of early intensive mobilization is currently a rather controversial issue.
导读:缺血性脑卒中患者早期康复有效性的确定具有很高的相关性，因为它解决了许多重要的社会医学问题。目的:根据文献资料，确定缺血性脑卒中患者早期康复的可能性和有效性。材料和方法:本研究是在分析世界科学研究成果和国际社会现有机制和文献的基础上进行的，以确定缺血性卒中患者早期康复的可能性和有效性。利用b谷歌Scholar、PubMed、Medscape、Scopus、Web of Science等国内外互联网资源进行科学信息检索。研究结果:确定缺血性卒中患者治疗的首要且相当有效的措施是早期开始康复措施，通过增加脑血流量提高脑细胞存活率，减少神经元缺血性坏死，使部分神经元恢复活力，显著降低患者脑卒中后水平残疾。结果表明，早期康复中一个重要但尚未确定的问题是早期活动的有效性及其强度，而康复策略的有效性完全取决于卒中发生时间与活动强度的正确组合。本研究确定早期康复干预对缺血性脑卒中具有显著的疗效和经济上的可行性，而早期强化动员的有效性和可行性目前是一个颇有争议的问题。
{"title":"EFFICIENCY OF EARLY REHABILITATION OF PATIENTS AFTER ISCHEMIC STROKE","authors":"S. K. Nazhar Saleh, S. V. Seleznyova, O. Kozynskyi, Ali-Kyzy Mamedalieva Sevinj, Singh Hira Harpreet","doi":"10.31612/2616-4868.1(23).2023.09","DOIUrl":"https://doi.org/10.31612/2616-4868.1(23).2023.09","url":null,"abstract":"Introduction: the relevance of determining the effectiveness of early rehabilitation of patients after an ischemic stroke is high, as it solves a number of important medical and social problems of society. \u0000The aim: to determine the possibilities and effectiveness of early rehabilitation of patients after an ischemic stroke according to the data of literary sources. \u0000Materials and methods: the research was conducted based on the results of the analysis of the world results of scientific research and the existing mechanisms and documents of international societies for determining the possibilities and effectiveness of early rehabilitation of patients after an ischemic stroke. The search for scientific information was performed using domestic and foreign Internet resources of Google Scholar, PubMed, Medscape, Scopus and Web of Science databases, etc. \u0000The results of the study: It was determined that the primary and quite effective measure in the treatment of patients after an ischemic stroke is the early start of rehabilitation measures, which improves the survival of brain cells due to an increase in cerebral blood flow, which reduces ischemic necrosis of neurons and revitalizes part of neurons and significantly reduces the post-stroke level disability of patients. It was established that a significant yet undetermined issue in early rehabilitation is the effectiveness of early mobilization and its intensity, and the effectiveness of the rehabilitation strategy is entirely based on the correct combination of the time from the onset of the stroke and the intensity of mobilization \u0000Conclusions: the study determined that early rehabilitation intervention in ischemic stroke is significantly effective and economically feasible, and the effectiveness and feasibility of early intensive mobilization is currently a rather controversial issue.","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70040792","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 : 2023-02-26DOI: 10.31612/2616-4868.1(23).2023.03
V. Shaprynskyi, V. R. Taheiev, S. Stukan, O. Chernychenko
The purpose of the work: to analyse clinical cases and the results of treatment of patients with diverticulosis of the large intestine in order to prevent complications. Materials and methods. The results of diagnosis and treatment of 75 patients with diverticulosis of the large intestine for the years 2016-2022, who were in the Clinical highly specialised surgical center with minimally invasive technologies in the Vinnytsia Regional Clinical Hospital named after M. I. Pyrogov of the Vinnytsia Regional Council. Research results and their discussion. We analysed the results of diagnosis and treatment of 75 patients with diverticulosis of the large intestine for the years 2016-2022, who were in the Clinical highly specialised surgical center with minimally invasive technologies in the Vinnytsia Regional Clinical Hospital named after M. I. Pyrogov of the Vinnytsia Regional Council. Colon diverticular disease was clinically and instrumentally confirmed and the following forms of the disease were established: diverticular bleeding - in 46 (61.33%), intestinal perforation with the development of diffuse fecal peritonitis - in 2 (2.66%), diverticulitis - in 12 (16%), asymptomatic diverticulosis - in 2 patients (2.66%), and in 13 patients there was a combination: diverticulitis and paracolic abscess - in 8 (10.66%), diverticulitis and limited purulent peritonitis - in 2 (6.66 %), diverticulitis and intestinal obstruction - in 3 (4%). There were 36 (48%) male patients, 39 (52%) female patients. The age of the patients ranged from 40 to 90 years. The average age was 65±2 years.
工作目的:分析大肠憩室病的临床病例及治疗效果，以预防并发症的发生。材料和方法。2016-2022年在文尼察地区临床医院的临床高度专业化微创外科中心治疗的75例大肠憩室病患者的诊断和治疗结果，该医院以文尼察地区委员会的M. I. Pyrogov命名。研究结果及其讨论。我们分析了2016-2022年75例大肠憩室病患者的诊断和治疗结果，这些患者在文尼察地区临床医院的临床高度专业化手术中心采用微创技术，以文尼察地区委员会的M. I. Pyrogov命名。结肠憩室病经临床和仪器诊断，确定了以下形式的疾病:憩室出血46例(61.33%)，肠穿孔伴弥漫性粪性腹膜炎2例(2.66%)，憩室炎12例(16%)，无症状憩室病2例(2.66%)，合并13例。憩室炎和结肠旁脓肿8例(10.66%)，憩室炎和局限性化脓性腹膜炎2例(6.66%)，憩室炎和肠梗阻3例(4%)。男性36例(48%)，女性39例(52%)。患者年龄在40 - 90岁之间。平均年龄65±2岁。
{"title":"DIAGNOSTIC AND TREATMENT OF DIVERTICULAR DISEASE OF THE COLON","authors":"V. Shaprynskyi, V. R. Taheiev, S. Stukan, O. Chernychenko","doi":"10.31612/2616-4868.1(23).2023.03","DOIUrl":"https://doi.org/10.31612/2616-4868.1(23).2023.03","url":null,"abstract":"The purpose of the work: to analyse clinical cases and the results of treatment of patients with diverticulosis of the large intestine in order to prevent complications. \u0000Materials and methods. \u0000The results of diagnosis and treatment of 75 patients with diverticulosis of the large intestine for the years 2016-2022, who were in the Clinical highly specialised surgical center with minimally invasive technologies in the Vinnytsia Regional Clinical Hospital named after M. I. Pyrogov of the Vinnytsia Regional Council. \u0000Research results and their discussion. \u0000We analysed the results of diagnosis and treatment of 75 patients with diverticulosis of the large intestine for the years 2016-2022, who were in the Clinical highly specialised surgical center with minimally invasive technologies in the Vinnytsia Regional Clinical Hospital named after M. I. Pyrogov of the Vinnytsia Regional Council. Colon diverticular disease was clinically and instrumentally confirmed and the following forms of the disease were established: diverticular bleeding - in 46 (61.33%), intestinal perforation with the development of diffuse fecal peritonitis - in 2 (2.66%), diverticulitis - in 12 (16%), asymptomatic diverticulosis - in 2 patients (2.66%), and in 13 patients there was a combination: diverticulitis and paracolic abscess - in 8 (10.66%), diverticulitis and limited purulent peritonitis - in 2 (6.66 %), diverticulitis and intestinal obstruction - in 3 (4%). There were 36 (48%) male patients, 39 (52%) female patients. The age of the patients ranged from 40 to 90 years. The average age was 65±2 years.","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70040677","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 : 2023-02-26DOI: 10.31612/2616-4868.1(23).2023.13
N. Ivasyk
Introduction. The Ministry of Economy of Ukraine, by its order No. 810-22 of April 9, 2022, approved the International Classification of Functioning, Limitations of Vital Activities and Health (ICF) as National Classifier NC 030:2022. This, in turn, requires appropriate approaches to both the entire rehabilitation process and its components. Purpose: to model the components of examination directions, as a component of the physical therapy program, for children with bronchopulmonary diseases, according to the international classification of functioning, limitations of life activities and health. Methods: General and specialized methods of cognition: analysis, generalization, systematization and comparison of information from scientific and methodical literature on the problems of physical therapy in bronchopulmonary diseases. Results. Rehabilitation examination of children with bronchopulmonary diseases includes both objective and subjective assessments, as well as observations, which are interconnected. Changing the focus from the classification of «disease consequences» to «health components», which is the basis of the ICF, requires looking at the examination component in the process of physical therapy from the side of the health components of a child with bronchopulmonary diseases. Based on this, we considered the examination as a component of the physical therapy program for children with bronchopulmonary diseases, classified using the ICF model. In our approach, we determined the main directions of the examination, based on the components of the ICF, since when selecting tests and scales, the child’s age and development must be taken into account first and foremost. Conclusions. Rehabilitation examination is a component of physical therapy, which is carried out with the aim of determining a rehabilitation diagnosis and is based on subjective, objective assessments and observational data. In this work, we identified the main directions for choosing examination methods based on ICF, which will contribute to the selection of examination tools, determining their priorities, and formulating a categorical profile of patients with bronchopulmonary diseases.
{"title":"EXAMINATION DIRECTIONS AS A COMPONENT OF PHYSICAL THERAPY, FOR CHILDREN WITH BRONCHOPULMONARY DISEASES FROM THE POINT OF VIEW OF THE INTERNATIONAL CLASSIFICATION OF FUNCTIONING, DISABILITY AND HEALTH","authors":"N. Ivasyk","doi":"10.31612/2616-4868.1(23).2023.13","DOIUrl":"https://doi.org/10.31612/2616-4868.1(23).2023.13","url":null,"abstract":"Introduction. The Ministry of Economy of Ukraine, by its order No. 810-22 of April 9, 2022, approved the International Classification of Functioning, Limitations of Vital Activities and Health (ICF) as National Classifier NC 030:2022. This, in turn, requires appropriate approaches to both the entire rehabilitation process and its components. \u0000Purpose: to model the components of examination directions, as a component of the physical therapy program, for children with bronchopulmonary diseases, according to the international classification of functioning, limitations of life activities and health. \u0000Methods: General and specialized methods of cognition: analysis, generalization, systematization and comparison of information from scientific and methodical literature on the problems of physical therapy in bronchopulmonary diseases. \u0000Results. Rehabilitation examination of children with bronchopulmonary diseases includes both objective and subjective assessments, as well as observations, which are interconnected. Changing the focus from the classification of «disease consequences» to «health components», which is the basis of the ICF, requires looking at the examination component in the process of physical therapy from the side of the health components of a child with bronchopulmonary diseases. Based on this, we considered the examination as a component of the physical therapy program for children with bronchopulmonary diseases, classified using the ICF model. In our approach, we determined the main directions of the examination, based on the components of the ICF, since when selecting tests and scales, the child’s age and development must be taken into account first and foremost. \u0000Conclusions. Rehabilitation examination is a component of physical therapy, which is carried out with the aim of determining a rehabilitation diagnosis and is based on subjective, objective assessments and observational data. In this work, we identified the main directions for choosing examination methods based on ICF, which will contribute to the selection of examination tools, determining their priorities, and formulating a categorical profile of patients with bronchopulmonary diseases.","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47690744","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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