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Experience in using the service design in the development of nursing services in the republic of Kazakhstan 服务设计在哈萨克斯坦共和国护理服务发展中的应用经验
Pub Date : 1900-01-01 DOI: 10.56936/18290825-2022.16.3-43
A. Masharipova, G. Derbissalina, D. Zhunussova, G. Nagashybek, D. Amangeldiyeva
Background. Service design is the activity of planning and implementing changes in medical organizations to improve the quality of medical services. In Europe and the USA, service design is widespread in many large multidisciplinary medical centers. Study design. This article is a description of the experience.Methods. The authors described their own experience of using service design in the field of nursing in a private medical center in Astana.Results. The team from the Astana Medical University chose the topic: “increasing the level of satisfaction of patients with chronic diseases with the quality of nursing care in the organization of primary health care.” We used ready-made tools, reflecting their ideas on paper, flipcharts, posters and stickers. Direct data collection (interviewing and observation) by our team was carried out within one month. The planned number of patients and nurses was 10 people each. The interview focused on the subjective experience of the interviewed patients and nurses, revealing their beliefs, attitudes, level of trust and quality of communication with each other. Then the facilitators collected the completed forms and summed up the results. Thus, the focus of attention was shifted towards the low level of communication skills of nurses, taking into account the repeated complaints of patients about the lack of information about upcoming manipulations (tests, operations, diet, etc.), diseases in general, methods of self-care; lack of empathy and medical ethics. The new goal was aimed at increasing patient satisfaction with the communication skills of polyclinic nurses. To solve this problem, it was decided to conduct a two-hour express training among the nurses of the polyclinic to improve the communication skills of nurses by implementing the NURSE protocol. Conclusions. Service design has been applied for the first time in the healthcare industry of Kazakhstan as an innovative tool for improving patient-centered nursing care.
背景。服务设计是在医疗机构中规划和实施变革以提高医疗服务质量的活动。在欧洲和美国,服务设计在许多大型多学科医疗中心广泛存在。研究设计。本文是对经验方法的描述。作者介绍了自己在阿斯塔纳一家私人医疗中心护理领域使用服务设计的经验。来自阿斯塔纳医科大学的研究小组选择的主题是:“在初级卫生保健组织中提高慢性病患者对护理质量的满意度。”我们使用现成的工具,在纸上、挂图、海报和贴纸上反映他们的想法。我们团队在一个月内进行了直接的数据收集(访谈和观察)。计划的病人和护士人数分别为10人。访谈侧重于访谈患者和护士的主观体验,揭示他们的信念、态度、相互信任的程度和沟通的质量。然后主持人收集完成的表格并总结结果。因此,考虑到患者一再抱怨缺乏关于即将进行的操作(检查、手术、饮食等)、一般疾病、自我护理方法的信息,将注意力的焦点转向护士的沟通技能水平低下;缺乏同理心和医德。新目标旨在提高病人对综合诊所护士沟通技巧的满意度。为了解决这一问题,我们决定对综合诊所的护士进行两小时的快速培训,通过实施护士协议来提高护士的沟通能力。结论。服务设计作为一种创新的工具,首次应用于哈萨克斯坦的医疗保健行业,以改善以患者为中心的护理。
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引用次数: 0
Laparoscopic hand-assisted donor heminephrectomy in living donor with horseshoe kidney. Case study 腹腔镜手辅助马蹄肾活体供者半肾切除术。案例研究
Pub Date : 1900-01-01 DOI: 10.56936/18290825-2022.16.3-65
B. Baimakhanov, A. Chormanov, I. Madadov, E. Belgibaev, E.S. Nabiev, Zh.M. Syrymov, B.G. Rgebaev, N. Saduakas, I. Sagatov
Report of our clinical case of laparoscopic hand-assisted donor heminephrectomy in living donor with horseshoe kidney (Horseshoe kidne) has a good innovation in donor kidney retrieval technique and particularly in case of congenital anomalies.Kidney transplantation is a “gold standard” of treatment of chronic kidney disease in terminal stage. Nowadays there is a strong deficit of donor organs. Due to undeveloped cadaveric kidney transplantation we always try to accept donors with different anatomic particularities. In our practice we perform traditionally laparoscopic hand-assisted donor nephrectomy either in case of single artery and vein or multiple vessels.This case is a report of kidney transplantation from 65 –years old woman for her 39-years old son with end-stage renal disease (ESRD). Technical challenge was due to that donor had a Horseshoe kidne with parenchymal isthmus, with 4 arteries on right half and 2 arteries on the left with retrocaval position of the latters.We performed literature review for similar cases and found out that usually open laparotomy was performed in this patients. So we decided not to change the familiar for us technique in this case also. Donor underwent laparoscopic hand-assisted donor heminephrectomy with subsequent successful implantation of graft and immediate function.
本文报道了腹腔镜手辅助马蹄肾活体供体半肾切除术的临床病例,在供肾回收技术上有很好的创新,特别是在先天性异常的情况下。肾移植是治疗晚期慢性肾病的“金标准”。现在供体器官严重缺乏。由于尸体肾移植的不成熟,我们总是尝试接受具有不同解剖特征的供体。在我们的实践中,我们进行传统的腹腔镜手辅助供体肾切除术,无论是单动脉和静脉或多血管。这是一个65岁的妇女为她39岁的终末期肾病(ESRD)的儿子进行肾移植的病例报告。技术上的挑战是由于供者的马蹄肾有实质峡部,右半部分有4条动脉,左侧有2条动脉,后者位于腔后位置。我们对类似病例进行了文献回顾,发现该患者通常采用开腹手术。所以我们决定在这种情况下也不改变我们熟悉的技术。供体行腹腔镜手辅助供体半肾切除术,移植成功,即刻恢复功能。
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引用次数: 0
Evaluation of pharmacist interventions as part of a multidisciplinary pain management team 评估药剂师干预作为多学科疼痛管理团队的一部分
Pub Date : 1900-01-01 DOI: 10.56936/18290825-2022.16.3-100
A. Barseghyan, L. Nazaryan, Simonyan
Pharmacists have an important role within the healthcare system. They can offer some services to the patients including consultation, patient education and therapeutic management. Community pharmacists can assess the type and severity of pain, monitor treatment and guide medication regulation to improve the treatment of the pain. The involvement of pharmacists in nonprescription medication counseling about pain will increase the public’s ability to understand the risks and benefits of over-the-counter drugs.Aim and objects was to study and analyze professional abilities and role of pharmacy employees during the pain management. The survey was conducted among 285 employees of licensed pharmacies in Armenia with the help of questionnaires, the number of which was determined according to “The Survey System Version 11.0”. Survey data were entered and analyzed using SPSS software package. The study was quantitative investigation and the questionnaire was developed based on the World Health Organization standard questionnaire. As a result of our research, it became clear that pharmacists have pure, indistinct knowledge about adverse reactions of over-the-counter analgesics and pharmacy employees in the Republic of Armenia have incomplete knowledge and ideas about pain management. According to the study pharmacists’ information sources was not reliable and the use of these sources in professional pharmaceutical practice were not inappropriate. Involvement of pharmacists in primary care pain management is very important and pain management training of pharmacy staffs should be encouraged.Pharmacist should be a part of a multidisciplinary pain management team and for this reason comprehensive information on pain management as well as development of practical skills should be included in continuing education programs for pharmacists.
药剂师在医疗保健系统中扮演着重要的角色。他们可以为患者提供咨询、患者教育和治疗管理等服务。社区药师可以评估疼痛的类型和严重程度,监测治疗情况,指导用药调节,提高疼痛的治疗效果。药剂师参与有关疼痛的非处方药物咨询将提高公众了解非处方药的风险和益处的能力。目的和对象是研究和分析药学人员在疼痛管理中的专业能力和作用。该调查是在亚美尼亚持牌药店的285名员工中进行的,调查问卷的数量根据“调查系统11.0版”确定。使用SPSS软件包对调查数据进行录入和分析。本研究采用定量调查法,根据世界卫生组织标准问卷编制问卷。我们的研究结果表明,药剂师对非处方镇痛药的不良反应有纯粹的、模糊的了解,而亚美尼亚共和国的药房员工对疼痛管理的知识和想法不完整。根据研究,药师的信息来源不可靠,在专业药学实践中使用这些信息来源并非不适当。药师参与初级保健疼痛管理非常重要,应鼓励对药学人员进行疼痛管理培训。药剂师应该是多学科疼痛管理团队的一部分,因此,关于疼痛管理的综合信息以及实用技能的发展应该包括在药剂师的继续教育计划中。
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引用次数: 0
The explorat ion of inflammat ory and coagulation biomarkers between pregnantwomen with andwithout COVID-19 感染和未感染COVID-19的孕妇炎症和凝血生物标志物的探讨
Pub Date : 1900-01-01 DOI: 10.56936/18290825-2022.16.2-25
M. P. Wardhana, D. Tumangger, H. J. Juwono, E. Ernawati, S. Rifdah, I. A. Wafa, K. Kuntaman, E. G. Dachlan
Objectives: to assess the effect-related inflammatory and coagulation biomarkers in pregnancy and their connection with the coronavirus disease of 2019 (COVID-19). Methods: A prospective case-control study was carried out among normal third-trimester pregnant women admitted to the labor room of Dr. Soetomo General Academic Hospital between January until June 2021. Two classified groups of patients were established in accordance with the result of the RT-PCR test. Demographic, clinical and laboratory results data of the two groups were collected and compared. Results: Platelet-to-lymphocyte ratio (PLR) was shown to be the only significant biomarkers found in the expectant with COVID-19, which was 35.8% higher compared to the ones free of COVID-19 [212.25 (157.57-269.37) vs 156.29 (128.55-195.3), p=0.048]. Logistic regression analysis of PLR between groups showed that the level of PLR was an independent factor in pregnant women with COVID-19 (OR 4.483, 95%CI 1.262-15.926). The ROC analysis showed that the PLR cut-off among the expectant was 171.335, with both sensitivity and specificity were 66.7% (p=0.021). The result shows no significant differences in leukocyte count, absolute neutrophils – lymphocyte count and percentage, neutrophil-to-lymphocyte ratio (NLR) and D-Dimer level between pregnant women infected with COVID-19 and free of the virus (p>0.05). Conclusion: Intriguingly, physiological adaptation during the course of the third trimester of pregnancy found no difference in most inflammation and coagulation markers, both in the condition of infected COVID-19 or not. The evidence from this single-centre study supports the viewpoint that elevated PLR was associated with independent biomarkers and thereby might be helpful to detect expectant with COVID-19.
目的:评估妊娠期炎症和凝血相关生物标志物及其与2019年冠状病毒病(COVID-19)的关系。方法:对2021年1月至6月在苏托莫综合学术医院产房就诊的正常妊娠晚期孕妇进行前瞻性病例对照研究。根据RT-PCR检测结果将患者分为两组。收集两组患者的人口学、临床及实验室结果资料进行比较。结果:血小板与淋巴细胞比值(PLR)是孕妇中唯一显著的生物标志物,与未感染COVID-19的孕妇相比,PLR高35.8% [212.25 (157.57-269.37)vs 156.29 (128.55-195.3), p=0.048]。各组间PLR的Logistic回归分析显示,PLR水平是感染新冠肺炎孕妇的独立影响因素(OR 4.483, 95%CI 1.262 ~ 15.926)。ROC分析显示孕妇的PLR截止值为171.335,敏感性和特异性均为66.7% (p=0.021)。结果显示,感染孕妇白细胞计数、绝对中性粒细胞-淋巴细胞计数和百分比、中性粒细胞/淋巴细胞比值(NLR)和d -二聚体水平与未感染孕妇无显著差异(p>0.05)。结论:有趣的是,无论是否感染COVID-19,妊娠晚期的生理适应在大多数炎症和凝血标志物上都没有差异。这项单中心研究的证据支持这样的观点,即PLR升高与独立的生物标志物有关,因此可能有助于检测COVID-19的孕妇。
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引用次数: 0
Evaluation of the comparative efficacy of the control of arterial hypertension and improvement of the quality of life of patients with arterial hypertension after coronavirus infection using various regimens of three-component antihypertensive therapy 评价三组份降压治疗不同方案对冠状病毒感染后动脉高血压患者控制动脉高血压和改善生活质量的比较疗效
Pub Date : 1900-01-01 DOI: 10.56936/18290825-2022.16.3-58
O. Kryuchkova, I. Klyaritskaya, E. Itskova, E. V. Maksimova, E.Yu. Turna, Y. Lutai, E. A. Kostyukova
In patients who have undergone coronavirus infection, decompensation of the course of chronic cardiovascular diseases, including arterial hypertension, is often observed, which is due to a number of their common pathogenetic mechanisms.To evaluate the comparative effectiveness of controlling arterial hypertension and improving the quality of life who underwent a new coronavirus infection.Totally 62 patients with arterial hypertension who had previously undergone coronavirus infection were examined. The criterion for inclusion in the study was a decrease in blood pressure control on the background of previously effective two-component therapy. Depending on the heart rate at rest, the patients were divided into two groups. In both groups, triple antihypertensive therapy was used as a second step. In the first group - a combination of perindopril 5 mg, indapamide 2.5 mg, amlodipine 5 mg. The second group included patients with a heart rate of more than 80 beats per minute, perindopril 5 mg, bisoprolol 5 mg, amlodipine 5 mg. The antihypertensive efficacy of the studied drug combinations was analyzed according to the data of 24-hour blood pressure monitoring. During the treatment of arterial hypertension, the dynamics of quality-of-life indicators was analyzed.A study of 24-hour monitoring and blood pressure variability in both groups of patients with coronavirus infection demonstrated the lack of effective blood pressure control. The use of the analyzed variants of three-component therapy made it possible to achieve the target level of blood pressure in 89.6% and 93.9% of cases, respectively. In both study groups, the achievement of office blood pressure control was accompanied by a statistically significant decrease in all its daily parameters.On the background of antihypertensive therapy in both groups of the study, there was a significant and reliable (p<0.05) increase in all parameters for assessing the quality of life, which reflects the effectiveness of the treatment of arterial hypertension in patients who have had a coronavirus infection in increasing satisfaction with their lives and improving social functioning.Therapy with the use of perindopril, bisoprolol, amlodipine was accompanied by the achievement of significantly (p<0.05) higher rates of mental and physical health components.
在冠状病毒感染的患者中,经常观察到慢性心血管疾病(包括动脉高血压)的代偿失代偿,这是由于它们的一些共同的发病机制。评价新型冠状病毒感染患者控制高血压和改善生活质量的比较效果。对62例既往冠状病毒感染的高血压患者进行了检查。纳入研究的标准是在先前有效的双组分治疗背景下血压控制下降。根据静息时的心率,将患者分为两组。在两组中,三联抗高血压治疗作为第二步。在第一组-培哚普利5毫克,吲达帕胺2.5毫克,氨氯地平5毫克的组合。第二组包括心率超过每分钟80次的患者,培哚普利5毫克,比索洛尔5毫克,氨氯地平5毫克。根据24小时血压监测数据,分析所研究药物组合的降压效果。在动脉性高血压治疗期间,分析生活质量指标的动态变化。一项对两组冠状病毒感染患者的24小时监测和血压变异性的研究表明,缺乏有效的血压控制。使用所分析的三组分治疗变体,分别有89.6%和93.9%的病例可以达到目标血压水平。在两个研究组中,办公室血压控制的实现伴随着其所有日常参数的统计显着下降。在两组患者均接受降压治疗的背景下,评估生活质量的所有参数均有显著且可靠(p<0.05)的提高,这反映了冠状病毒感染后动脉高血压患者治疗在提高生活满意度和改善社会功能方面的有效性。使用培哚普利、比索洛尔、氨氯地平治疗可显著提高患者身心健康指标(p<0.05)。
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引用次数: 0
Palliative Care: A Concept Analysis 姑息治疗:概念分析
Pub Date : 1900-01-01 DOI: 10.56936/18290825-2022.16.2-111
S. Alarsan, N.. Fa'ous, N. Alkhateeb
Objective: Palliative care is a defined medical specialty, and it is focused on helping patients and families who are facing serious illness achieve the best possible quality of life. Despite the extensive literature available about palliative care, it still has imprecise due to its involvement in different specialties and disciplines of healthcare. Therefore, it is crucial to clarify what is meant by palliative care and defines its defining attributes, antecedents and consequences. Method: This study adopted Walker and Avant’s concept analysis approach for analyzing palliative care concept. A thorough literature search was performed in PubMed, CINAHL and Embase databases during the period (1970-2021). A total of 17 articles were reviewed and used to achieve the study objective. Result: After reviewing the screened articles, the study formulated a definition of palliative care as the meaningful and intentional holistic care of patients suffering from terminal illnesses caused by acknowledging and minimize symptoms that would deter the patients’ quality of life while achieving patient dignity by utilizing compassion and support. The study revealed that the defining attributes of palliative care include Holistic, compassion, support, individualized, realistic care. Conclusion: Palliative care was identified as holistic, compassion, supportive and individualized realistic care provided for patients suffering serious illness in order to achieve the desired level of quality of life.
目的:姑息治疗是一种明确的医学专业,它的重点是帮助面临严重疾病的患者和家庭实现尽可能高的生活质量。尽管关于姑息治疗有广泛的文献,但由于它涉及不同的专业和医疗保健学科,它仍然不精确。因此,至关重要的是澄清什么是姑息治疗,并定义其定义属性,前因和后果。方法:本研究采用Walker和Avant的概念分析法对姑息治疗概念进行分析。在PubMed、CINAHL和Embase数据库(1970-2021)中进行了全面的文献检索。为了达到研究目的,共回顾和使用了17篇文章。结果:在回顾筛选的文章后,本研究将姑息治疗定义为对患有绝症的患者进行有意义和有意的整体护理,通过承认和减少影响患者生活质量的症状,同时利用同情和支持实现患者尊严。研究表明,姑息治疗的定义属性包括整体、同情、支持、个性化和现实护理。结论:姑息治疗是为患有严重疾病的患者提供全面、同情、支持和个性化的现实护理,以达到预期的生活质量水平。
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引用次数: 0
Potential drugs against multidrug resistant bacteria from ocimum tenuiflorum: An in silico analysis 苦楝多药耐药细菌的潜在药物:计算机分析
Pub Date : 1900-01-01 DOI: 10.56936/18290825-2022.16.3-49
A. P. Mohideen, K. Shamna
Antimicrobial resistance is a global concern threatening the whole world. Antimicrobial resistance pathogens cause more than two million illnesses and nearly 23000 deaths per year in the United States. аntimicrobial resistance is linked to roughly 25,000 fatalities per year in Europe. The economic effects of аntimicrobial resistance are significant, with an estimated $20 billion in extra medical spending in the United States each year. This leads to necessity for development of novel antimicrobial agents from various sources. Ocimum tenuiflorum is a popular plant with several biological properties. The present study focuses on investigating the antibacterial potential of the compounds present in Ocimum tenuiflorum by in silico techniques. Initially, compounds were screened for druglikeness analysis based on Lipinski rule of five (RO5). Molecular docking was performed against bacterial DNA gyrase and ligand interactions on the binding sites of the target protein was examined. PASS prediction for antibacterial activity was determined. From the analysis of 22 compounds, we identified four compounds showing higher binding energies, binding site interaction, druglikeness and PASS property. Thus, the compounds Apigenin, Gardenin B, Isothymusin and Cirsilineol can be used for treatment of multidrug resistance bacterial infections.
抗菌素耐药性是一个全球性问题,威胁着全世界。在美国,抗菌素耐药性病原体每年导致200多万人患病,近2.3万人死亡。在欧洲,抗生素耐药性每年与大约2.5万人死亡有关。抗生素耐药性的经济影响是显著的,据估计,美国每年的额外医疗支出为200亿美元。这导致需要从各种来源开发新的抗菌剂。芦笋是一种广受欢迎的植物,具有多种生物学特性。本研究主要利用硅片技术对芦花中所含化合物的抑菌潜力进行研究。首先,根据Lipinski五法则(RO5)筛选化合物进行药物相似性分析。对细菌DNA旋切酶进行分子对接,并检测靶蛋白结合位点上配体的相互作用。对其抗菌活性进行PASS预测。从22个化合物的分析中,我们发现4个化合物具有较高的结合能、结合位点相互作用、药物相似性和PASS特性。因此,芹菜素、栀子苷B、异胸腺素和茜草烯醇等化合物可用于治疗多重耐药细菌感染。
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引用次数: 0
Application of polyhexanide as a new highly effective antiseptic composition 聚己胺作为一种新型高效防腐组合物的应用
Pub Date : 1900-01-01 DOI: 10.56936/18290825-2022.16.1-58
A. Kulikova, Z. Khabadze, Yu. A. Generalova, R. F. Mokhamed El-Khala, D. Nazarova, Ya. A. Yollybayev
Currently, antiseptics are used at all stages of surgical treatment. Currently, the search continues for antiseptics that have effective properties in suppressing pathological microflora and as safe as possible in relation to tissues. One of the promising antiseptic solutions is a solution based on polyhexanide. The aim of this work was to study the available reports on the effectiveness of the polyhexanide solution, its safety, and experience of use.To assess the effectiveness of using a polyhexonide solution as an antiseptic, a search was made for publications in the scientific databases “PubMed” and “Google Scholar”.A total of 2026 scientific articles were found during the search. When studying the content of the texts, 31 articles were accepted for consideration, corresponding to the given criteria.Polyhexanide solution is widely used in surgical practice. In wound healing, antiseptic treatment is one of the key steps. The suppression of the reproduction of pathological microflora and the effect on the biofilm is extremely important. When analyzing the publications, different results were noted using the polyhexanide solution.Studies of the effectiveness of the polyhexanide solution are currently being actively pursued. Due to its significant efficacy, safety, and ease of use, polyhexamethylene biguanide is promising for use in surgical practice.
目前,杀菌剂用于手术治疗的各个阶段。目前,对防腐剂的研究仍在继续,这些防腐剂在抑制病理性微生物群方面具有有效的特性,并且对组织尽可能安全。一种很有前途的防腐解决方案是基于聚己烷的解决方案。本研究的目的是研究现有的关于聚己烷溶液的有效性、安全性和使用经验的报告。为了评估使用聚己醇溶液作为防腐剂的有效性,在科学数据库“PubMed”和“谷歌Scholar”中对出版物进行了搜索。在检索过程中,共发现了2026篇科学论文。在研究案文的内容时,根据所给的标准接受了31条供审议。聚己胺溶液在外科实践中应用广泛。在伤口愈合中,消毒处理是关键步骤之一。抑制病理性菌群的繁殖和对生物膜的影响是非常重要的。在分析出版物时,使用聚己烷溶液注意到不同的结果。目前正在积极研究聚己烷溶液的有效性。由于其显著的疗效、安全性和易用性,聚己二胍在外科实践中有很大的应用前景。
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引用次数: 0
Physicochemical indicators of dental patient saliva who have undergone an uncomplicated coronavirus infection 单纯冠状病毒感染牙科患者唾液理化指标分析
Pub Date : 1900-01-01 DOI: 10.56936/18290825-2022.16.1-43
N. G. Sarkisyan, N. Kataeva, A. Akhmetova, A.R. Kukhareva, N. S. Chumakov, K. A. Khlystova, S. Melikyan
Today, it has been proven that saliva is the main medium through which the new COVID-19 coronavirus infection spreads. Since the oral cavity is the gateway for the SARS-CoV-2 virus, the degree of change in the physicochemical parameters of the saliva of people who have had coronavirus infection compared to people who have not had COVID-19 is of interest.This study involved dental patients of the first and second health groups with a history of chronic generalized periodontitis of moderate degree in the stage of remission. We studied physicochemical parameters of saliva such as pH, surface tension and base buffering capacity. The results of this stage of the study showed saliva acidification, that is a decrease in pH in people who had had a new coronavirus infection compared to the indicators of people from the control group. The average values of the surface tension of saliva in patients of the control group are 30% less than in those who have had COVID-19. This indicates that the saliva of people who have not been sick with the new coronavirus contains more surface-active agents (surfactants). Surfactants provide rinsing and disinfecting functions of saliva, therefore, it can be concluded that these functions are less pronounced in patients who have recovered from COVID-19. The base buffering capacity of the saliva of patients who have had COVID-19 is, on average, 35% higher than that of people from the control group. Thus, the pH and the base buffering capacity are in correlation: the lower the pH value, the higher the acidity of the saliva and the higher the base buffering capacity is.At the second stage of the study, similar physicochemical parameters of patients’ saliva were measured after the application of an oral spray containing a synthetic peptide (ZP2) of the active center of granulocyte-macrophage colony-stimulating factor. This spray was used as an antibacterial therapy for the oral cavity after professional hygiene of patients. In 5 minutes after spray irrigation, an increase in saliva pH was observed in all test subjects within the physiological norm. In patients, regardless of their anamnesis, the surface tension of saliva changed in different ways. In a number of people, it increased, which indicates an increase in the concentration of surfactants in saliva, while in others it decreased, which can be explained by the high rate of penetration of surfactants from saliva through the gums into the blood. After the application of the ZP-2 peptide, the base buffering capacity of saliva decreases or remains unchanged. In patients of the control group, the indicators of the base buffering capacity of saliva change less than in patients who have undergone COVID-19.All the studied physicochemical parameters of saliva in patients who had had uncomplicated COVID-19, three months after receiving two negative results for the SARS-CoV-2 virus, remained within the physiological norm.
今天,已经证明唾液是新型COVID-19冠状病毒感染传播的主要媒介。由于口腔是SARS-CoV-2病毒的门户,因此与未感染COVID-19的人相比,感染冠状病毒的人唾液的理化参数变化程度令人感兴趣。本研究涉及第一健康组和第二健康组有中度慢性广泛性牙周炎缓解期病史的牙科患者。我们研究了唾液的理化参数,如pH值、表面张力和碱缓冲能力。这一阶段的研究结果显示,与对照组相比,感染了新型冠状病毒的人的唾液酸化,即pH值下降。对照组患者的唾液表面张力平均值比COVID-19患者低30%。这表明未感染新型冠状病毒的人的唾液含有更多的表面活性剂(表面活性剂)。表面活性剂具有唾液的冲洗和消毒功能,因此可以得出结论,这些功能在COVID-19康复患者中不太明显。新冠肺炎患者唾液的基础缓冲能力平均比对照组高35%。因此,pH值与碱的缓冲能力是相关的,pH值越低,唾液的酸度越高,碱的缓冲能力越高。在研究的第二阶段,在使用含有粒细胞-巨噬细胞集落刺激因子活性中心合成肽(ZP2)的口服喷雾剂后,测量了患者唾液的类似理化参数。该喷雾剂用于患者专业卫生后的口腔抗菌治疗。喷灌后5分钟,所有受试者唾液pH值均在生理规范范围内升高。在患者中,不管他们是否健忘症,唾液的表面张力以不同的方式改变。在一些人身上,它增加了,这表明唾液中表面活性剂的浓度增加了,而在另一些人身上,它减少了,这可以解释为表面活性剂从唾液通过牙龈进入血液的高渗透率。使用ZP-2肽后,唾液的碱缓冲能力降低或保持不变。在对照组患者中,唾液基础缓冲能力指标的变化小于新冠肺炎患者。在两次SARS-CoV-2病毒检测阴性3个月后,未合并COVID-19患者唾液的所有理化参数均保持在生理规范范围内。
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引用次数: 0
Influence of changes in the intestinal microbiome on the course and progression of metabolically associated fatty liver disease 肠道微生物组的变化对代谢相关脂肪肝疾病的过程和进展的影响
Pub Date : 1900-01-01 DOI: 10.56936/18290825-2022.16.2-38
E. V. Maksimova, I. L. Kliaritskaia, E. Stilidi, E. I. Grigorenko, Y. Moshko
Introduction: The frequency of detection of metabolically associated fatty liver disease in the population of developed countries is becoming a non-infectious pandemic, the growth drivers of which are obesity and diabetes mellitus. Currently, metabolically associated fatty liver disease occupies a firm position in the list of the most common liver diseases all over the world. Chronic liver diseases are accompanied by pronounced pathological changes in the composition of the human microflora, manifested by a deficiency of obligate microorganisms and microbial contamination of the small intestine, which requires a long-term therapeutic correction aimed at normalizing the gut microflora.Objective: to study the impact of the intestinal microbiome disorders on the course and progression of metabolically associated fatty liver disease.Materials and methods. The study included 105 patients with metabolically associated fatty liver disease. The diagnosis of metabolically associated fatty liver disease was exhibited on the basis of proven liver steatosis in combination with one of the following criteria: overweight/obesity, type 2 diabetes/insulin resistance syndrome, signs of metabolic dysregulation. Patients underwent a comprehensive clinical and laboratory study. The stage of liver fibrosis was determined using ultrasound elastography (Fibroscan). The study of the intestinal microbiome was carried out using the method of gas chromatography-mass spectrometry.Results and its discussion. It was found that 68.6% of the cases of metabolically associated fatty liver disease were associated with obesity, 27.6% - with overweight body mass. It was revealed that in most patients there was an increase in ALT level, a violation of lipid metabolism (increased levels of total cholesterol, LDL and triglycerides, as well as a decrease in HDL levels), the development of insulin resistance syndrome. Violation of the of the intestinal microflora was revealed in 71.4% of patients. Patients with impaired intestinal microflora have higher levels of ALT, cholesterol, LDL, triglycerides, HOMA-index and lower levels of HDL, higher stage of fibrosis compared to the group without impaired intestinal microflora.Conclusion. Disruption of the intestinal microflora occurs in the majority of patients with metabolically associated fatty liver disease and has a negative impact on the course (leading to more pronounced lipid metabolism disorders, higher ALT and HOMA index levels), as well as the progression of metabolically associated fatty liver disease (leading to a higher stage of fibrosis).
在发达国家的人群中,代谢相关脂肪肝的检测频率正在成为一种非传染性大流行,其增长驱动力是肥胖和糖尿病。目前,代谢性脂肪性肝病在世界范围内最常见的肝脏疾病中占有稳固的地位。慢性肝病伴随着人体微生物群组成的明显病理变化,表现为专性微生物的缺乏和小肠的微生物污染,这需要长期的治疗纠正,旨在使肠道微生物群正常化。目的:研究肠道菌群紊乱对代谢性脂肪肝病程和进展的影响。材料和方法。该研究包括105名患有代谢相关脂肪肝的患者。代谢相关脂肪性肝病的诊断是基于肝脏脂肪变性并符合以下标准之一:超重/肥胖、2型糖尿病/胰岛素抵抗综合征、代谢失调的迹象。患者接受了全面的临床和实验室研究。采用超声弹性成像(Fibroscan)确定肝纤维化分期。采用气相色谱-质谱联用技术对肠道菌群进行研究。结果及其讨论。研究发现,68.6%的代谢性脂肪肝病例与肥胖有关,27.6%与体重超重有关。结果显示,在大多数患者中,ALT水平升高,脂质代谢紊乱(总胆固醇、低密度脂蛋白和甘油三酯水平升高,高密度脂蛋白水平下降),并出现胰岛素抵抗综合征。71.4%的患者存在肠道菌群违规。肠道菌群受损患者的ALT、胆固醇、LDL、甘油三酯、homa -指数水平较高,HDL水平较低,纤维化分期较高。大多数代谢性脂肪肝患者发生肠道菌群破坏,并对病程(导致更明显的脂质代谢紊乱,ALT和HOMA指数水平升高)以及代谢性脂肪肝疾病的进展(导致更高阶段的纤维化)产生负面影响。
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引用次数: 1
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THE NEW ARMENIAN MEDICAL JOURNAL
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