Pub Date : 2022-08-23DOI: 10.31612/2616-4868.3(21).2022.03
V. Chernii, L. Feinzilberg, Y. Kurylenko
Introduction. Heart rate variability is a non-invasive method used to assess the modulation of the autonomic nervous system in the sinus node of the heart, which reflects the variability of the durations of successive R-R intervals on electrocardiograms. Phasagraphy is an innovative method of cardiology that allows to estimate the indicator of βT - symmetry of the T wave, which reflects the period of early repolarization of the heart. The aim. To expand the diagnostic criteria for perioperative hemodynamic disorders in patients who underwent surgery - coronary artery bypass grafting with cardiopulmonary bypass. Materials and methods. 500 patients were operated on at the State Institution of Science «Research and Practical Center of Preventive and Clinical Medicine» State Administrative Department. All underwent coronary artery bypass graft surgery with cardiopulmonary bypass. 80 patients were selected and examined by Fazagraf®, βT and LF / HF were analyzed. The main group included 35 patients who developed hemodynamic disorders in the early postoperative period. Inotropic support with dobutamine and metabolic support with a combination of levocarnitine and arginine were used to stabilize hemodynamics. The control group included 45 patients who did not have hemodynamic disorders. Results. At the stages of this study, the stability of LF/HF values was recorded, which indicates the adequacy of perioperative anesthesia and analgesia. The LF/HF in the preoperative period of the main group differed from the control group. After stabilization of hemodynamics LF/HF reached reference values. In order to correct acute left ventricular failure with dobutamine and the combination of levocarnitine and arginine in the main group of patients, the βT index shifted to the zone corresponding to the "health" of the myocardium. Conclusions. The LF/HF value reliably reflects the ratio of sympathetic and parasympathetic parts of the autonomic nervous system. An increase in LF/HF before surgery indicates the risk of hemodynamic disorders after surgery, and its decrease in the postoperative period - to stabilize the patient's condition. βT is associated with clinical data on myocardial status and can be used to determine myocardial health in patients with coronary heart disease. The combination of levocarnitine and arginine has a pronounced metabolic effect on the myocardium, which underwent surgery with cardiopulmonary bypass.
{"title":"POSSIBILITIES OF USING THE PHASEGRAPHY METHOD AS A MARKER OF ISCHEMIC CHANGES IN THE MYOCARDIA IN CARDIAC SURGICAL PATIENTS WHO HAVE UNDERGONE ARTOCORONARY BYPASS WITH THE USE OF ARTIFICIAL CIRCULATION","authors":"V. Chernii, L. Feinzilberg, Y. Kurylenko","doi":"10.31612/2616-4868.3(21).2022.03","DOIUrl":"https://doi.org/10.31612/2616-4868.3(21).2022.03","url":null,"abstract":"Introduction. Heart rate variability is a non-invasive method used to assess the modulation of the autonomic nervous system in the sinus node of the heart, which reflects the variability of the durations of successive R-R intervals on electrocardiograms. Phasagraphy is an innovative method of cardiology that allows to estimate the indicator of βT - symmetry of the T wave, which reflects the period of early repolarization of the heart. \u0000The aim. To expand the diagnostic criteria for perioperative hemodynamic disorders in patients who underwent surgery - coronary artery bypass grafting with cardiopulmonary bypass. \u0000Materials and methods. 500 patients were operated on at the State Institution of Science «Research and Practical Center of Preventive and Clinical Medicine» State Administrative Department. All underwent coronary artery bypass graft surgery with cardiopulmonary bypass. 80 patients were selected and examined by Fazagraf®, βT and LF / HF were analyzed. The main group included 35 patients who developed hemodynamic disorders in the early postoperative period. Inotropic support with dobutamine and metabolic support with a combination of levocarnitine and arginine were used to stabilize hemodynamics. The control group included 45 patients who did not have hemodynamic disorders. \u0000Results. At the stages of this study, the stability of LF/HF values was recorded, which indicates the adequacy of perioperative anesthesia and analgesia. The LF/HF in the preoperative period of the main group differed from the control group. After stabilization of hemodynamics LF/HF reached reference values. In order to correct acute left ventricular failure with dobutamine and the combination of levocarnitine and arginine in the main group of patients, the βT index shifted to the zone corresponding to the \"health\" of the myocardium. \u0000Conclusions. The LF/HF value reliably reflects the ratio of sympathetic and parasympathetic parts of the autonomic nervous system. An increase in LF/HF before surgery indicates the risk of hemodynamic disorders after surgery, and its decrease in the postoperative period - to stabilize the patient's condition. βT is associated with clinical data on myocardial status and can be used to determine myocardial health in patients with coronary heart disease. The combination of levocarnitine and arginine has a pronounced metabolic effect on the myocardium, which underwent surgery with cardiopulmonary bypass.","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70041831","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 : 2022-08-23DOI: 10.31612/2616-4868.3(21).2022.12
A.I. Slobodian, B. Palamar
Resume. In the article, based on the study of the legal documents in force in Ukraine and the analysis of modern features of the organization and provision of medical care for oncological diseases of the breast, the structure, tasks and functions of the health care system regarding the provision of medical care to women with oncological diseases of the breast are determined. Introduction. In recent years, as a result of radical changes in the politics, economy and development strategy of Ukraine, changes have also taken place in the medical field. The priority of the development of family medicine became not only a declaration and a slogan, but received a powerful legal and economic basis. One of the most important rights of a citizen of Ukraine is the Constitutional right to health care and medical assistance. The state program "Healthy Nation" has practical recommendations for improving the health of citizens, preventing diseases and overcoming the consequences of diseases [1, 13]. The priority in the activities of executive authorities at all levels has become 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 healthy environment for human activities (working conditions, living conditions, education, recreation, 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 (LA) "Basics of the Legislation of Ukraine on Health Care" dated 11/19/1992 No. 2802-ХІІ (as amended from 11/06/2017), where a number of articles directly or indirectly indicate measures with disease prevention. In the specified ZU, the organizational aspects of prevention of all classes of diseases are covered, in particular, in Article 4 "Basic principles of health care" it is emphasized that one of the principles of the approach to health care is of a preventive and preventive nature. Among the causes of mortality and disability of the population, malignant neoplasms are one of the most dangerous for human health, they rank second after cardiovascular diseases and are one of the most important and most dangerous medico-biological and socio-economic problems of health care in Ukraine. The relevance of the fight against malignant neoplasms today is determined by the constant increase in morbidity, disability and mortality of cancer patients [1, 5]. The purpose of the work is to carry out a scientific analysis of domestic and foreign sources of information regarding regulatory support in Ukraine and modern views on the organization of medical care for breast cancer in women. Research materials and methods. On the basis of the study of domestic and foreign sources of information regarding the features of modern medical care for oncological diseases of the breast in women, an analytical review of the literature and an analysis of the legal framework were conducted. At
{"title":"THE CURRENT STATE OF REGULATORY AND LEGAL SECURITY IN UKRAINE AND THE ORGANIZATION OF MEDICAL ASSISTANCE FOR ONCOLOGICAL DISEASES OF THE BREAST GLAND","authors":"A.I. Slobodian, B. Palamar","doi":"10.31612/2616-4868.3(21).2022.12","DOIUrl":"https://doi.org/10.31612/2616-4868.3(21).2022.12","url":null,"abstract":"Resume. In the article, based on the study of the legal documents in force in Ukraine and the analysis of modern features of the organization and provision of medical care for oncological diseases of the breast, the structure, tasks and functions of the health care system regarding the provision of medical care to women with oncological diseases of the breast are determined. \u0000Introduction. In recent years, as a result of radical changes in the politics, economy and development strategy of Ukraine, changes have also taken place in the medical field. The priority of the development of family medicine became not only a declaration and a slogan, but received a powerful legal and economic basis. One of the most important rights of a citizen of Ukraine is the Constitutional right to health care and medical assistance. The state program \"Healthy Nation\" has practical recommendations for improving the health of citizens, preventing diseases and overcoming the consequences of diseases [1, 13]. \u0000The priority in the activities of executive authorities at all levels has become 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 healthy environment for human activities (working conditions, living conditions, education, recreation, 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 (LA) \"Basics of the Legislation of Ukraine on Health Care\" dated 11/19/1992 No. 2802-ХІІ (as amended from 11/06/2017), where a number of articles directly or indirectly indicate measures with disease prevention. In the specified ZU, the organizational aspects of prevention of all classes of diseases are covered, in particular, in Article 4 \"Basic principles of health care\" it is emphasized that one of the principles of the approach to health care is of a preventive and preventive nature. \u0000Among the causes of mortality and disability of the population, malignant neoplasms are one of the most dangerous for human health, they rank second after cardiovascular diseases and are one of the most important and most dangerous medico-biological and socio-economic problems of health care in Ukraine. The relevance of the fight against malignant neoplasms today is determined by the constant increase in morbidity, disability and mortality of cancer patients [1, 5]. \u0000The purpose of the work is to carry out a scientific analysis of domestic and foreign sources of information regarding regulatory support in Ukraine and modern views on the organization of medical care for breast cancer in women. \u0000Research materials and methods. On the basis of the study of domestic and foreign sources of information regarding the features of modern medical care for oncological diseases of the breast in women, an analytical review of the literature and an analysis of the legal framework were conducted. At","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49558903","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 : 2022-08-23DOI: 10.31612/2616-4868.3(21).2022.01
O. Lytvak, A. Petruk
Objective: to study the structural and metabolic features of endometrial structure in reproductive age women with menstrual disorders after COVID - 19 and to determine the correlation between histological status and parameters of endometrial morphometry in this group of patients. Materials and methods. Bibliographic, information-analytical, clinical-instrumental, laboratory, histomorphological 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 and discussion. Menstrual disorders such as menometrorrhagia is one of the main reasons for seeking medical help and hospitalization. A significant role of the menometrorrhagia development belongs to the disruption of hormonal homeostasis with changes in the growth and differentiation of cellular elements of the endometrium. Stressors can activate the hypothalamic-pituitary-gonadal axis (HPG axis) and alter the neuromodulatory cascade that controls the regulation of gonadotropin-releasing hormone (GnRH). In addition gonadotropin-releasing hormone (GnRH) may play a role in the autocrine regulator of carcinoma cell line proliferation [13]. According to the WHO more than 106 million patients suffered from COVID – 19 worldwide in 2021. Fear of contracting the virus, forced social exclusion, as well as insecurities about financial stability and the future, have had a significant impact on the mental health of many people in European countries. [1,3,4]. As stress has its own characteristics for the female body we study the structural and metabolic characteristics of hyperplastic processes in reproductive age women with menstrual disorders as menometrorrhagia after COVID - 19 to improve the algorithm of examination and prediction of pathological processes of the endometrium [2,5,6,7]. Conclusions. The described histological picture indicates the presence of asynchrony of the processes of secretory transformation of the endometrium into the luteal phase of the MC. The period of endometrial monitoring in patients of reproductive age with menstrual irregularities by type of menometrorrhagia after COVID-19 should be at least 3-6 months after surgery, as a probable increase in the risk of recurrence of GE over time.
{"title":"Clinical and morphological aspects of the reproductive system of reproductive age women with menstrual disorders after COVID-19","authors":"O. Lytvak, A. Petruk","doi":"10.31612/2616-4868.3(21).2022.01","DOIUrl":"https://doi.org/10.31612/2616-4868.3(21).2022.01","url":null,"abstract":"Objective: to study the structural and metabolic features of endometrial structure in reproductive age women with menstrual disorders after COVID - 19 and to determine the correlation between histological status and parameters of endometrial morphometry in this group of patients. \u0000Materials and methods. Bibliographic, information-analytical, clinical-instrumental, laboratory, histomorphological 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 and discussion. Menstrual disorders such as menometrorrhagia is one of the main reasons for seeking medical help and hospitalization. A significant role of the menometrorrhagia development belongs to the disruption of hormonal homeostasis with changes in the growth and differentiation of cellular elements of the endometrium. Stressors can activate the hypothalamic-pituitary-gonadal axis (HPG axis) and alter the neuromodulatory cascade that controls the regulation of gonadotropin-releasing hormone (GnRH). In addition gonadotropin-releasing hormone (GnRH) may play a role in the autocrine regulator of carcinoma cell line proliferation [13]. According to the WHO more than 106 million patients suffered from COVID – 19 worldwide in 2021. Fear of contracting the virus, forced social exclusion, as well as insecurities about financial stability and the future, have had a significant impact on the mental health of many people in European countries. [1,3,4]. As stress has its own characteristics for the female body we study the structural and metabolic characteristics of hyperplastic processes in reproductive age women with menstrual disorders as menometrorrhagia after COVID - 19 to improve the algorithm of examination and prediction of pathological processes of the endometrium [2,5,6,7]. \u0000Conclusions. The described histological picture indicates the presence of asynchrony of the processes of secretory transformation of the endometrium into the luteal phase of the MC. The period of endometrial monitoring in patients of reproductive age with menstrual irregularities by type of menometrorrhagia after COVID-19 should be at least 3-6 months after surgery, as a probable increase in the risk of recurrence of GE over time.","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70041729","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 : 2022-08-23DOI: 10.31612/2616-4868.3(21).2022.09
T. P. Nikolaienko-Kamyshova, E.A. Akhe
Summary: Anemia is a global public health problem that needs to be identified. When determining the algorithms for examination and treatment of anemic syndrome, it is necessary to carefully study the risk factors for its development, taking into account comorbidity. Carrying out of diagnostic search in several directions will allow to specify mechanisms of development of an anemic syndrome which at a combination worsen a clinical condition. Special attention should be paid to patients with manifestations of anemic syndrome on the background of endocrine pathology, namely autoimmune thyroiditis in hypothyroidism, as the incidence rate among women of childbearing age has increased significantly, which determines the direction of research and aim of this publication. The article presents a clinical case of observation and treatment of a patient with chronic autoimmune thyroiditis in a state of hypothyroidism and adenomyosis, accompanied by abnormal uterine bleeding, which was complicated by iron deficiency anemia. Because the patient initially considered uterine bleeding to be the main problem, she was observed by a gynecologist; at the same time changes of indicators of the general analysis of blood in favor of anemia are established. Treatment of endometriosis and the appointment of iron supplements led to improvement with the normalization of laboratory parameters. For 6 months the patient did not consult a doctor, no laboratory control was performed. If she felt worse, the patient consulted a family doctor. Careful examination with the involvement of an endocrinologist allowed to diagnose chronic autoimmune thyroiditis in a state of hypothyroidism and prescribe adequate therapy, which helped to normalize the patient's condition. Conclusion. Manifestations of anemic syndrome require determining the causes of its occurrence with the development of algorithms for examination and monitoring of treatment. The general practice physician should be the main coordinator in studying the causes of anemia and the management of patients in the outpatient phase with the involvement of physicians of other specialties.
{"title":"ABOUT CONNECTION AUTOIMMUNE THYROIDITIS WITH MANIFESTATION OF IRON DEFICIENCY ANEMIA IN A CONDITION OF HYPOTHYROIDISM IN GENERAL CLINICAL PRACTICE. CLINICAL CASE","authors":"T. P. Nikolaienko-Kamyshova, E.A. Akhe","doi":"10.31612/2616-4868.3(21).2022.09","DOIUrl":"https://doi.org/10.31612/2616-4868.3(21).2022.09","url":null,"abstract":"Summary: Anemia is a global public health problem that needs to be identified. When determining the algorithms for examination and treatment of anemic syndrome, it is necessary to carefully study the risk factors for its development, taking into account comorbidity. Carrying out of diagnostic search in several directions will allow to specify mechanisms of development of an anemic syndrome which at a combination worsen a clinical condition. \u0000Special attention should be paid to patients with manifestations of anemic syndrome on the background of endocrine pathology, namely autoimmune thyroiditis in hypothyroidism, as the incidence rate among women of childbearing age has increased significantly, which determines the direction of research and aim of this publication. \u0000The article presents a clinical case of observation and treatment of a patient with chronic autoimmune thyroiditis in a state of hypothyroidism and adenomyosis, accompanied by abnormal uterine bleeding, which was complicated by iron deficiency anemia. Because the patient initially considered uterine bleeding to be the main problem, she was observed by a gynecologist; at the same time changes of indicators of the general analysis of blood in favor of anemia are established. Treatment of endometriosis and the appointment of iron supplements led to improvement with the normalization of laboratory parameters. For 6 months the patient did not consult a doctor, no laboratory control was performed. If she felt worse, the patient consulted a family doctor. Careful examination with the involvement of an endocrinologist allowed to diagnose chronic autoimmune thyroiditis in a state of hypothyroidism and prescribe adequate therapy, which helped to normalize the patient's condition. \u0000Conclusion. Manifestations of anemic syndrome require determining the causes of its occurrence with the development of algorithms for examination and monitoring of treatment. The general practice physician should be the main coordinator in studying the causes of anemia and the management of patients in the outpatient phase with the involvement of physicians of other specialties.","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70041965","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 : 2022-08-23DOI: 10.31612/2616-4868.3(21).2022.11
T. Chursina, A. Kravchenko, K. Mikhaliev
Aim: to provide a literature review of the current data on various pathomechanisms of left ventricular (LV) remodeling in heart failure (HF) patients and their role in the development and progression of myocardial dysfunction. This paper is a first part of the review, devoted to the current state of pathophysiology of LV remodeling in HF. Material and methods. The thematic scientific papers, published during the last decade, constituted the study material. The research methodology involved bibliosemantic method and structural and logical analysis. Results and discussion. LV remodeling is the result of complex changes at the molecular, cellular and tissue levels, affecting the myocardial mass, geometry and performance, and ultimately leading to HF development and progression. LV systolic dysfunction occurs through the numerous mechanisms, including the defects in sarcomere function, abnormal excitation-contraction coupling and calcium homeostasis, ion channel dysfunction, mitochondrial and metabolic abnormalities, depressed cardiomyocytes survival signaling, redox pathobiology, inflammation and inadequate vasculogenesis. The term «LV diastolic dysfunction» covers the alterations in diastolic distensibility, filling or relaxation of the LV, regardless of whether LV (global) systolic function is normal or abnormal, and regardless of whether the patient has clinical manifestations of HF. The up-to-date pathophysiological paradigm of the development and progression of HF with LV diastolic dysfunction and preserved LV (global) systolic function considers systemic inflammation as a key pathomechanism of structural and functional changes of the myocardium, promoted by various cardiovascular and extracardiac conditions. In its turn, the systemic inflammation promotes endothelial dysfunction, contributing to multiple end-organ damage. Conclusion. The deepening one`s knowledge of various pathomechanisms of LV remodeling and related myocardial dysfunction in HF patients is an important prerequisite for identifying new perspectives on further fundamental research аnd more rational designing of future clinical trials.
{"title":"LEFT VENTRICULAR REMODELING IN HEART FAILURE (PART I): CURRENT UNDERSTANDING OF PATHOMECHANISMS AND RELATED MYOCARDIAL DYSFUNCTION","authors":"T. Chursina, A. Kravchenko, K. Mikhaliev","doi":"10.31612/2616-4868.3(21).2022.11","DOIUrl":"https://doi.org/10.31612/2616-4868.3(21).2022.11","url":null,"abstract":"Aim: to provide a literature review of the current data on various pathomechanisms of left ventricular (LV) remodeling in heart failure (HF) patients and their role in the development and progression of myocardial dysfunction. This paper is a first part of the review, devoted to the current state of pathophysiology of LV remodeling in HF. \u0000Material and methods. The thematic scientific papers, published during the last decade, constituted the study material. The research methodology involved bibliosemantic method and structural and logical analysis. \u0000Results and discussion. LV remodeling is the result of complex changes at the molecular, cellular and tissue levels, affecting the myocardial mass, geometry and performance, and ultimately leading to HF development and progression. LV systolic dysfunction occurs through the numerous mechanisms, including the defects in sarcomere function, abnormal excitation-contraction coupling and calcium homeostasis, ion channel dysfunction, mitochondrial and metabolic abnormalities, depressed cardiomyocytes survival signaling, redox pathobiology, inflammation and inadequate vasculogenesis. The term «LV diastolic dysfunction» covers the alterations in diastolic distensibility, filling or relaxation of the LV, regardless of whether LV (global) systolic function is normal or abnormal, and regardless of whether the patient has clinical manifestations of HF. The up-to-date pathophysiological paradigm of the development and progression of HF with LV diastolic dysfunction and preserved LV (global) systolic function considers systemic inflammation as a key pathomechanism of structural and functional changes of the myocardium, promoted by various cardiovascular and extracardiac conditions. In its turn, the systemic inflammation promotes endothelial dysfunction, contributing to multiple end-organ damage. \u0000Conclusion. The deepening one`s knowledge of various pathomechanisms of LV remodeling and related myocardial dysfunction in HF patients is an important prerequisite for identifying new perspectives on further fundamental research аnd more rational designing of future clinical trials.","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70042010","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 : 2022-08-23DOI: 10.31612/2616-4868.3(21).2022.04
N.M. Pryplavkо, E.M. Kravchenko
The article is devoted to the topical issues of the chronotherapeutic approach in the treatment of patients with hypertension (AH). Based on the review of the modern scientific sources, the data about the potential of chronotherapy as a variant of the patient-oriented approach in the treatment of AH, which can positively influence both the efficiency of hypotensive therapy and the incidence of cardiovascular complications. Taking into account the prognostic significance of nocturnal blood pressure (BP) values, the interest in chronotherapeutic approach to prescription of hypotensive drugs in the treatment of AH has increased. Determination of the role of nocturnal BP changes as a predictor of overall cardiovascular mortality, myocardial infarction and stroke allowed to change the view on the existing traditional treatment regimen. In particular, the results of several studies have demonstrated a significant advantage of using antihypertensive drugs at night compared to the usual practice of taking all such drugs after awakening, both in terms of improving BP control and reducing the risk of cardiovascular complications and mortality.
{"title":"CHRONOTHERAPY – NEW POSSIBILITIES FOR OPTIMIZING TREATMENT OF PATIENTS WITH ARTERIAL HYPERTENSION","authors":"N.M. Pryplavkо, E.M. Kravchenko","doi":"10.31612/2616-4868.3(21).2022.04","DOIUrl":"https://doi.org/10.31612/2616-4868.3(21).2022.04","url":null,"abstract":"The article is devoted to the topical issues of the chronotherapeutic approach in the treatment of patients with hypertension (AH). Based on the review of the modern scientific sources, the data about the potential of chronotherapy as a variant of the patient-oriented approach in the treatment of AH, which can positively influence both the efficiency of hypotensive therapy and the incidence of cardiovascular complications. \u0000 Taking into account the prognostic significance of nocturnal blood pressure (BP) values, the interest in chronotherapeutic approach to prescription of hypotensive drugs in the treatment of AH has increased. Determination of the role of nocturnal BP changes as a predictor of overall cardiovascular mortality, myocardial infarction and stroke allowed to change the view on the existing traditional treatment regimen. In particular, the results of several studies have demonstrated a significant advantage of using antihypertensive drugs at night compared to the usual practice of taking all such drugs after awakening, both in terms of improving BP control and reducing the risk of cardiovascular complications and mortality.","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70041952","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 : 2022-08-23DOI: 10.31612/2616-4868.3(21).2022.08
A. Chemeris, I. Khudetskyy, Y. Anotova-Rafi
Abstract. Cerebral palsy is one of the most widespread nervous diseases for children [1]. From data of VOOZ annually there is growth of quantity of children with disabilities, including cerebral palsy. According to the Center for Medical Statistics of Ukraine, children with disabilities make up about 2% of the child population, thus relative majority - are children who have lost mobility due to congenital and acquired diseases and injuries of the central and peripheral nervous systems [2]. The most common form of cerebral palsy is spastic diplegia (bilateral paralysis of the same parts of the body). Children with spastic diplegia and lesions of all extremities, muscle tone of the extremities is increased, which may eventually lead to contracture. In turn, these contractures lead to persistent restrictions of active and passive movements in the joints and can be prevented or eliminated in the process of physical therapy. The analysis of the scientific literature on these issues allowed us to conclude that it is necessary to further improve existing methods of physical therapy of the cerebral palsy with spastic diplegia, which determines the relevance of this research.
{"title":"APPROACHES AND METHODS OF PHYSICAL THERAPY OF CHILDREN IN CEREBRAL PALSY WITH SPACSTIC DIPILEGIA","authors":"A. Chemeris, I. Khudetskyy, Y. Anotova-Rafi","doi":"10.31612/2616-4868.3(21).2022.08","DOIUrl":"https://doi.org/10.31612/2616-4868.3(21).2022.08","url":null,"abstract":"Abstract. Cerebral palsy is one of the most widespread nervous diseases for children [1]. From data of VOOZ annually there is growth of quantity of children with disabilities, including cerebral palsy. According to the Center for Medical Statistics of Ukraine, children with disabilities make up about 2% of the child population, thus relative majority - are children who have lost mobility due to congenital and acquired diseases and injuries of the central and peripheral nervous systems [2]. The most common form of cerebral palsy is spastic diplegia (bilateral paralysis of the same parts of the body). Children with spastic diplegia and lesions of all extremities, muscle tone of the extremities is increased, which may eventually lead to contracture. In turn, these contractures lead to persistent restrictions of active and passive movements in the joints and can be prevented or eliminated in the process of physical therapy. The analysis of the scientific literature on these issues allowed us to conclude that it is necessary to further improve existing methods of physical therapy of the cerebral palsy with spastic diplegia, which determines the relevance of this research.","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70041961","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 : 2022-08-23DOI: 10.31612/2616-4868.3(21).2022.06
V.I. Horoshko
Abstract. Early sports specialization, increased professional load, technical complexity of motor elements, lack of adequate means of rehabilitation in the training process have become the main triggers in the emergence of MNPS. The aim of the study was to study the mechanisms of development, clinical manifestations and development of the etiological system of treatment of cervical myofascial pain in the absence of actual organic pathology of the spine. Promising treatment is the use of reflexology. Effects of reflexology: analgesia, psychiatric (depression, sedation), nutrition, recovery, muscle relaxation. Conclusions: Athletes are mainly characterized by pain in the muscles that provide static work, as well as different options for the distribution of MNPS, depending on the sport. The upper and lower extremities are involved in performing active motor functions characteristic of sports. In general, local symptoms of pain were observed in 52.5% of athletes, and common - in 40.6%. At the same time, MNPS was most common in 63.4% of cases of cervical wrestlers and 58.4% of cases of lumbosacral region; in athletes, the development of myofascial disorders increases the bioelectrical activity of muscles at rest; Athletes with common symptoms have reduced control processes in the central nervous system [1]. It is characterized by an increase in multisynaptic reflex excitability at the level of the brain stem; emotional disorders in athletes in the presence of myofascial pain are characteristic in the presence of the third stage of the pathological process; the occurrence of general symptoms of MNPS according to the study leads to an increase in the average time of sensorimotor response, deterioration of motor processes and increased fatigue when performing a series of tests; MNPS treatment, which includes reflexology and PIR programs based on clinical and instrumental studies, significantly improves the athlete's condition during 12 months of follow-up.
{"title":"MYOFASCIAL NECK PAIN SYNDROME IN WRESTLING ATHLETES: PREVENTION AND RECOVERY","authors":"V.I. Horoshko","doi":"10.31612/2616-4868.3(21).2022.06","DOIUrl":"https://doi.org/10.31612/2616-4868.3(21).2022.06","url":null,"abstract":"Abstract. Early sports specialization, increased professional load, technical complexity of motor elements, lack of adequate means of rehabilitation in the training process have become the main triggers in the emergence of MNPS. The aim of the study was to study the mechanisms of development, clinical manifestations and development of the etiological system of treatment of cervical myofascial pain in the absence of actual organic pathology of the spine. Promising treatment is the use of reflexology. Effects of reflexology: analgesia, psychiatric (depression, sedation), nutrition, recovery, muscle relaxation. Conclusions: Athletes are mainly characterized by pain in the muscles that provide static work, as well as different options for the distribution of MNPS, depending on the sport. The upper and lower extremities are involved in performing active motor functions characteristic of sports. In general, local symptoms of pain were observed in 52.5% of athletes, and common - in 40.6%. At the same time, MNPS was most common in 63.4% of cases of cervical wrestlers and 58.4% of cases of lumbosacral region; in athletes, the development of myofascial disorders increases the bioelectrical activity of muscles at rest; Athletes with common symptoms have reduced control processes in the central nervous system [1]. It is characterized by an increase in multisynaptic reflex excitability at the level of the brain stem; emotional disorders in athletes in the presence of myofascial pain are characteristic in the presence of the third stage of the pathological process; the occurrence of general symptoms of MNPS according to the study leads to an increase in the average time of sensorimotor response, deterioration of motor processes and increased fatigue when performing a series of tests; MNPS treatment, which includes reflexology and PIR programs based on clinical and instrumental studies, significantly improves the athlete's condition during 12 months of follow-up.","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70041956","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 : 2022-08-23DOI: 10.31612/2616-4868.3(21).2022.05
N. Pylypenko
Purpose - to present an analysis of the theoretical foundations and practical approaches to preventing and overcoming the negative mental consequences of crisis situations in the population during the war. Material and methods -The study used the bibliographic method, as well as the method of analysis and synthesis of scientific materials from scientific sources. Results and discussion. The results of our study showed that it is important for specialists involved in the organization and provision of crisis psychological assistance to take into account that in traumatic situations, victims and their relatives are in dire need of information, social, medical and other types of assistance. Orientation is towards an integrated approach in providing assistance contributes to a more rapid recovery of the pre-crisis functional state of a person, his ability to adequately perceive reality, greater self-control of behavior in a crisis situation and a decrease in the likelihood of mental disorders and psychosomatic diseases as a result of a traumatic experience. Of particular importance in the provision of emergency psychological assistance are theoretical ideas about mental (cognitive, emotional, behavioral, etc.) changes caused by the influence of extreme, crisis situations. In the cognitive-cognitive sphere of a person, there are violations of perception, attention, thinking, memory. There are serious negative changes in volitional actions (decision-making, control, self-regulation). On the part of the emotional sphere, there are anxiety, panic states, fear, horror, aggression, anger, guilt, shame, depression, apathy, etc. Among somatovegetative disorders there are loss of appetite, sleep disturbance, a sharp weight decrease (or increase), a decrease in the overall tone of the body, flabbiness, muscle tension, trembling, etc. are observed. In behavioral manifestations, there is a general disorganization, which manifests itself in the loss of purposefulness of behavior, its controllability by a person; aimless increased activity prevails or, on the contrary, passivity, lethargy. In the sphere of social interaction, aggressive behavior, conflict, the search for the perpetrators and blaming others, alienation, social isolation, etc. are often observed. Conclusion. Being in crisis conditions and experiencing the traumatic consequences of war, a person experiences a whole range of negative emotional states. Mental processes and states experienced by a person as a result of a crisis event are characterized by the obsessive reproduction of the traumatic experience, which is embodied in symptomatic behavior, and is caused by the desire to avoid repeating the emotional experiences that took place during the traumatic event. The central idea of the vast majority of theoretical and practical approaches to overcoming the traumatic consequences of crisis events is that the use of certain psychotechniques should deprive a person of experiencing negative emotion
{"title":"THEORETICAL FOUNDATIONS AND PRACTICAL APPROACHES TO PREVENTING AND OVERCOMING THE NEGATIVE MENTAL CONSEQUENCES OF CRISIS SITUATIONS IN THE POPULATION DURING THE WAR","authors":"N. Pylypenko","doi":"10.31612/2616-4868.3(21).2022.05","DOIUrl":"https://doi.org/10.31612/2616-4868.3(21).2022.05","url":null,"abstract":"Purpose - to present an analysis of the theoretical foundations and practical approaches to preventing and overcoming the negative mental consequences of crisis situations in the population during the war. \u0000Material and methods -The study used the bibliographic method, as well as the method of analysis and synthesis of scientific materials from scientific sources. \u0000Results and discussion. The results of our study showed that it is important for specialists involved in the organization and provision of crisis psychological assistance to take into account that in traumatic situations, victims and their relatives are in dire need of information, social, medical and other types of assistance. Orientation is towards an integrated approach in providing assistance contributes to a more rapid recovery of the pre-crisis functional state of a person, his ability to adequately perceive reality, greater self-control of behavior in a crisis situation and a decrease in the likelihood of mental disorders and psychosomatic diseases as a result of a traumatic experience. \u0000Of particular importance in the provision of emergency psychological assistance are theoretical ideas about mental (cognitive, emotional, behavioral, etc.) changes caused by the influence of extreme, crisis situations. In the cognitive-cognitive sphere of a person, there are violations of perception, attention, thinking, memory. There are serious negative changes in volitional actions (decision-making, control, self-regulation). On the part of the emotional sphere, there are anxiety, panic states, fear, horror, aggression, anger, guilt, shame, depression, apathy, etc. Among somatovegetative disorders there are loss of appetite, sleep disturbance, a sharp weight decrease (or increase), a decrease in the overall tone of the body, flabbiness, muscle tension, trembling, etc. are observed. In behavioral manifestations, there is a general disorganization, which manifests itself in the loss of purposefulness of behavior, its controllability by a person; aimless increased activity prevails or, on the contrary, passivity, lethargy. In the sphere of social interaction, aggressive behavior, conflict, the search for the perpetrators and blaming others, alienation, social isolation, etc. are often observed. \u0000Conclusion. Being in crisis conditions and experiencing the traumatic consequences of war, a person experiences a whole range of negative emotional states. Mental processes and states experienced by a person as a result of a crisis event are characterized by the obsessive reproduction of the traumatic experience, which is embodied in symptomatic behavior, and is caused by the desire to avoid repeating the emotional experiences that took place during the traumatic event. The central idea of the vast majority of theoretical and practical approaches to overcoming the traumatic consequences of crisis events is that the use of certain psychotechniques should deprive a person of experiencing negative emotion","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48050130","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 : 2022-08-23DOI: 10.31612/2616-4868.3(21).2022.10
D. Krishtafor, O. Pylypenko, A.Y. Halushchak, I.O. Putko
Introduction. Rigor mortis is the tension of skeletal and smooth muscles that occurs after death and fixes the body in a certain position. It is one of the signs of biological death and usually develops in 1.5 - 3 hours, starting from the lower jaw. The full development of rigor mortis is observed in 12 - 24 hours after death. But in rare cases, its development can be significantly accelerated. Clinical case. A 34-year-old man was in the department of anesthesiology and intensive care for 4 days with a diagnosis of explosive trauma, neck injury with damage to the right carotid artery, hemispheric ischemic stroke. In the setting of multiple organ failure, moderate coma, central hyperthermia (40.3 °C), resistant to antipyretics, he went into a cardiac arrest. Resuscitation measures (including triple defibrillation) for 50 minutes were without effect. During the ascertainment of biological death, the presence of rigor mortis was noted in the lower jaw, neck and extremities, which was absent during the first 30 minutes of resuscitation and at the beginning of the asystolic rhythm. Discussion. The occurrence of rigor mortis is explained by the release of calcium ions from myocytes and the depletion of muscle adenosine triphosphate, which leads to the formation of a stable bond between actin and myosin. Instant or accelerated rigor mortis is rare. According to the literature, high body temperature, strenuous exercise before death, electric shock, convulsions and muscular dystrophy contribute to the acceleration of rigor mortis. Conclusions. In our case, the patient had severe hyperthermia (40.3 ° C), and defibrillation was performed during resuscitation, ie the body was exposed to electric current. Probably, these factors caused the accelerated development of rigor mortis.
{"title":"A CASE OF ACCELERATED RIGOR MORTIS","authors":"D. Krishtafor, O. Pylypenko, A.Y. Halushchak, I.O. Putko","doi":"10.31612/2616-4868.3(21).2022.10","DOIUrl":"https://doi.org/10.31612/2616-4868.3(21).2022.10","url":null,"abstract":"Introduction. Rigor mortis is the tension of skeletal and smooth muscles that occurs after death and fixes the body in a certain position. It is one of the signs of biological death and usually develops in 1.5 - 3 hours, starting from the lower jaw. The full development of rigor mortis is observed in 12 - 24 hours after death. But in rare cases, its development can be significantly accelerated. Clinical case. A 34-year-old man was in the department of anesthesiology and intensive care for 4 days with a diagnosis of explosive trauma, neck injury with damage to the right carotid artery, hemispheric ischemic stroke. In the setting of multiple organ failure, moderate coma, central hyperthermia (40.3 °C), resistant to antipyretics, he went into a cardiac arrest. Resuscitation measures (including triple defibrillation) for 50 minutes were without effect. During the ascertainment of biological death, the presence of rigor mortis was noted in the lower jaw, neck and extremities, which was absent during the first 30 minutes of resuscitation and at the beginning of the asystolic rhythm. Discussion. The occurrence of rigor mortis is explained by the release of calcium ions from myocytes and the depletion of muscle adenosine triphosphate, which leads to the formation of a stable bond between actin and myosin. Instant or accelerated rigor mortis is rare. According to the literature, high body temperature, strenuous exercise before death, electric shock, convulsions and muscular dystrophy contribute to the acceleration of rigor mortis. Conclusions. In our case, the patient had severe hyperthermia (40.3 ° C), and defibrillation was performed during resuscitation, ie the body was exposed to electric current. Probably, these factors caused the accelerated development of rigor mortis.","PeriodicalId":34164,"journal":{"name":"Klinichna ta profilaktichna meditsina","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48223195","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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