Pub Date : 2022-10-21DOI: 10.31612/2616-4868.4(22).2022.03
V. Yelenskyi
Resume. The article deals with current issues in the organization of providing dental care to the population in today's conditions. Regulatory documents were studied and modern and global approaches to the prevention of common dental diseases in the population were analyzed. The influence of the organization of preventive work in the dental industry on the prevention of common dental diseases in the population has been clarified. Introduction. Dental health is an integral part of the overall health of each individual and society in general. The medical and social significance of the problem of oral cavity diseases is determined not only by its significant spread but also by the high rate of complications [5, 8]. The process of treatment of patients with diseases of the oral cavity should be complex and should be part of a multidisciplinary approach and should be carried out with the aim of prevention, complications, or weakening of the functional overload of the periodontium and the tooth as a whole. According to scientists in Ukraine, the rate of dental morbidity among adults and children reaches 93%, which means that this is the proportion of the country's population that needs dental care. It is worth noting that the priority in the activities of executive authorities at all levels is the provision of high-quality and affordable medical care with the orientation of the health care system on the prevention of diseases, a safe and health-friendly environment for human life (working, living, training, relaxing, nutrition), healthy lifestyle of the population and improvement of the demographic situation. The legal regulation of the mentioned activity is ensured by the Law of Ukraine "Basics of the Legislation of Ukraine on Health Protection" dated November 19, 1992 No. 2802-ХІІ (as amended from November 6, 2017), where several articles indicate measures for the prevention of diseases. In the aforementioned Law of Ukraine, the organizational aspects of prevention of all classes of diseases are singled out, in particular, Article 4 "Basic principles of health care" emphasizes one of the principles of the approach to health care, which is preventive [14]. The purpose of the article. To analyze domestic and global approaches to the prevention of common dental diseases of the population. To conduct an analysis of modern trends in medical care and medical and social support of dental care to the population in the context of modern challenges. Research materials and methods. Analysis and generalization of data based on domestic and foreign sources. Used methods of systemic and structural-logical analyses. The materials were documents and information sources, normative legal acts of Ukraine regarding medical and dental care for the population.
{"title":"MEDICAL AND SOCIAL SUPPORT OF DENTAL CARE IN THE CONTEXT OF TODAY'S CHALLENGES","authors":"V. Yelenskyi","doi":"10.31612/2616-4868.4(22).2022.03","DOIUrl":"https://doi.org/10.31612/2616-4868.4(22).2022.03","url":null,"abstract":"Resume. The article deals with current issues in the organization of providing dental care to the population in today's conditions. Regulatory documents were studied and modern and global approaches to the prevention of common dental diseases in the population were analyzed. The influence of the organization of preventive work in the dental industry on the prevention of common dental diseases in the population has been clarified. \u0000Introduction. Dental health is an integral part of the overall health of each individual and society in general. The medical and social significance of the problem of oral cavity diseases is determined not only by its significant spread but also by the high rate of complications [5, 8]. \u0000The process of treatment of patients with diseases of the oral cavity should be complex and should be part of a multidisciplinary approach and should be carried out with the aim of prevention, complications, or weakening of the functional overload of the periodontium and the tooth as a whole. According to scientists in Ukraine, the rate of dental morbidity among adults and children reaches 93%, which means that this is the proportion of the country's population that needs dental care. \u0000It is worth noting that the priority in the activities of executive authorities at all levels is the provision of high-quality and affordable medical care with the orientation of the health care system on the prevention of diseases, a safe and health-friendly environment for human life (working, living, training, relaxing, nutrition), healthy lifestyle of the population and improvement of the demographic situation. The legal regulation of the mentioned activity is ensured by the Law of Ukraine \"Basics of the Legislation of Ukraine on Health Protection\" dated November 19, 1992 No. 2802-ХІІ (as amended from November 6, 2017), where several articles indicate measures for the prevention of diseases. In the aforementioned Law of Ukraine, the organizational aspects of prevention of all classes of diseases are singled out, in particular, Article 4 \"Basic principles of health care\" emphasizes one of the principles of the approach to health care, which is preventive [14]. \u0000The purpose of the article. To analyze domestic and global approaches to the prevention of common dental diseases of the population. To conduct an analysis of modern trends in medical care and medical and social support of dental care to the population in the context of modern challenges. \u0000Research materials and methods. Analysis and generalization of data based on domestic and foreign sources. Used methods of systemic and structural-logical analyses. The materials were documents and information sources, normative legal acts of Ukraine regarding medical and dental care for the population.","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46999145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-21DOI: 10.31612/2616-4868.4(22).2022.05
T. Chernii, V. Chernii, D. Fokina
Introduction. Elimination of intracellular energy deficit and "smoldering" systemic inflammation, as well as elimination of water-electrolyte and metabolic disorders can be singled out as the main directions of therapy for the long-term consequences of Long COVID. The aim: to study and analyze the results of treatment with a pathogenetically justified combination of drugs Xavron, Tivorel and Xylat in patients with asthenic manifestations in the framework of Long-COVID. Materials and methods. During 2021, a clinical and neurological examination of 50 patients aged 47 to 76 years with a diagnosis of chronic cerebral ischemia (CMI) and an asthenic syndrome that persisted for more than 3 months after a laboratory-confirmed SARS-CoV-2 infection was carried out. The diagnosis was confirmed by the results of a clinical-neurological and neuropsychological examination using scales for the assessment of cognitive function (MMSE), emotional status (DASS-21), fatigue (FAS) and the neurological deficit assessment scale (MOND) developed by us. 20 patients additionally received a 10-day course of infusions of a combination of Xavron drugs in a dose of 30 mg No. 10, Tivorel 100.0 No. 5, and Xylate 200.0 No. 5 every other day, respectively. Thus, 50 patients were divided into two groups: the first - 20 people and the second - 30 people. Results. Correlation analysis revealed a strong positive correlation between the CIRS-G comorbidity score and the MOND score. A positive correlation coefficient between comorbidity and asthenic syndrome, assessed on the FAS scale, was also expressed - 0.699 (p=<0.001). A somewhat weaker negative relationship was found between anxiety and the number of points on the CIRS-G scale – -0.474 (p=0.035). At the same time, the assessment of other parameters on the DASS-21 scale, such as depression and stress, did not show a reliably significant correlation effect. Also, the severity of cognitive deficits in this group did not depend on the number of comorbid diseases. There was also a positive correlation coefficient between comorbidity and asthenic syndrome as assessed by FAS - 0.699 (p=<0.001). A weaker negative correlation was seen between anxiety and CIRS-G - -0.474 (p=0.035). However, other DASS-21 scores, such as depression and stress, did not show a significant correlation effect. Also, the severity of cognitive deficits in this group did not depend on the number of comorbidities. All patients who received treatment with a combination of Xavron, Tivorel and Xylat noted an improvement in general well-being and a decrease in the severity of neurological symptoms. Changes in the severity of neurological deficit in 30 patients with Long-COVID (MOND) of the second group after the completion of the treatment course were significantly lower than in the first research group (P<0.05). Conclusions. The combination of Xavron, Tivorel and Xylat is pathogenetically primed and safe for the treatment of patients with long-covid. the use of t
{"title":"The role of comorbidity in the development of Long-COVID","authors":"T. Chernii, V. Chernii, D. Fokina","doi":"10.31612/2616-4868.4(22).2022.05","DOIUrl":"https://doi.org/10.31612/2616-4868.4(22).2022.05","url":null,"abstract":"Introduction. Elimination of intracellular energy deficit and \"smoldering\" systemic inflammation, as well as elimination of water-electrolyte and metabolic disorders can be singled out as the main directions of therapy for the long-term consequences of Long COVID. \u0000The aim: to study and analyze the results of treatment with a pathogenetically justified combination of drugs Xavron, Tivorel and Xylat in patients with asthenic manifestations in the framework of Long-COVID. \u0000Materials and methods. During 2021, a clinical and neurological examination of 50 patients aged 47 to 76 years with a diagnosis of chronic cerebral ischemia (CMI) and an asthenic syndrome that persisted for more than 3 months after a laboratory-confirmed SARS-CoV-2 infection was carried out. The diagnosis was confirmed by the results of a clinical-neurological and neuropsychological examination using scales for the assessment of cognitive function (MMSE), emotional status (DASS-21), fatigue (FAS) and the neurological deficit assessment scale (MOND) developed by us. 20 patients additionally received a 10-day course of infusions of a combination of Xavron drugs in a dose of 30 mg No. 10, Tivorel 100.0 No. 5, and Xylate 200.0 No. 5 every other day, respectively. Thus, 50 patients were divided into two groups: the first - 20 people and the second - 30 people. \u0000Results. Correlation analysis revealed a strong positive correlation between the CIRS-G comorbidity score and the MOND score. A positive correlation coefficient between comorbidity and asthenic syndrome, assessed on the FAS scale, was also expressed - 0.699 (p=<0.001). \u0000A somewhat weaker negative relationship was found between anxiety and the number of points on the CIRS-G scale – -0.474 (p=0.035). At the same time, the assessment of other parameters on the DASS-21 scale, such as depression and stress, did not show a reliably significant correlation effect. Also, the severity of cognitive deficits in this group did not depend on the number of comorbid diseases. There was also a positive correlation coefficient between comorbidity and asthenic syndrome as assessed by FAS - 0.699 (p=<0.001). A weaker negative correlation was seen between anxiety and CIRS-G - -0.474 (p=0.035). However, other DASS-21 scores, such as depression and stress, did not show a significant correlation effect. Also, the severity of cognitive deficits in this group did not depend on the number of comorbidities. All patients who received treatment with a combination of Xavron, Tivorel and Xylat noted an improvement in general well-being and a decrease in the severity of neurological symptoms. Changes in the severity of neurological deficit in 30 patients with Long-COVID (MOND) of the second group after the completion of the treatment course were significantly lower than in the first research group (P<0.05). \u0000Conclusions. The combination of Xavron, Tivorel and Xylat is pathogenetically primed and safe for the treatment of patients with long-covid. the use of t","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47584408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-21DOI: 10.31612/2616-4868.4(22).2022.04
O. Kovalenko, O. V. Litvin
Encephalopathy is common in people of working age. In the last decade there was an important question the relationship of thyroid and cerebrovascular disease. The aim of the study was to investigate the characteristics of the brain’s elektorogenezis and cerebral hemodynamics in patients with hypertensive encephalopathy and related dyscirculatory hypothyroidism. We examined 97 patients, including 60 people with the HDE and the associated hypothyroidism and 37 - with the HDE without hypothyroidism. The fact, that bioelectrical activity of the brain in patients with hypothyroidism and related HDE was mostly characterized by desynchronization and disorganization of the cortical rhythm, was revealed during the study. Changes revealed by the EEG reflected the presence of metabolic and hemodynamic disturbances of the brain. Also, in patients with GDE and accompanying hypothyroidism, according to the duplex scanning of cerebral vessels, there is a significant decrease in cerebral blood supply and structural changes in vessels with a decrease in the elasticity of the common carotid artery and vertebral arteries and a decrease in cerebral reactivity accordingly. Thus, the comorbidity of HDE and hypothyroidism appears credible changes in the functional activity of the brain and decrease in cerebral reactivity.
{"title":"Features of the bioelectrical activity of the brain and cerebral hemodynamics in patients with hypertensive dyscirculatory encephalopathy and hypothyroidism","authors":"O. Kovalenko, O. V. Litvin","doi":"10.31612/2616-4868.4(22).2022.04","DOIUrl":"https://doi.org/10.31612/2616-4868.4(22).2022.04","url":null,"abstract":"Encephalopathy is common in people of working age. In the last decade there was an important question the relationship of thyroid and cerebrovascular disease. The aim of the study was to investigate the characteristics of the brain’s elektorogenezis and cerebral hemodynamics in patients with hypertensive encephalopathy and related dyscirculatory hypothyroidism. \u0000We examined 97 patients, including 60 people with the HDE and the associated hypothyroidism and 37 - with the HDE without hypothyroidism. \u0000The fact, that bioelectrical activity of the brain in patients with hypothyroidism and related HDE was mostly characterized by desynchronization and disorganization of the cortical rhythm, was revealed during the study. Changes revealed by the EEG reflected the presence of metabolic and hemodynamic disturbances of the brain. Also, in patients with GDE and accompanying hypothyroidism, according to the duplex scanning of cerebral vessels, there is a significant decrease in cerebral blood supply and structural changes in vessels with a decrease in the elasticity of the common carotid artery and vertebral arteries and a decrease in cerebral reactivity accordingly. Thus, the comorbidity of HDE and hypothyroidism appears credible changes in the functional activity of the brain and decrease in cerebral reactivity.","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48763726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-21DOI: 10.31612/2616-4868.4(22).2022.11
T. Ponomarenko, M. Denysenko
(experience of implementation of the Strategy for the development of an effective system (rehabilitation of war veterans and members of their families, families of dead (deceased) war veterans of Kyiv region on the basis of the municipal non-profit enterprise of the Kyiv Regional Council "Kyiv Regional Mental Health Center") Introduction. The article examines the experience of implementing the Strategy of development of effective system rehabilitation of war veterans and members of their families deceased (killed) war veterans on the basis of a communal non-profit enterprise of the Kyiv Regional Council "Kyiv Regional Center of mental health". Objective. Dissemination of experience in implementing the Strategy for the development of an effective rehabilitation system for war veterans and their families, families members of fallen combatants in order to preserve their ability to work and increase a duration and quality of life. Materials and methods. A content analysis of the existing regulatory and legal framework on the organization of psychological and psychiatric assistance to combatants and members of their families. At the time when was using he bibliosemantic method, were studied sources of scientific and scientific-practical literature on the problematic issues. Also were used methods of system analysis, organizational experiment, statistical and structural-logical. Results and their discussion. The need to solve the problems of rehabilitation and psychological and psychiatric support for participants in military conflicts is one of the the most important issues of our time. Unfortunately for today, considering the events in the country, the issue of treatment, diagnosis and prevention of mental disorders associated with stressful events of wartime, has become very relevant for us. Conclusions. Thus, the actuality of the issues of treatment, diagnosis and the prevention of mental disorders associated with stressful events of wartime is growing, and not only for professionals about mental health, but also for doctors of all specialties without exception. Our research shows that the traumatic effect of stress on soldiers, who have not formed readiness to participate in combat operations, personal immaturity, infantilism, unformed volitional sphere, which in the future provoked the emergence of destructive personality changes, behavioral disorders.
{"title":"Direction of implementation of social adaptation of demobilized combatants with mental and behavioral disorders","authors":"T. Ponomarenko, M. Denysenko","doi":"10.31612/2616-4868.4(22).2022.11","DOIUrl":"https://doi.org/10.31612/2616-4868.4(22).2022.11","url":null,"abstract":"(experience of implementation of the Strategy for the development of an effective system (rehabilitation of war veterans and members of their families, families of dead (deceased) war veterans of Kyiv region on the basis of the municipal non-profit enterprise of the Kyiv Regional Council \"Kyiv Regional Mental Health Center\") \u0000 \u0000Introduction. The article examines the experience of implementing the Strategy of development of effective system rehabilitation of war veterans and members of their families deceased (killed) war veterans on the basis of a communal non-profit enterprise of the Kyiv Regional Council \"Kyiv Regional Center of mental health\". \u0000Objective. Dissemination of experience in implementing the Strategy for the development of an effective rehabilitation system for war veterans and their families, families members of fallen combatants in order to preserve their ability to work and increase a duration and quality of life. \u0000Materials and methods. A content analysis of the existing regulatory and legal framework on the organization of psychological and psychiatric assistance to combatants and members of their families. At the time when was using he bibliosemantic method, were studied sources of scientific and scientific-practical literature on the problematic issues. Also were used methods of system analysis, organizational experiment, statistical and structural-logical. \u0000Results and their discussion. The need to solve the problems of rehabilitation and psychological and psychiatric support for participants in military conflicts is one of the the most important issues of our time. Unfortunately for today, considering the events in the country, the issue of treatment, diagnosis and prevention of mental disorders associated with stressful events of wartime, has become very relevant for us. \u0000Conclusions. Thus, the actuality of the issues of treatment, diagnosis and the prevention of mental disorders associated with stressful events of wartime is growing, and not only for professionals about mental health, but also for doctors of all specialties without exception. Our research shows that the traumatic effect of stress on soldiers, who have not formed readiness to participate in combat operations, personal immaturity, infantilism, unformed volitional sphere, which in the future provoked the emergence of destructive personality changes, behavioral disorders.","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47185834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-21DOI: 10.31612/2616-4868.4(22).2022.10
Y.U. Nikolaieva, M. Levin
The aim of the stady. To determine the concentration of diclofenac sodium in the air of the working area within the same room in order to determine the possible contamination of the sample being analyzed, when simultaneously working with different substances of medicinal products. Materials and methods. Air sampling was carried out using a TYPHOON-S4 electric aspirator for 30 minutes at a speed of 20 l/min. The test to determine the concentration of diclofenac sodium in air was carried out by concentrating the analytical sample with regard to the microconcentration of the substance by the method of solid-phase extraction, using Oasis MCX 6cc (150 mg) LP Extraction Cartridges, after which desorption was carried out with a solvent - methanol. The obtained samples were analyzed by the method of high-performance liquid chromatography using a Dionex Ultimate 3000 chromatograph with a diode-matrix detector. The sensitivity of the method reaches ng/ml. The results. As part of the work, a specific, highly sensitive method for determining the concentration of sodium diclofenac in the air was developed and testing was carried out by determining the concentration of sodium diclofenac in the air of the working area during certain analytical operations (pouring, weighing the substance, crushing tablets containing the active pharmaceutical ingredient under analysis, homogenization). The linear dependence of the diclofenac sodium peak area on the concentration of the substance in the solution (0.025-10 μg/ml) has been proven. Based on the obtained data, it was established that the volatile microparticles of diclofenac sodium substance are subject to air deposition, and as a result, a certain amount of this API penetrates into the analyzed samples of other drugs nearby. This fact can lead to obtaining unreliable results during the control of the quality and safety of medicinal products, which can have negative consequences for preserving the health of the population when using medicinal products of inadequate quality. At the same time, the research results show a proportional decrease in the concentration of sodium diclofenac in the air of the working area within one laboratory room as the air aspiration distance from the analytical operation being performed increases. However, at a distance of 0.2 m, the content of sodium diclofenac in the air of the working area exceeds the MPC by two times. These results indicate not only the possible background contamination of the analytical sample during the simultaneous work of several or one operator with different APIs or ready-made medicinal products, but also the possible harm to the analyst's health. Conclusions. A technique for determining microconcentrations of the active substance in the air of the working area has been developed. It has been found that samples can be easily contaminated with microparticles from other sources if proper precautions are not taken during collection, sample preparation and analysis
{"title":"ABOUT THE POSSIBILITY OF CONTAMINATION OF ANALYTICAL SAMPLES DURING QUALITY CONTROL OF MEDICINES AND WORK WITHIN THE SAME LABORATORY ROOM WITH DIFFERENT SUBSTANCES","authors":"Y.U. Nikolaieva, M. Levin","doi":"10.31612/2616-4868.4(22).2022.10","DOIUrl":"https://doi.org/10.31612/2616-4868.4(22).2022.10","url":null,"abstract":"The aim of the stady. To determine the concentration of diclofenac sodium in the air of the working area within the same room in order to determine the possible contamination of the sample being analyzed, when simultaneously working with different substances of medicinal products. \u0000Materials and methods. Air sampling was carried out using a TYPHOON-S4 electric aspirator for 30 minutes at a speed of 20 l/min. The test to determine the concentration of diclofenac sodium in air was carried out by concentrating the analytical sample with regard to the microconcentration of the substance by the method of solid-phase extraction, using Oasis MCX 6cc (150 mg) LP Extraction Cartridges, after which desorption was carried out with a solvent - methanol. The obtained samples were analyzed by the method of high-performance liquid chromatography using a Dionex Ultimate 3000 chromatograph with a diode-matrix detector. The sensitivity of the method reaches ng/ml. \u0000The results. As part of the work, a specific, highly sensitive method for determining the concentration of sodium diclofenac in the air was developed and testing was carried out by determining the concentration of sodium diclofenac in the air of the working area during certain analytical operations (pouring, weighing the substance, crushing tablets containing the active pharmaceutical ingredient under analysis, homogenization). The linear dependence of the diclofenac sodium peak area on the concentration of the substance in the solution (0.025-10 μg/ml) has been proven. Based on the obtained data, it was established that the volatile microparticles of diclofenac sodium substance are subject to air deposition, and as a result, a certain amount of this API penetrates into the analyzed samples of other drugs nearby. This fact can lead to obtaining unreliable results during the control of the quality and safety of medicinal products, which can have negative consequences for preserving the health of the population when using medicinal products of inadequate quality. At the same time, the research results show a proportional decrease in the concentration of sodium diclofenac in the air of the working area within one laboratory room as the air aspiration distance from the analytical operation being performed increases. However, at a distance of 0.2 m, the content of sodium diclofenac in the air of the working area exceeds the MPC by two times. These results indicate not only the possible background contamination of the analytical sample during the simultaneous work of several or one operator with different APIs or ready-made medicinal products, but also the possible harm to the analyst's health. \u0000Conclusions. A technique for determining microconcentrations of the active substance in the air of the working area has been developed. It has been found that samples can be easily contaminated with microparticles from other sources if proper precautions are not taken during collection, sample preparation and analysis","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48833798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-21DOI: 10.31612/2616-4868.4(22).2022.06
B. Lysenko
The aim. To determine the factors affecting reproductive function in women with cystic-degenerative changes in the ovaries. Materials and Methods. The study involved 398 women who were divided into groups: main (I) – 177 patients with cystic-degenerative changes of the ovaries and infertility; comparison group (II) – 121 women with cystic-degenerative changes of the ovaries and realized reproductive function; control group (K) – 100 healthy fertile patients of reproductive age. Clinical, instrumental, laboratory research methods and methods of statistical analysis were used. Results. In the course of the study, it was found that cystic-degenerative changes of the ovaries in women of reproductive age are formed against the background of dyshormonal disorders associated with the pathological influence of benign thyroid pathology, and are also combined with at least one other risk factor for the development of infertility. Among the patients of the 1st group, 71 had primary infertility (40.1%, the duration varied from two to five years and was, on average, 3.6±0.9 years), secondary infertility was 106 (59.8% ) women (the duration was, on average, 5.6±0.7 years). The highest percentage of endocrine pathology was also observed in the 1st group, autoimmune thyroiditis (AIT) with subclinical hypothyroidism (55%), hyperprolactinemia syndrome - (21.4%), mixed type of hyperandrogenism - (7.2%) were most often observed. The leading place among the various causes of infertility in women with cystic-degenerative changes of the ovaries was occupied by endocrine disorders, namely AIT - 44.5%, glandular endometrial hyperplasia (20.1%) and uterine factor (13.7%). The most common gynecological pathology in the examined women of the three research groups were: abnormal uterine bleeding - 136 (29.9%), 130 (28.5%) and hyperplastic processes of the endometrium - in 136 (29.9%). According to the obtained results, the following were registered: laparoscopy - 110 (27.0%), laparohysteroscopy with laparoscopy - 140 (34.3%), hysteroscopy - 87 (21.3%), laparotomy - 71 (17.3%). Anamnestic data on the frequency of gynecological surgical interventions in women with cystic-degenerative changes of the ovaries and infertility indicate that the examined women represent a complex contingent from the point of view of implementation of reproductive function, since 61.9% of patients underwent from one to three gynecological operations, which in general contributes to the spread of the adhesion process (15-69%, respectively), which leads to a violation of the fallopian tube function, as a concomitant tubo-peritoneal factor of infertility. Conclusions. The results of the conducted studies indicate the presence of disorders of the reproductive function of women with cystic-degenerative changes of the ovaries, the factors of which are somatic morbidity, including endocrine pathology; accompanying gynecological pathology - chronic inflammatory processes, hyperplastic processes of the en
{"title":"Polymorbidity as a factor affecting reproductive function in women with benign cystic-degenerative changes in the ovaries","authors":"B. Lysenko","doi":"10.31612/2616-4868.4(22).2022.06","DOIUrl":"https://doi.org/10.31612/2616-4868.4(22).2022.06","url":null,"abstract":"The aim. To determine the factors affecting reproductive function in women with cystic-degenerative changes in the ovaries. \u0000Materials and Methods. The study involved 398 women who were divided into groups: main (I) – 177 patients with cystic-degenerative changes of the ovaries and infertility; comparison group (II) – 121 women with cystic-degenerative changes of the ovaries and realized reproductive function; control group (K) – 100 healthy fertile patients of reproductive age. Clinical, instrumental, laboratory research methods and methods of statistical analysis were used. \u0000Results. In the course of the study, it was found that cystic-degenerative changes of the ovaries in women of reproductive age are formed against the background of dyshormonal disorders associated with the pathological influence of benign thyroid pathology, and are also combined with at least one other risk factor for the development of infertility. Among the patients of the 1st group, 71 had primary infertility (40.1%, the duration varied from two to five years and was, on average, 3.6±0.9 years), secondary infertility was 106 (59.8% ) women (the duration was, on average, 5.6±0.7 years). The highest percentage of endocrine pathology was also observed in the 1st group, autoimmune thyroiditis (AIT) with subclinical hypothyroidism (55%), hyperprolactinemia syndrome - (21.4%), mixed type of hyperandrogenism - (7.2%) were most often observed. The leading place among the various causes of infertility in women with cystic-degenerative changes of the ovaries was occupied by endocrine disorders, namely AIT - 44.5%, glandular endometrial hyperplasia (20.1%) and uterine factor (13.7%). \u0000The most common gynecological pathology in the examined women of the three research groups were: abnormal uterine bleeding - 136 (29.9%), 130 (28.5%) and hyperplastic processes of the endometrium - in 136 (29.9%). According to the obtained results, the following were registered: laparoscopy - 110 (27.0%), laparohysteroscopy with laparoscopy - 140 (34.3%), hysteroscopy - 87 (21.3%), laparotomy - 71 (17.3%). Anamnestic data on the frequency of gynecological surgical interventions in women with cystic-degenerative changes of the ovaries and infertility indicate that the examined women represent a complex contingent from the point of view of implementation of reproductive function, since 61.9% of patients underwent from one to three gynecological operations, which in general contributes to the spread of the adhesion process (15-69%, respectively), which leads to a violation of the fallopian tube function, as a concomitant tubo-peritoneal factor of infertility. \u0000Conclusions. The results of the conducted studies indicate the presence of disorders of the reproductive function of women with cystic-degenerative changes of the ovaries, the factors of which are somatic morbidity, including endocrine pathology; accompanying gynecological pathology - chronic inflammatory processes, hyperplastic processes of the en","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69342286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-21DOI: 10.31612/2616-4868.4(22).2022.01
D. D. Dyachuk, G.S. Zdelova
Introduction. We considered the main aspects of the organization of providing ophthalmic care to the adult population in Ukraine, analyzed the problems and described our own experience in implementing innovative technologies for improving the prevention, diagnosis, and surgical treatment of eye diseases. Aim. Conducting an analysis of the market for the provision of medical services to patients with diseases of the visual organs to determine the ability of a health care institution to provide a full cycle of diagnostics and surgical treatment in the conditions of one institution. Materials and methods. Bibliosemantic and statistical methods, a SWOT analysis was conducted to determine the effectiveness of management Results and their discussion. Based on the results of the marketing analysis, it was established the possibility of organizing and providing comprehensive timely high-tech microsurgical treatment of ophthalmic diseases in patients using modern equipment on the basis of SIS RPCPCM SADS and, importantly, by one doctor. This makes it possible not only to improve the quality of ophthalmic services, but also to increase the scope of their provision, shorten the patient's route and increase access to timely high-tech microsurgical treatment of ophthalmic diseases. Conclusions. Thus, the presented organizational structure and the implementation of a full cycle of providing high-tech ophthalmic care to adult patients will ensure a constant improvement in the quality of providing medical care to the population and, to a certain extent, reduce the costs of providing it.
{"title":"ASSESSMENT OF THE READINESS OF A MULTIPROFESSIONAL HEALTH CARE FACILITY FOR THE IMPLEMENTATION OF NEW ORGANIZATIONAL FORMALS OF OPHTHALMOLOGY ASSISTANCE TO THE ADULT POPULATION","authors":"D. D. Dyachuk, G.S. Zdelova","doi":"10.31612/2616-4868.4(22).2022.01","DOIUrl":"https://doi.org/10.31612/2616-4868.4(22).2022.01","url":null,"abstract":"Introduction. We considered the main aspects of the organization of providing ophthalmic care to the adult population in Ukraine, analyzed the problems and described our own experience in implementing innovative technologies for improving the prevention, diagnosis, and surgical treatment of eye diseases. \u0000Aim. Conducting an analysis of the market for the provision of medical services to patients with diseases of the visual organs to determine the ability of a health care institution to provide a full cycle of diagnostics and surgical treatment in the conditions of one institution. \u0000Materials and methods. Bibliosemantic and statistical methods, a SWOT analysis was conducted to determine the effectiveness of management \u0000Results and their discussion. \u0000Based on the results of the marketing analysis, it was established the possibility of organizing and providing comprehensive timely high-tech microsurgical treatment of ophthalmic diseases in patients using modern equipment on the basis of SIS RPCPCM SADS and, importantly, by one doctor. This makes it possible not only to improve the quality of ophthalmic services, but also to increase the scope of their provision, shorten the patient's route and increase access to timely high-tech microsurgical treatment of ophthalmic diseases. \u0000Conclusions. Thus, the presented organizational structure and the implementation of a full cycle of providing high-tech ophthalmic care to adult patients will ensure a constant improvement in the quality of providing medical care to the population and, to a certain extent, reduce the costs of providing it.","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48042294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-21DOI: 10.31612/2616-4868.4(22).2022.09
O. Mozyrska, N. Slyusar
The aim of the study The aim of this study was to assess the value of interventions aimed at improving the skin barrier and skin care products, as well as breastfeeding and early introduction of complementary foods, for the primary prevention of atopic dermatitis (AD) and food allergy in infants. Materials and methods We started a survey in the period from May 2022, which continues to this day. The survey was conducted with the help of Google forms and distributed on the Internet, as well as parents of children who applied for help at Kyiv children’s clinical hospital No. 2 and MC "Allergolog" were interviewed. The relationship between intervention methods and the development of AD and food allergy was determined using the odds ratio (OR) with a 95% confidence interval (CI). Results According to the survey data, 42,2% of children received moisturizing cream, parents of 16,5% of children reported using moisturizing oil for bathing the child, 12,4% of parents used less soap and bathed the child less often, 28,9% reported that they did not use none of these methods and means of care. AD occurred in 23,7% of children interviewed. The odds ratio for the moisturizing cream group was 68,6 (CI 3,9-1201,5), p=0,004, for the groups that used moisturizing oils for bathing – 8,9 (CI 0,4-197,6), p= 0,17, for the group where the intervention was a reduction in bathing and using soap – 7,1 (CI 0,3-186,0), p=0,24. 18,6% of respondents reported a reaction to food that occurred in the child within 2 hours after consumption. We have not found any role of emollients (OR=1,4, CI 0,4-4,9), p=0,56, moisturizing oils for bathing (OR=0,3, CI 0,03-2,6), p=0,27, and reduced use of soap and water (OR=1,4 (CI 0,3-7,2), p=0,66 for the development of food allergy. The duration of breastfeeding (more than 3 months) did not affect the risk of developing AD (OR = 0,1, CI 0,01-2,6), p = 0,19, or food allergy (OR = 1,3, CI 0,3-6,9), p=0,74. Also, the role of earlier introduction of supplementary food on the development of AD and food allergy was not shown: the OR for AD was 0,9 (CI 0,3-2,7), p=0,8, the OR for food allergy was 0,8 (CI 0,2- 2,9), p=0,76. Conclusions This study did not reveal the protective role of skin care products, breastfeeding, and early introduction of complementary foods for the development of AD and food allergies in children. A larger survey will allow us to study the effect of emollients and other preventive measures on the development of food allergies in a group of children with AD.
本研究的目的是评估旨在改善皮肤屏障和护肤产品的干预措施，以及母乳喂养和早期引入辅食，对婴儿特应性皮炎(AD)和食物过敏的一级预防的价值。材料和方法我们从2022年5月开始调查，一直持续到今天。该调查是借助谷歌表格进行的，并在互联网上分发，同时还采访了在基辅第二儿童临床医院和MC "过敏症科"申请帮助的儿童的父母。采用比值比(OR)确定干预方法与AD和食物过敏发生之间的关系，置信区间为95%。结果调查数据显示，42.2%的儿童使用了润肤霜，16.5%的儿童家长报告使用了润肤油给孩子洗澡，12.4%的家长较少使用肥皂并减少了给孩子洗澡的次数，28.9%的儿童报告没有使用这些护理方法和手段。受访儿童中有23.7%发生AD。使用保湿霜组的优势比为68,6 (CI 3,9-1201,5)， p=0,004;使用保湿油洗澡组的优势比为8,9 (CI 0,4-197,6)， p= 0,17;干预减少洗澡和使用肥皂的组的优势比为7,1 (CI 0,3-186,0)， p=0,24。18.6%的受访者报告儿童在食用后2小时内对食物产生反应。我们没有发现润肤剂(OR=1,4, CI 0,4-4,9)， p=0,56，沐浴保湿油(OR=0,3, CI 0,03-2,6)， p=0,27，以及减少肥皂和水的使用(OR=1,4 (CI 0,3-7,2)， p=0,66对食物过敏的发展有任何作用。母乳喂养时间(超过3个月)不影响发生AD的风险(OR = 0,1, CI 0,01-2,6)， p= 0,19，或食物过敏(OR = 1,3, CI 0,3-6,9)， p=0,74。此外，早期引入辅食对AD和食物过敏发展的作用没有显示:AD的OR为0,9 (CI 0,3-2,7)， p=0,8，食物过敏的OR为0,8 (CI 0,2- 2,9)， p=0,76。结论本研究并未揭示护肤品、母乳喂养和早期引入辅食对儿童AD和食物过敏的保护作用。一项更大的调查将使我们能够研究润肤剂和其他预防措施对一组AD患儿食物过敏发展的影响。
{"title":"THE ROLE OF SKIN CARE PRODUCTS AND EARLY FOOD FOR THE PREVENTION OF ATOPIC DERMATITIS IN INFANTS","authors":"O. Mozyrska, N. Slyusar","doi":"10.31612/2616-4868.4(22).2022.09","DOIUrl":"https://doi.org/10.31612/2616-4868.4(22).2022.09","url":null,"abstract":"The aim of the study \u0000The aim of this study was to assess the value of interventions aimed at improving the skin barrier and skin care products, as well as breastfeeding and early introduction of complementary foods, for the primary prevention of atopic dermatitis (AD) and food allergy in infants. \u0000Materials and methods \u0000We started a survey in the period from May 2022, which continues to this day. The survey was conducted with the help of Google forms and distributed on the Internet, as well as parents of children who applied for help at Kyiv children’s clinical hospital No. 2 and MC \"Allergolog\" were interviewed. The relationship between intervention methods and the development of AD and food allergy was determined using the odds ratio (OR) with a 95% confidence interval (CI). \u0000Results \u0000According to the survey data, 42,2% of children received moisturizing cream, parents of 16,5% of children reported using moisturizing oil for bathing the child, 12,4% of parents used less soap and bathed the child less often, 28,9% reported that they did not use none of these methods and means of care. \u0000AD occurred in 23,7% of children interviewed. The odds ratio for the moisturizing cream group was 68,6 (CI 3,9-1201,5), p=0,004, for the groups that used moisturizing oils for bathing – 8,9 (CI 0,4-197,6), p= 0,17, for the group where the intervention was a reduction in bathing and using soap – 7,1 (CI 0,3-186,0), p=0,24. \u000018,6% of respondents reported a reaction to food that occurred in the child within 2 hours after consumption. We have not found any role of emollients (OR=1,4, CI 0,4-4,9), p=0,56, moisturizing oils for bathing (OR=0,3, CI 0,03-2,6), p=0,27, and reduced use of soap and water (OR=1,4 (CI 0,3-7,2), p=0,66 for the development of food allergy. \u0000The duration of breastfeeding (more than 3 months) did not affect the risk of developing AD (OR = 0,1, CI 0,01-2,6), p = 0,19, or food allergy (OR = 1,3, CI 0,3-6,9), p=0,74. Also, the role of earlier introduction of supplementary food on the development of AD and food allergy was not shown: the OR for AD was 0,9 (CI 0,3-2,7), p=0,8, the OR for food allergy was 0,8 (CI 0,2- 2,9), p=0,76. \u0000Conclusions \u0000This study did not reveal the protective role of skin care products, breastfeeding, and early introduction of complementary foods for the development of AD and food allergies in children. A larger survey will allow us to study the effect of emollients and other preventive measures on the development of food allergies in a group of children with AD.","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69341856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-21DOI: 10.31612/2616-4868.4(22).2022.12
M. Mishchenko
Introduction: the relevance of determining national trends in prevalence of diseases among the adult population in Ukraine is high, as it solves several important medical, social and economic problems of society. The aim: to determine national trends in prevalence of diseases among the adult population in Ukraine and Kharkiv region. Materials and methods: data from official sources of statistical information of Ukraine (State Institution "Center for Medical Statistics of the Ministry of Health of Ukraine") were used to determine national trends in prevalence of diseases among the adult population in Ukraine and Kharkiv region. A systematic analysis and generalization of the obtained data was performed and trends in prevalence of diseases among the adult population in Ukraine and Kharkiv region. Results: a decrease in the prevalence of diseases among the adult population of Ukraine over the 2010-2017 years with trends of -18.3% (general morbidity) and -25.9% (diseases detected for the first time in life) has been determined. Over the 2010-2019 years, the dynamics of reducing the prevalence of diseases and morbidity of adult residents of the Kharkiv region with trends of -12.6% and -23.0% has been established. For 2018-2019, progressive trends in reducing the prevalence of most diseases were noted, except for eating disorders and metabolic disorders (trends of increase, respectively, + 2.2% and + 2.9%) and symptoms, signs and deviations from the norm, which were found in clinical and laboratory studies (trends + 2.8% and + 3.5%) and neoplasms (only in terms of 100 thousand people) — + 0.1%. Discussion: the obtained results of the general dynamics of trends in the prevalence of diseases of the population in Ukraine completely coincide with the data of other world studies. Conclusions: there was a significant decrease in the spread of prevalence of diseases and morbidity among the mature population of Ukraine and the Kharkiv region.
{"title":"NATIONAL TRENDS IN THE PREVALENCE OF DISEASES AMONG RESIDENTS OF UKRAINE AND KHARKIV REGION","authors":"M. Mishchenko","doi":"10.31612/2616-4868.4(22).2022.12","DOIUrl":"https://doi.org/10.31612/2616-4868.4(22).2022.12","url":null,"abstract":"Introduction: the relevance of determining national trends in prevalence of diseases among the adult population in Ukraine is high, as it solves several important medical, social and economic problems of society. \u0000The aim: to determine national trends in prevalence of diseases among the adult population in Ukraine and Kharkiv region. \u0000Materials and methods: data from official sources of statistical information of Ukraine (State Institution \"Center for Medical Statistics of the Ministry of Health of Ukraine\") were used to determine national trends in prevalence of diseases among the adult population in Ukraine and Kharkiv region. A systematic analysis and generalization of the obtained data was performed and trends in prevalence of diseases among the adult population in Ukraine and Kharkiv region. \u0000Results: a decrease in the prevalence of diseases among the adult population of Ukraine over the 2010-2017 years with trends of -18.3% (general morbidity) and -25.9% (diseases detected for the first time in life) has been determined. Over the 2010-2019 years, the dynamics of reducing the prevalence of diseases and morbidity of adult residents of the Kharkiv region with trends of -12.6% and -23.0% has been established. For 2018-2019, progressive trends in reducing the prevalence of most diseases were noted, except for eating disorders and metabolic disorders (trends of increase, respectively, + 2.2% and + 2.9%) and symptoms, signs and deviations from the norm, which were found in clinical and laboratory studies (trends + 2.8% and + 3.5%) and neoplasms (only in terms of 100 thousand people) — + 0.1%. \u0000Discussion: the obtained results of the general dynamics of trends in the prevalence of diseases of the population in Ukraine completely coincide with the data of other world studies. \u0000Conclusions: there was a significant decrease in the spread of prevalence of diseases and morbidity among the mature population of Ukraine and the Kharkiv region.","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69341868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-21DOI: 10.31612/2616-4868.4(22).2022.07
A. Khabrat, O. Lytvak
The aim. To analyze the methods of visual diagnosis used in reproductive age women with uterine fibroids. Materials and Methods. Retrospective analisys, information–analytical methods were used in the work. Sources of information were data from the scientific literature on the topic of the study, modern gadleins, a review of randomized controlled trials. Results. Depending on the types of visual diagnostics used in the preoperative examination were formed groups: I group (n=120) – patients were examined only by the sonographic method; II group (n=80) – patients were examined by MRI and ultrasound. Comparative analysis of the MRI and sonographic studies results determined the number of myomatous nodes inpatients of the II group (n=80 (100%): by ultrasound – solitary nodes in 52 (65%), multiple in 28 (35%), and by MRI – a solitary nodule in 37 women (according to FIGO classification – type SM0 – 16 women, SMI in 8 patients, SMII in 8 patients, O3–6 typein 5 women), two nodules in 27 people and three myomatous nodules in 16 women (among multiple myomas n=43 (100%) according to the FIGO classification, , were diagnosed: SM0/О3–4 type– 20 (47%), SM1/О3–4 type –13 (30%), SM2/ O3–4 type –10 (23%), and according to MP type: MP1 – 16 (37%), MP2 –11 (26%), MP3 –16 (37%), and among solitary nodes n=37 (100% ): MP1 – 27 (71%), MP2 –10 (29%). The frequency of cases of inconsistency the clinical situation with ultrasound data interms of the number and localization of myomatous nodes in multinodular UF, especially in SM0–2/О3–4 type combinations, was 39, 0%, and when was using MRI – 8.0% (p<0.05). The structure of organ–preserving surgical intervention in the scope of myomectomy is presented as follows: hysteroscopy – 118 (59%), a combination of laparoscopy and hysteroscopy – 50 (25%), in 28 (14%) a combination of laparoscopy and hysteroscopy was converted to laparoscopic–vaginal access and 2.0% were converted to laparoscopic laparotomy. In the 1st group (n=120(100%)) where only preoperative ultrasound was used, a higher specific weight of conversions from hysteroscopy to laparoscopy – 36 cases (30%), from a combination of laparoscopy and hysteroscopy to laparoscopic–vaginalaccess – 24 (20%) and from laparoscopy laparotomy – 12 (10%). Conclusions. Ultrasound in the perioperative period is unable to fully determine clear navigation for the operation, especially for multinodular UF and hard–to–reach UF localization for hysteroscopic myomectomy. This clinical problem can be solved by using MRI in the perioperative diagnostic and intraoperative sonography.
{"title":"Analysis of the informativeness of perioperative visual diagnostics of uterine fibroids","authors":"A. Khabrat, O. Lytvak","doi":"10.31612/2616-4868.4(22).2022.07","DOIUrl":"https://doi.org/10.31612/2616-4868.4(22).2022.07","url":null,"abstract":"The aim. To analyze the methods of visual diagnosis used in reproductive age women with uterine fibroids. \u0000Materials and Methods. Retrospective analisys, information–analytical methods were used in the work. Sources of information were data from the scientific literature on the topic of the study, modern gadleins, a review of randomized controlled trials. \u0000Results. Depending on the types of visual diagnostics used in the preoperative examination were formed groups: I group (n=120) – patients were examined only by the sonographic method; II group (n=80) – patients were examined by MRI and ultrasound. Comparative analysis of the MRI and sonographic studies results determined the number of myomatous nodes inpatients of the II group (n=80 (100%): by ultrasound – solitary nodes in 52 (65%), multiple in 28 (35%), and by MRI – a solitary nodule in 37 women (according to FIGO classification – type SM0 – 16 women, SMI in 8 patients, SMII in 8 patients, O3–6 typein 5 women), two nodules in 27 people and three myomatous nodules in 16 women (among multiple myomas n=43 (100%) according to the FIGO classification, , were diagnosed: SM0/О3–4 type– 20 (47%), SM1/О3–4 type –13 (30%), SM2/ O3–4 type –10 (23%), and according to MP type: MP1 – 16 (37%), MP2 –11 (26%), MP3 –16 (37%), and among solitary nodes n=37 (100% ): MP1 – 27 (71%), MP2 –10 (29%). The frequency of cases of inconsistency the clinical situation with ultrasound data interms of the number and localization of myomatous nodes in multinodular UF, especially in SM0–2/О3–4 type combinations, was 39, 0%, and when was using MRI – 8.0% (p<0.05). The structure of organ–preserving surgical intervention in the scope of myomectomy is presented as follows: hysteroscopy – 118 (59%), a combination of laparoscopy and hysteroscopy – 50 (25%), in 28 (14%) a combination of laparoscopy and hysteroscopy was converted to laparoscopic–vaginal access and 2.0% were converted to laparoscopic laparotomy. In the 1st group (n=120(100%)) where only preoperative ultrasound was used, a higher specific weight of conversions from hysteroscopy to laparoscopy – 36 cases (30%), from a combination of laparoscopy and hysteroscopy to laparoscopic–vaginalaccess – 24 (20%) and from laparoscopy laparotomy – 12 (10%). \u0000Conclusions. Ultrasound in the perioperative period is unable to fully determine clear navigation for the operation, especially for multinodular UF and hard–to–reach UF localization for hysteroscopic myomectomy. This clinical problem can be solved by using MRI in the perioperative diagnostic and intraoperative sonography.","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69342325","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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