Nataliya Matolynets, Jacek Rolinski, K. Lishchuk-Yakymovych, Y. Tolstyak
The review focused on managing sepsis and septic shock patients by administering intravenous immunoglobulins (IVIG). Treatment outcomes and survival prognosis of septic patients were discussed in view of different regimens and dosages of IVIG. The principles of determining the appropriate dosage of IVIG in different medical facilities were compared. Own clinical case of complex treatment of septic shock using IVIG was proposed. The patient experienced a septic shock after transurethral resection of the prostate to treat a prostate abscess. Additionally, the patient was diagnosed with acute cerebrovascular disorder and various cardiovascular ailments, including type 2 diabetes mellitus and stage 2 chronic kidney disease. This septic patient was diagnosed with immunodeficiency disorder with lymphopenia, hypoproteinemia, procalcitoninemia, and significant secondary autoimmune inflammatory disorders. Despite the expected unfavorable prognosis, after comprehensive treatment with early application of moderate doses of IVIG, the patient’s condition stabilized, and organ functions remained satisfactory. Therefore, early administration of intravenous immunoglobulin had a favorable clinical outcome in the treatment of septic shock, thereby indicating the need to utilize a multidisciplinary approach, including involving an immunologist, in managing septic conditions.
{"title":"USING INTRAVENOUS IMMUNOGLOBULIN IN A PATIENT WITH SEPTIC SHOCK AND MULTIPLE COMORBIDITIES: A REVIEW BASED ON A CLINICAL CASE","authors":"Nataliya Matolynets, Jacek Rolinski, K. Lishchuk-Yakymovych, Y. Tolstyak","doi":"10.25040/ntsh2023.02.13","DOIUrl":"https://doi.org/10.25040/ntsh2023.02.13","url":null,"abstract":"The review focused on managing sepsis and septic shock patients by administering intravenous immunoglobulins (IVIG). Treatment outcomes and survival prognosis of septic patients were discussed in view of different regimens and dosages of IVIG. The principles of determining the appropriate dosage of IVIG in different medical facilities were compared. Own clinical case of complex treatment of septic shock using IVIG was proposed. The patient experienced a septic shock after transurethral resection of the prostate to treat a prostate abscess. Additionally, the patient was diagnosed with acute cerebrovascular disorder and various cardiovascular ailments, including type 2 diabetes mellitus and stage 2 chronic kidney disease. This septic patient was diagnosed with immunodeficiency disorder with lymphopenia, hypoproteinemia, procalcitoninemia, and significant secondary autoimmune inflammatory disorders. Despite the expected unfavorable prognosis, after comprehensive treatment with early application of moderate doses of IVIG, the patient’s condition stabilized, and organ functions remained satisfactory. Therefore, early administration of intravenous immunoglobulin had a favorable clinical outcome in the treatment of septic shock, thereby indicating the need to utilize a multidisciplinary approach, including involving an immunologist, in managing septic conditions.","PeriodicalId":345961,"journal":{"name":"Proceeding of the Shevchenko Scientific Society. Medical Sciences","volume":"117 20","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139163581","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}
Does science have a moral component? Today, as well as in the past, the perspectives of scientists diverge. Some scientists join political groups and work for them. They only care about financial benefits and waiving moral and ethical rules. Others take an alienated stance, arguing that science only has scientific objectives that must be addressed. They lack concern for ethical aspects and stand by the motto “science for the sake of science.” Others say it is important to have ethical rules in science and that we cannot preserve humankind and its movement towards the future without ethical and moral principles. Considering that the world is currently in the second decade of the 21st century, it is evident that it has been divided into two distinct axes: the first being democracy, with its significance to every human life, and the second being dictatorship and tyranny, where human life is deemed worthless in pursuit of a particular objective. Ukraine has become the first outpost of this division and an example for humankind, where moral and ethical rules serve as the foundation of its statehood, which it has been defending in the cruel war with the Moscow nuclear empire since 2014. Ukraine, through its centuries-old sacrifices and historical experience, has enlightened humanity with the authentic foundations of morality: the heroism of its defenders, the fervent patriotism of its people, spiritual principles, empathy, saving people and animals, aiding the needy, the volunteer movement, the humane treatment of prisoners of war, and adherence to international legal principles. Our main goal is to protect our personal freedom, which is vital for every scientist to be self-fulfilled. What is the distinction in morality/ethics between homo sovieticus and a doctor? The Hippocratic Oath has been a moral compass for all doctors for several millennia. Its essence has not changed. The Soviet government abolished the Hippocratic Oath in 1917 because it prevented their political objective of enslaving the population [1]. The Bolsheviks imposed a new healthcare system through a decree: they legalized abortions in 1920 and active euthanasia (by medical professionals) in 1922 [1,2]. The Presidium of the Verkhovna Rada reinstated the Hippocratic Oath in 1971. Called “The Oath of the Soviet Doctor,” it was meant to raise the doctor’s prestige and emphasize their duty before the Soviet state [3]. The decline of medical ethics in the Russian Federation also saw the abandonment of ancient traditions focused on the patient in the principles of medical practitioners’ activities and the continued functioning as a tool of the ruling government [4]. The oath of Russian physicians, with its patronizing and sexist language, completely disregards the rights of the patient and the physician’s responsibility to take preventive measures and fulfill their duties before society. The expert in medical ethics, Pellegrino, observed, “It’s hard to imagine a more devastating mutilat
{"title":"MORAL AND ETHICAL COMPONENT OF SCIENCE IN TIMES OF WAR","authors":"V. Chopyak, Wolodymyr P. Maksymowych","doi":"10.25040/ntsh2023.02.01","DOIUrl":"https://doi.org/10.25040/ntsh2023.02.01","url":null,"abstract":"Does science have a moral component? Today, as well as in the past, the perspectives of scientists diverge. Some scientists join political groups and work for them. They only care about financial benefits and waiving moral and ethical rules. Others take an alienated stance, arguing that science only has scientific objectives that must be addressed. They lack concern for ethical aspects and stand by the motto “science for the sake of science.” Others say it is important to have ethical rules in science and that we cannot preserve humankind and its movement towards the future without ethical and moral principles. Considering that the world is currently in the second decade of the 21st century, it is evident that it has been divided into two distinct axes: the first being democracy, with its significance to every human life, and the second being dictatorship and tyranny, where human life is deemed worthless in pursuit of a particular objective. Ukraine has become the first outpost of this division and an example for humankind, where moral and ethical rules serve as the foundation of its statehood, which it has been defending in the cruel war with the Moscow nuclear empire since 2014. Ukraine, through its centuries-old sacrifices and historical experience, has enlightened humanity with the authentic foundations of morality: the heroism of its defenders, the fervent patriotism of its people, spiritual principles, empathy, saving people and animals, aiding the needy, the volunteer movement, the humane treatment of prisoners of war, and adherence to international legal principles. Our main goal is to protect our personal freedom, which is vital for every scientist to be self-fulfilled. What is the distinction in morality/ethics between homo sovieticus and a doctor? The Hippocratic Oath has been a moral compass for all doctors for several millennia. Its essence has not changed. The Soviet government abolished the Hippocratic Oath in 1917 because it prevented their political objective of enslaving the population [1]. The Bolsheviks imposed a new healthcare system through a decree: they legalized abortions in 1920 and active euthanasia (by medical professionals) in 1922 [1,2]. The Presidium of the Verkhovna Rada reinstated the Hippocratic Oath in 1971. Called “The Oath of the Soviet Doctor,” it was meant to raise the doctor’s prestige and emphasize their duty before the Soviet state [3]. The decline of medical ethics in the Russian Federation also saw the abandonment of ancient traditions focused on the patient in the principles of medical practitioners’ activities and the continued functioning as a tool of the ruling government [4]. The oath of Russian physicians, with its patronizing and sexist language, completely disregards the rights of the patient and the physician’s responsibility to take preventive measures and fulfill their duties before society. The expert in medical ethics, Pellegrino, observed, “It’s hard to imagine a more devastating mutilat","PeriodicalId":345961,"journal":{"name":"Proceeding of the Shevchenko Scientific Society. Medical Sciences","volume":"61 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139163796","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}
Ihor Trutyak, Vasyl Malickii, Michael Samotowka, Vasyl Trunkvalter, Roman Trutyak, Vitalij Ivaschenko
Among the wounded with limb injuries admitted to the Military Medical Center of the Western region during the year of Russia’s full-scale war in Ukraine, 29% had a mine-blast injury, 47% had shrapnel wounds, 8% had gunshot bullet wounds, 1.5% – thermal injuries, and14.5% – traumatic injuries. Upper limbs were injured in 22%, lower – in 32%, 15% had two limbs injured, and 31% had combined combat trauma. In all hospitalized with multi-fragment fractures, limbs were fixed with external fixation devices. 2% of patients had vascular damage. All wounded had unhealed wounds with a soft tissue defect. The average age of patients was 30 years. There were no comorbid diseases in the wounded, and concomitant diseases that did not affect the course of injury were found in 10%. Amputations of limbs were performed in 6.5%. Traumatic separation of a limb segment or its destruction with crushed bone and non-viable soft tissues, nerve damage with significant defect, soft tissue and bone defect, as well as thermal ischemia of the limb for more than 6 hours with necrosis of its soft tissues, were indications for primary limb amputation in 3% of wounded and injured, which were in the nature of primary debridement. Progressive wound infection with the development of the septic condition of the wounded despite intensive treatment, total ischemic necrosis, and recrudescent arrosive bleeding from great vessels required a secondary limb amputation in 1.5%. In 1.5% of the wounded, staged operations were performed as re-amputations. Re-amputation had to be performed in 0.6% of patients with an inappropriate limb stump level, which complicated prosthetics. To reduce the number of amputations for secondary indications, a timely diagnosis is needed of compartment syndrome and rational treatment of soft tissue wounds and gunshot fractures with surgical and medical prevention of the infectious process.
{"title":"PROBLEMATIC ISSUES OF LIMB AMPUTATION IN WOUNDED WITH COMBAT TRAUMA","authors":"Ihor Trutyak, Vasyl Malickii, Michael Samotowka, Vasyl Trunkvalter, Roman Trutyak, Vitalij Ivaschenko","doi":"10.25040/ntsh2023.02.08","DOIUrl":"https://doi.org/10.25040/ntsh2023.02.08","url":null,"abstract":"Among the wounded with limb injuries admitted to the Military Medical Center of the Western region during the year of Russia’s full-scale war in Ukraine, 29% had a mine-blast injury, 47% had shrapnel wounds, 8% had gunshot bullet wounds, 1.5% – thermal injuries, and14.5% – traumatic injuries. Upper limbs were injured in 22%, lower – in 32%, 15% had two limbs injured, and 31% had combined combat trauma. In all hospitalized with multi-fragment fractures, limbs were fixed with external fixation devices. 2% of patients had vascular damage. All wounded had unhealed wounds with a soft tissue defect. The average age of patients was 30 years. There were no comorbid diseases in the wounded, and concomitant diseases that did not affect the course of injury were found in 10%. Amputations of limbs were performed in 6.5%. Traumatic separation of a limb segment or its destruction with crushed bone and non-viable soft tissues, nerve damage with significant defect, soft tissue and bone defect, as well as thermal ischemia of the limb for more than 6 hours with necrosis of its soft tissues, were indications for primary limb amputation in 3% of wounded and injured, which were in the nature of primary debridement. Progressive wound infection with the development of the septic condition of the wounded despite intensive treatment, total ischemic necrosis, and recrudescent arrosive bleeding from great vessels required a secondary limb amputation in 1.5%. In 1.5% of the wounded, staged operations were performed as re-amputations. Re-amputation had to be performed in 0.6% of patients with an inappropriate limb stump level, which complicated prosthetics. To reduce the number of amputations for secondary indications, a timely diagnosis is needed of compartment syndrome and rational treatment of soft tissue wounds and gunshot fractures with surgical and medical prevention of the infectious process.","PeriodicalId":345961,"journal":{"name":"Proceeding of the Shevchenko Scientific Society. Medical Sciences","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139164974","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}
Upper gastrointestinal bleeding is a common reason for presentation to the hospital. Appropriate resuscitation followed by endoscopic assessment and endotherapy for high-risk lesions (active bleeding or non-bleeding with visible vessels) forms the cornerstone of management. Pharmacological therapies are utilised at each stage of management in both variceal and non-variceal bleeding. Proton pump inhibitors and prokinetic agents can be administered pre-endoscopically with vasoactive medication and antibiotics utilised in suspected variceal bleeding. Epinephrine may be used as a temporising measure to improve visualisation during endoscopy but should not applied as a single agent. Topical endoscopic therapies have also shown promise in achieving haemostasis. Following endoscopy, a high dose of proton pump inhibitor should be given to patients who require endotherapy and vasoactive medications, and antibiotics continued in confirmed variceal bleeds. The timing of resumption of antithrombotic medication is dependent on the agent utilised and underlying thrombotic risk.
{"title":"CURRENT PHARMACOLOGICAL MANAGEMENT IN UPPER GASTROINTESTINAL BLEEDING","authors":"J. Orpen-Palmer, Adrian Stanley","doi":"10.25040/ntsh2023.02.05","DOIUrl":"https://doi.org/10.25040/ntsh2023.02.05","url":null,"abstract":"Upper gastrointestinal bleeding is a common reason for presentation to the hospital. Appropriate resuscitation followed by endoscopic assessment and endotherapy for high-risk lesions (active bleeding or non-bleeding with visible vessels) forms the cornerstone of management. Pharmacological therapies are utilised at each stage of management in both variceal and non-variceal bleeding. Proton pump inhibitors and prokinetic agents can be administered pre-endoscopically with vasoactive medication and antibiotics utilised in suspected variceal bleeding. Epinephrine may be used as a temporising measure to improve visualisation during endoscopy but should not applied as a single agent. Topical endoscopic therapies have also shown promise in achieving haemostasis. Following endoscopy, a high dose of proton pump inhibitor should be given to patients who require endotherapy and vasoactive medications, and antibiotics continued in confirmed variceal bleeds. The timing of resumption of antithrombotic medication is dependent on the agent utilised and underlying thrombotic risk.","PeriodicalId":345961,"journal":{"name":"Proceeding of the Shevchenko Scientific Society. Medical Sciences","volume":"37 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139166039","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}
T. Pastryk, Olga Gershuni, Alla Lazko, Alla Yaremko, Halyna Martyniuk, Andriy Yagensky, Volodymyr Vakin
On May 11–12, 2023, the I International Scientific Practical Conference “Doctors and Nursing – Medical Front in Ukraine and the World” took place in Lutsk, Ukraine. The conference was dedicated to the 150th anniversary of the Shevchenko Scientific Society (SSS). The conference was organized by the Municipal Institution of Higher Education Volyn Medical Institute of Volyn Region Council, in collaboration with Danylo Halytsky Lviv National Medical University, I.Y. Horbachevsky Ternopil National Medical University, Vilnius University (Lithuania), Higher Private Educational Institution Lviv Medical University, the Shevchenko Scientific Society, and Health Tech Without Borders (Switzerland, USA). The conference was held with the support of the State Institution “Center for Nursing Development of the Ministry of Health of Ukraine”. Partners in conference organization also included Volyn Orthodox Theological Academy, Maastricht University (the Netherlands), Volyn Region Emergency Medical Center and Disaster Medicine Municipal Enterprise, German-Ukrainian Association of Nurses, NeanderklinikHarzwald (Germany), “Myloserdia” Association of Volyn Nurses PO and Lviv Association of Allergists, Immunologists, and Rehabilitologists Charitable Organization. During the course of the event, a total of over 100 speeches were delivered by medical scientists and practicing physicians, as well as researchers in diverse disciplines from Ukraine, the United States, Great Britain, Poland, Lithuania, Germany, the Netherlands, and Switzerland. Workshops were conducted on relevant issues in medical practice in times of war. A total of approximately 1100 individuals participated in the conference, comprising physicians from diverse disciplines and nurses, emergency medical professionals and disaster medicine specialists, scientific and pedagogical personnel, employees of the State Emergency Service, physical rehabilitation specialists, psychologists, representatives of the clergy and public organizations, and young scientists. A new interdisciplinary format of scientific dialogue has been started between representatives of medical and nursing specialities, the education sector, psychologists, and clergy. It helps find ways to address relevant issues in the medical sector in complex conditions of the present day.
{"title":"I INTERNATIONAL SCIENTIFIC AND PRACTICAL CONFERENCE “DOCTORS AND NURSING – MEDICAL FRONT IN UKRAINE AND THE WORLD”","authors":"T. Pastryk, Olga Gershuni, Alla Lazko, Alla Yaremko, Halyna Martyniuk, Andriy Yagensky, Volodymyr Vakin","doi":"10.25040/ntsh2023.02.02","DOIUrl":"https://doi.org/10.25040/ntsh2023.02.02","url":null,"abstract":"On May 11–12, 2023, the I International Scientific Practical Conference “Doctors and Nursing – Medical Front in Ukraine and the World” took place in Lutsk, Ukraine. The conference was dedicated to the 150th anniversary of the Shevchenko Scientific Society (SSS). The conference was organized by the Municipal Institution of Higher Education Volyn Medical Institute of Volyn Region Council, in collaboration with Danylo Halytsky Lviv National Medical University, I.Y. Horbachevsky Ternopil National Medical University, Vilnius University (Lithuania), Higher Private Educational Institution Lviv Medical University, the Shevchenko Scientific Society, and Health Tech Without Borders (Switzerland, USA). The conference was held with the support of the State Institution “Center for Nursing Development of the Ministry of Health of Ukraine”. Partners in conference organization also included Volyn Orthodox Theological Academy, Maastricht University (the Netherlands), Volyn Region Emergency Medical Center and Disaster Medicine Municipal Enterprise, German-Ukrainian Association of Nurses, NeanderklinikHarzwald (Germany), “Myloserdia” Association of Volyn Nurses PO and Lviv Association of Allergists, Immunologists, and Rehabilitologists Charitable Organization. During the course of the event, a total of over 100 speeches were delivered by medical scientists and practicing physicians, as well as researchers in diverse disciplines from Ukraine, the United States, Great Britain, Poland, Lithuania, Germany, the Netherlands, and Switzerland. Workshops were conducted on relevant issues in medical practice in times of war. A total of approximately 1100 individuals participated in the conference, comprising physicians from diverse disciplines and nurses, emergency medical professionals and disaster medicine specialists, scientific and pedagogical personnel, employees of the State Emergency Service, physical rehabilitation specialists, psychologists, representatives of the clergy and public organizations, and young scientists. A new interdisciplinary format of scientific dialogue has been started between representatives of medical and nursing specialities, the education sector, psychologists, and clergy. It helps find ways to address relevant issues in the medical sector in complex conditions of the present day.","PeriodicalId":345961,"journal":{"name":"Proceeding of the Shevchenko Scientific Society. Medical Sciences","volume":"4 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139165224","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}
Introduction: Non-ossifying fibroma (NOF) is a frequent fibrotic lesion of bone, observed in up to 40% of children. Extensive NOF lesions and deficient healing may cause a pathological fracture or a malignant transformation. Prediction of complications requires knowledge of the mechanisms controlling NOF, and systemic analysis may provide insight into these mechanisms. Aim: To identify regulators that may predict the risk of complications, e.g., pathologic fracture or malignant transformation. Methods: Data were retrieved from public databases, e.g., PubMed and dedicated databases. We retrieved regulators with confirmed association with NOF, regulators of processes engaged in NOF, and regulators of bone remodelling and giant cell tumors of bone. Systemic analysis was performed using Cytoscape and FunCoup tools. Results: Networks representing NOF mechanisms, bone healing, and malignant transformation were generated. The network analysis identified mechanisms that may predict the efficacy of healing of NOF lesion or the risk of malignant transformation of NOF. Forty-one compounds were identified as potential signature predictor of the efficacy of bone healing. The list contains known and novel regulators of bone. Signalling pathways, hormones, vitamins, minerals, proliferation and differentiation regulators are in the 41 signature. We report here a list of 62 molecules that are engaged in bone tumorigenesis and in NOF, e.g., oncogenes and tumor suppressors, tumorigenesis-associated signalling pathways and hormones Deregulation of these molecules increases the risk of malignant transformation of NOF. Conclusion: The 41 and 62 signatures identify potential markers of the risk of non-efficient healing or malignant transformation of NOF.
{"title":"SYSTEMS BIOLOGY SIGNATURE FOR PROGNOSIS OF NON-OSSIFYING FIBROMA","authors":"S. Souchelnytskyi","doi":"10.25040/ntsh2023.02.07","DOIUrl":"https://doi.org/10.25040/ntsh2023.02.07","url":null,"abstract":"Introduction: Non-ossifying fibroma (NOF) is a frequent fibrotic lesion of bone, observed in up to 40% of children. Extensive NOF lesions and deficient healing may cause a pathological fracture or a malignant transformation. Prediction of complications requires knowledge of the mechanisms controlling NOF, and systemic analysis may provide insight into these mechanisms. Aim: To identify regulators that may predict the risk of complications, e.g., pathologic fracture or malignant transformation. Methods: Data were retrieved from public databases, e.g., PubMed and dedicated databases. We retrieved regulators with confirmed association with NOF, regulators of processes engaged in NOF, and regulators of bone remodelling and giant cell tumors of bone. Systemic analysis was performed using Cytoscape and FunCoup tools. Results: Networks representing NOF mechanisms, bone healing, and malignant transformation were generated. The network analysis identified mechanisms that may predict the efficacy of healing of NOF lesion or the risk of malignant transformation of NOF. Forty-one compounds were identified as potential signature predictor of the efficacy of bone healing. The list contains known and novel regulators of bone. Signalling pathways, hormones, vitamins, minerals, proliferation and differentiation regulators are in the 41 signature. We report here a list of 62 molecules that are engaged in bone tumorigenesis and in NOF, e.g., oncogenes and tumor suppressors, tumorigenesis-associated signalling pathways and hormones Deregulation of these molecules increases the risk of malignant transformation of NOF. Conclusion: The 41 and 62 signatures identify potential markers of the risk of non-efficient healing or malignant transformation of NOF.","PeriodicalId":345961,"journal":{"name":"Proceeding of the Shevchenko Scientific Society. Medical Sciences","volume":"30 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139164904","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}
M. Khmil, N.Ya. Petryshyn, Yuliia Pravak, S. Halnykina, A. Khmil Doswald, Lesia Romanchuk, Mirosław Szlachcic
Infertility is a major medical and social issue. In vitro fertilization is an advanced ART technique that helps to successfully cure infertility. Quality preparation for an IVF protocol and the subsequent pregnancy is important and should include treatment of concomitant pathology, evaluation of the condition of the uterine cavity and its optimal preparation in order to prevent reproductive failures and early obstetric losses. This study assessed the effectiveness of optimized cryoprotocols for preparation for embryo transfer in patients with infertility and the comorbid course of uterine leiomyoma and chronic endometritis. We performed clinical examination and comparative analysis of anamnestic data of 100 women with infertility and comorbid uterine leiomyoma and chronic endometritis. The patients were divided into two groups depending on the proposed treatment scheme and the outcomes were compared to a control group. In all groups, stimulation of superovulation was carried out following a short protocol with a GnRH antagonist. We determined that patients with infertility comorbid with uterine leiomyoma and chronic endometritis, when compared to the control group patients, had a history of early menarche, early onset of sexual life, a greater number of sexual partners, a greater incidence of urogenital infections, and of performed intrauterine surgical procedures. The patients in the modified treatment group received a lower mean total dose of gonadotropins, had a shorter duration of stimulation, and fewer days of anti-GnRH administration compared to the traditional treatment group. The patients in the modified treatment group also had a higher frequency of clinical pregnancy and delivery compared to those received conventional treatment. An appropriate anti-inflammatory and antibiotic therapy and comprehensive preparation of the uterine cavity for embryo transfer are key factors in the success of IVF protocols.
不孕不育是一个重大的医学和社会问题。体外受精是一种先进的 ART 技术，有助于成功治愈不孕症。体外受精方案和随后妊娠的高质量准备工作非常重要，应包括治疗并发病症、评估子宫腔状况及其最佳准备，以防止生殖失败和早期产科损失。本研究评估了针对不孕症患者以及合并子宫肌瘤和慢性子宫内膜炎病程的患者胚胎移植准备的优化冷冻方案的有效性。我们对 100 名患有不孕症并合并子宫白肌瘤和慢性子宫内膜炎的妇女进行了临床检查和异常数据对比分析。根据建议的治疗方案将患者分为两组，并将结果与对照组进行比较。在所有组别中，均采用 GnRH 拮抗剂的短期方案刺激超排卵。我们发现，与对照组患者相比，合并子宫纵膈肌瘤和慢性子宫内膜炎的不孕症患者有月经初潮早、性生活开始早、性伴侣数量多、泌尿生殖系统感染和宫腔内手术的发生率高的特点。与传统治疗组相比，改良治疗组患者接受的促性腺激素平均总剂量较低，刺激持续时间较短，服用抗 GnRH 的天数较少。与接受传统治疗的患者相比，改良治疗组患者的临床妊娠和分娩频率也更高。适当的抗炎和抗生素治疗以及胚胎移植前子宫腔的全面准备是试管婴儿方案取得成功的关键因素。
{"title":"CLINICAL RESULTS OF INFERTILITY TREATMENT IN PATIENTS WITH A COMORBIDITY OF UTERINE LEIOMYOMA AND CHRONIC ENDOMETRITIS WITH OPTIMIZATION OF CRYOPTOCOLS FOR EMBRYO TRANSFER PREPARATION","authors":"M. Khmil, N.Ya. Petryshyn, Yuliia Pravak, S. Halnykina, A. Khmil Doswald, Lesia Romanchuk, Mirosław Szlachcic","doi":"10.25040/ntsh2023.02.17","DOIUrl":"https://doi.org/10.25040/ntsh2023.02.17","url":null,"abstract":"Infertility is a major medical and social issue. In vitro fertilization is an advanced ART technique that helps to successfully cure infertility. Quality preparation for an IVF protocol and the subsequent pregnancy is important and should include treatment of concomitant pathology, evaluation of the condition of the uterine cavity and its optimal preparation in order to prevent reproductive failures and early obstetric losses. This study assessed the effectiveness of optimized cryoprotocols for preparation for embryo transfer in patients with infertility and the comorbid course of uterine leiomyoma and chronic endometritis. We performed clinical examination and comparative analysis of anamnestic data of 100 women with infertility and comorbid uterine leiomyoma and chronic endometritis. The patients were divided into two groups depending on the proposed treatment scheme and the outcomes were compared to a control group. In all groups, stimulation of superovulation was carried out following a short protocol with a GnRH antagonist. We determined that patients with infertility comorbid with uterine leiomyoma and chronic endometritis, when compared to the control group patients, had a history of early menarche, early onset of sexual life, a greater number of sexual partners, a greater incidence of urogenital infections, and of performed intrauterine surgical procedures. The patients in the modified treatment group received a lower mean total dose of gonadotropins, had a shorter duration of stimulation, and fewer days of anti-GnRH administration compared to the traditional treatment group. The patients in the modified treatment group also had a higher frequency of clinical pregnancy and delivery compared to those received conventional treatment. An appropriate anti-inflammatory and antibiotic therapy and comprehensive preparation of the uterine cavity for embryo transfer are key factors in the success of IVF protocols.","PeriodicalId":345961,"journal":{"name":"Proceeding of the Shevchenko Scientific Society. Medical Sciences","volume":"61 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139165389","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}
G. Andersen, Chin-Mei Zhao, Jon Erik Grønbech, Yijiang Chen, Oksana Zayachkivska, O. Røe, Duan Chen
This brief communication presented a dissertation of PhD thesis on translational research using state-of-the-art methods of multi-disciplinary integrations between basic and clinical research and between dry- (computational) and wet- (experimental and clinical) investigations. The findings showed possible causal association between neural innervation and tumorigenesis of gastric cancer via Wnt signaling and metabolic reprogramming within the tumor microenvironment. Accordingly, selective vagotomy, Botulinum neurotoxin type A (injection into the tumor areas), RAD001 (also known as Everolimus), CPI-613 (devimistat) and ivermectin were found to be potential for treatment of gastric cancer. The assessment showed that this translational research approach guaranteed the efficient development of novel knowledge in fundamental medical sciences, and that the identification of the role of vagal innervation and the possibilities of its modulation during gastric tumorigenesis represented valuable contributions to the fields of gastroenterology and cancer research. Possible roles of angiogenesis vs neurogenesis and brain-gut axis would be worth exploring in further research.
{"title":"CLINICAL ASPECTS IN TRANSLATIONAL RESEARCH ON GASTRIC TUMORIGENESIS AND DEVELOPMENT OF NEW TREATMENTS","authors":"G. Andersen, Chin-Mei Zhao, Jon Erik Grønbech, Yijiang Chen, Oksana Zayachkivska, O. Røe, Duan Chen","doi":"10.25040/ntsh2023.02.18","DOIUrl":"https://doi.org/10.25040/ntsh2023.02.18","url":null,"abstract":"This brief communication presented a dissertation of PhD thesis on translational research using state-of-the-art methods of multi-disciplinary integrations between basic and clinical research and between dry- (computational) and wet- (experimental and clinical) investigations. The findings showed possible causal association between neural innervation and tumorigenesis of gastric cancer via Wnt signaling and metabolic reprogramming within the tumor microenvironment. Accordingly, selective vagotomy, Botulinum neurotoxin type A (injection into the tumor areas), RAD001 (also known as Everolimus), CPI-613 (devimistat) and ivermectin were found to be potential for treatment of gastric cancer. The assessment showed that this translational research approach guaranteed the efficient development of novel knowledge in fundamental medical sciences, and that the identification of the role of vagal innervation and the possibilities of its modulation during gastric tumorigenesis represented valuable contributions to the fields of gastroenterology and cancer research. Possible roles of angiogenesis vs neurogenesis and brain-gut axis would be worth exploring in further research.","PeriodicalId":345961,"journal":{"name":"Proceeding of the Shevchenko Scientific Society. Medical Sciences","volume":"154 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139165858","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}
The seventh international symposium, SMART LION, was held on September 26, 2023. It was to celebrate the 150th anniversary of the Shevchenko Scientific Society and the 125th anniversary of the Medical Commission. The topics concerned the challenges our country faces today. Organizers of SMART LION 2023 are Professors Valentyna Chopyak, Oksana Zayachkivska, and Vassyl Lonchyna. They managed to gather almost two hundred participants offline and over a thousand guests online. Olena Lazareva, Vira Rokoshevska, Oleh Bilianskyi, Oksana Hdyria, and Oleh Fitkalo delivered their reports on the development of rehabilitation in Ukraine and its main avenues. The emergence of post-traumatic stress disorder (PTSD) is a critical challenge for contemporary Ukraine and has long been a significant obstacle for global medicine. That is the reason why Oleh Berezyuk, Head of the Mental Health Service of the UNBROKEN National Rehabilitation Center, brought up the matter of difficulties in correctly diagnosing and treating PTSD in the context of a multidisciplinary hospital, while Professor Valentyna Chopyak and MD Svitlana Zubchenko focused the attention of attendees on PTSD immune-rehabilitation. During the concluding block of the symposium, which focused on the contemporary interpretation of physical therapy and occupational therapy, as well as interprofessional education, communication, and cooperation, attendees were afforded the chance to listen to highly intriguing reports presented by Renata Roman (Canada), Ellen Godwin (USA), Karl J. Sandin (USA), David Omut (USA), and Oksana Zayachkivska (Ukraine, USA). The scientific event concluded with a round table on the future of physical therapy and rehabilitation in Ukraine, with its outcomes leading to the resolution of the seventh international symposium, SMART LION 2023.
{"title":"7TH INTERNATIONAL SYMPOSIUM “SMART LION”. REHABILITATION IN UKRAINE, SEPTEMBER 26, 2023","authors":"A. Bekesevych, Alla Lazko, Ihor Hresko","doi":"10.25040/ntsh2023.02.03","DOIUrl":"https://doi.org/10.25040/ntsh2023.02.03","url":null,"abstract":"The seventh international symposium, SMART LION, was held on September 26, 2023. It was to celebrate the 150th anniversary of the Shevchenko Scientific Society and the 125th anniversary of the Medical Commission. The topics concerned the challenges our country faces today. Organizers of SMART LION 2023 are Professors Valentyna Chopyak, Oksana Zayachkivska, and Vassyl Lonchyna. They managed to gather almost two hundred participants offline and over a thousand guests online. Olena Lazareva, Vira Rokoshevska, Oleh Bilianskyi, Oksana Hdyria, and Oleh Fitkalo delivered their reports on the development of rehabilitation in Ukraine and its main avenues. The emergence of post-traumatic stress disorder (PTSD) is a critical challenge for contemporary Ukraine and has long been a significant obstacle for global medicine. That is the reason why Oleh Berezyuk, Head of the Mental Health Service of the UNBROKEN National Rehabilitation Center, brought up the matter of difficulties in correctly diagnosing and treating PTSD in the context of a multidisciplinary hospital, while Professor Valentyna Chopyak and MD Svitlana Zubchenko focused the attention of attendees on PTSD immune-rehabilitation. During the concluding block of the symposium, which focused on the contemporary interpretation of physical therapy and occupational therapy, as well as interprofessional education, communication, and cooperation, attendees were afforded the chance to listen to highly intriguing reports presented by Renata Roman (Canada), Ellen Godwin (USA), Karl J. Sandin (USA), David Omut (USA), and Oksana Zayachkivska (Ukraine, USA). The scientific event concluded with a round table on the future of physical therapy and rehabilitation in Ukraine, with its outcomes leading to the resolution of the seventh international symposium, SMART LION 2023.","PeriodicalId":345961,"journal":{"name":"Proceeding of the Shevchenko Scientific Society. Medical Sciences","volume":"62 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139165384","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}
M. Fetsych, Natalia Igumentseva, Severyn Ferneza, R. Yarema, Natalia Volodko
Background: Ovarian cancer (OC) has the greatest mortality rate among oncogynecological diseases. Most cases are diagnosed at the peritoneal dissemination stage, resulting in radical treatment. Most cases (75%) are diagnosed in III-IV stages at the stage of peritoneal dissemination, making the radical treatment impossible. Intraoperative hyperthermic intraperitoneal chemoperfusion (HIPEC), which has ceased to be an experimental technique over the past decade, is increasingly used among the methods of combating peritoneal carcinomatosis and demonstrates an increase in recurrence-free and overall survival in advanced stages of OC. Nevertheless, certain pathophysiological aspects of the effect of HIPEC on intra-abdominal homeostasis, and therefore on the further course of the disease, have not been elucidated. However, understanding this effect may be the key to the successful application of HIPEC and predicting its efficacy in each case of OC. Objectives: To access changes in intraperitoneal homeostasis in patients with advanced OC after HIPEC procedure (as a stage of cytoreductive surgery); in particular, to evaluate changes of TNF and TGF-β expression under the influence of HIPEC and systemic chemotherapy in the OC microenvironment. Materials and methods: The study included 33 OC patients treated at Lviv Regional Cancer Centre in 2016–2020. Twelve of them received HIPEC. The primary tumor cultures and primary cultures of peritoneal mesothelium and macrophages were obtained for all patients. The cytokines TNF and TGF-β activity were determined in their conditional media. Results: The decrease of TNF and TGF-β concentrations in the drainage exudate after HIPEC was revealed compared with the same parameters in the ascitic fluid before the operation. One-hour hyperthermia of the primary culture of peritoneal ascites-associated macrophages of recurrent OC patients decreased the TNF level in conditional media. A decline was found in 10 out of 12 cases. Conclusions: HIPEC has a cytokine-modulating effect on the intra-abdominal homeostasis of patients with OC, suppressing TNF expression by peritoneal macrophages. Reduced activity of TNF in supernatants of OC primary tumor cultures was associated with higher sensitivity to chemotherapy.
{"title":"CYTOKINE-MODULATING INFLUENCE OF HIPEC ON THE INTRAPERITONEAL HOMEOSTASIS FORMATION IN PATIENTS WITH OVARIAN CANCER","authors":"M. Fetsych, Natalia Igumentseva, Severyn Ferneza, R. Yarema, Natalia Volodko","doi":"10.25040/ntsh2023.02.14","DOIUrl":"https://doi.org/10.25040/ntsh2023.02.14","url":null,"abstract":"Background: Ovarian cancer (OC) has the greatest mortality rate among oncogynecological diseases. Most cases are diagnosed at the peritoneal dissemination stage, resulting in radical treatment. Most cases (75%) are diagnosed in III-IV stages at the stage of peritoneal dissemination, making the radical treatment impossible. Intraoperative hyperthermic intraperitoneal chemoperfusion (HIPEC), which has ceased to be an experimental technique over the past decade, is increasingly used among the methods of combating peritoneal carcinomatosis and demonstrates an increase in recurrence-free and overall survival in advanced stages of OC. Nevertheless, certain pathophysiological aspects of the effect of HIPEC on intra-abdominal homeostasis, and therefore on the further course of the disease, have not been elucidated. However, understanding this effect may be the key to the successful application of HIPEC and predicting its efficacy in each case of OC. Objectives: To access changes in intraperitoneal homeostasis in patients with advanced OC after HIPEC procedure (as a stage of cytoreductive surgery); in particular, to evaluate changes of TNF and TGF-β expression under the influence of HIPEC and systemic chemotherapy in the OC microenvironment. Materials and methods: The study included 33 OC patients treated at Lviv Regional Cancer Centre in 2016–2020. Twelve of them received HIPEC. The primary tumor cultures and primary cultures of peritoneal mesothelium and macrophages were obtained for all patients. The cytokines TNF and TGF-β activity were determined in their conditional media. Results: The decrease of TNF and TGF-β concentrations in the drainage exudate after HIPEC was revealed compared with the same parameters in the ascitic fluid before the operation. One-hour hyperthermia of the primary culture of peritoneal ascites-associated macrophages of recurrent OC patients decreased the TNF level in conditional media. A decline was found in 10 out of 12 cases. Conclusions: HIPEC has a cytokine-modulating effect on the intra-abdominal homeostasis of patients with OC, suppressing TNF expression by peritoneal macrophages. Reduced activity of TNF in supernatants of OC primary tumor cultures was associated with higher sensitivity to chemotherapy.","PeriodicalId":345961,"journal":{"name":"Proceeding of the Shevchenko Scientific Society. Medical Sciences","volume":"172 S387","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139165645","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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