Pub Date : 2024-07-18DOI: 10.31612/2616-4868.5.2024.09
Nellia O. Kotyk, Yurii B. Yashchenko
Introduction. The relevance of the necessity to review approaches to the organization of the existing system for providing cosmetology services to the population is driven by the rapid increase in cosmetology service providers and the high demand for these services. This occurs under conditions of an imperfect regulatory framework governing the provision of aesthetic, cosmetic, and cosmetology services and their list, the absence of standards for their delivery, the treatment of complications, and the training of qualified medical personnel. Aim. To develop an enhanced model for organizing the provision of aesthetic, cosmetic, and cosmetology medical services to the population. Materials and methods. The study was conducted through a systematic approach and analysis using the bibliosemantic method and content analysis. Results. The development of the conceptual model for providing cosmetology services to the population is based on the findings of domestic scientists, which include a comparative legal analysis of the cosmetology service market in Ukraine and other countries worldwide. In developing the model, a differentiation of medical services in the cosmetology market into aesthetic, cosmetic, and cosmetology medical services was carried out by identifying their distinct characteristics. Due to the absence of a clear list of cosmetology services in the healthcare sector, we relied on the National Classifier of Types of Economic Activity and the State Classifier of Products and Services for classification. In determining providers of cosmetology services and their functions, we referred to the directory of qualification characteristics of healthcare professionals. The system's conceptual model for providing cosmetology services to the population is positioned as a cluster model, which encompasses organizational and methodological aspects and is based on the triad of medical science, practice, and education. Conclusions. A conceptual model for the system of providing cosmetology services to the population has been developed based on the classification of types of medical activities of service providers using the principles of systemic and socio-engineering approaches. The expected outcomes of its implementation should include: improvement in the quality of cosmetology services provided to the population, provision of highly qualified medical personnel, development of interdisciplinary communications, economic efficiency, and ensuring infectious, surgical, and pharmaceutical safety for consumers of aesthetic, cosmetic, and cosmetology medical services.
{"title":"ENHANCED MODEL OF THE SYSTEM FOR PROVIDING COSMETOLOGY SERVICES TO THE POPULATION","authors":"Nellia O. Kotyk, Yurii B. Yashchenko","doi":"10.31612/2616-4868.5.2024.09","DOIUrl":"https://doi.org/10.31612/2616-4868.5.2024.09","url":null,"abstract":"Introduction. The relevance of the necessity to review approaches to the organization of the existing system for providing cosmetology services to the population is driven by the rapid increase in cosmetology service providers and the high demand for these services. This occurs under conditions of an imperfect regulatory framework governing the provision of aesthetic, cosmetic, and cosmetology services and their list, the absence of standards for their delivery, the treatment of complications, and the training of qualified medical personnel. \u0000Aim. To develop an enhanced model for organizing the provision of aesthetic, cosmetic, and cosmetology medical services to the population. \u0000Materials and methods. The study was conducted through a systematic approach and analysis using the bibliosemantic method and content analysis. \u0000Results. The development of the conceptual model for providing cosmetology services to the population is based on the findings of domestic scientists, which include a comparative legal analysis of the cosmetology service market in Ukraine and other countries worldwide. In developing the model, a differentiation of medical services in the cosmetology market into aesthetic, cosmetic, and cosmetology medical services was carried out by identifying their distinct characteristics. Due to the absence of a clear list of cosmetology services in the healthcare sector, we relied on the National Classifier of Types of Economic Activity and the State Classifier of Products and Services for classification. In determining providers of cosmetology services and their functions, we referred to the directory of qualification characteristics of healthcare professionals. The system's conceptual model for providing cosmetology services to the population is positioned as a cluster model, which encompasses organizational and methodological aspects and is based on the triad of medical science, practice, and education. \u0000Conclusions. A conceptual model for the system of providing cosmetology services to the population has been developed based on the classification of types of medical activities of service providers using the principles of systemic and socio-engineering approaches. The expected outcomes of its implementation should include: improvement in the quality of cosmetology services provided to the population, provision of highly qualified medical personnel, development of interdisciplinary communications, economic efficiency, and ensuring infectious, surgical, and pharmaceutical safety for consumers of aesthetic, cosmetic, and cosmetology medical services.","PeriodicalId":502404,"journal":{"name":"Clinical and Preventive Medicine","volume":" 20","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141824733","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 : 2024-07-18DOI: 10.31612/2616-4868.5.2024.04
A. Bezushko, P. Hasiuk, A. Vorobets, T. Dzetsiukh
Aim. To assess the condition of periodontal tissues in patients with gastroesophageal reflux disease. Materials and methods. For the study, 65 patients with GERD were selected who were hospitalized in the gastroenterology department of Ternopil City Hospital No. 2. In total, the sample included 34 (52.31%) men and 31 (47.69%) women. To identify inflammatory changes in the gum mucosa, the papillary-marginal-alveolar index (PMA) and the complex periodontal index (CPI) according to P.O. Leus (1989) were used. Statistical processing of the data obtained during the study was carried out using licensed statistical analysis packages Microsoft Excel 2016 and Statsoft Statistica 12. Results. As a result of our study, we found that only 18.5% of patients suffering from GERD had clinically healthy gums. 9.2% of patients showed signs of mild gingivitis (PMA index values were within 20%). According to the PMA index, 33.8% of patients in the main group were diagnosed with moderate gingivitis (values ranged from 25-50%). In 38.5%, manifestations of severe gingivitis were visualized (the PMA index value was more than 51%). We have found that in patients with GERD, the manifestations of inflammatory phenomena in periodontal tissues increase with age and their severity increases. Manifestations of moderate gingivitis predominated in people of mature age, while severe gingivitis in the senile group. According to the data obtained when determining the CPI index, 11.2 % of patients with erosive lesions of the esophagus were diagnosed with moderate periodontal tissue damage (CPI value was (2.9±0.1)). In 44.4 % of patients with the erosive form of GERD, mild periodontal tissue damage was visualized (CPI = (1.6 ± 0.1)). All patients with periodontitis secondary to erosive GERD were elderly (45-59 years, according to WHO). Only 44.4 % of patients with the erosive form of GERD and 100.0 % of patients with non-erosive GERD had no inflammation of periodontal tissue (the average CPI value did not exceed 1.0). Conclusions. Based on the studies described above, we can come to the conclusion that inflammatory processes in the tissues of the periodontal complex and oral mucosa in patients suffering from gastroesophageal reflux disease are interconnected processes that aggravate each other.
{"title":"ASSESSMENT OF DIAGNOSED CHANGES IN PERIODONTAL TISSUES IN PATIENTS WITH GASTROESOPHAGEAL REFLUX DISEASE","authors":"A. Bezushko, P. Hasiuk, A. Vorobets, T. Dzetsiukh","doi":"10.31612/2616-4868.5.2024.04","DOIUrl":"https://doi.org/10.31612/2616-4868.5.2024.04","url":null,"abstract":"Aim. To assess the condition of periodontal tissues in patients with gastroesophageal reflux disease. \u0000Materials and methods. For the study, 65 patients with GERD were selected who were hospitalized in the gastroenterology department of Ternopil City Hospital No. 2. In total, the sample included 34 (52.31%) men and 31 (47.69%) women. To identify inflammatory changes in the gum mucosa, the papillary-marginal-alveolar index (PMA) and the complex periodontal index (CPI) according to P.O. Leus (1989) were used. Statistical processing of the data obtained during the study was carried out using licensed statistical analysis packages Microsoft Excel 2016 and Statsoft Statistica 12. \u0000Results. As a result of our study, we found that only 18.5% of patients suffering from GERD had clinically healthy gums. 9.2% of patients showed signs of mild gingivitis (PMA index values were within 20%). According to the PMA index, 33.8% of patients in the main group were diagnosed with moderate gingivitis (values ranged from 25-50%). In 38.5%, manifestations of severe gingivitis were visualized (the PMA index value was more than 51%). We have found that in patients with GERD, the manifestations of inflammatory phenomena in periodontal tissues increase with age and their severity increases. Manifestations of moderate gingivitis predominated in people of mature age, while severe gingivitis in the senile group. According to the data obtained when determining the CPI index, 11.2 % of patients with erosive lesions of the esophagus were diagnosed with moderate periodontal tissue damage (CPI value was (2.9±0.1)). In 44.4 % of patients with the erosive form of GERD, mild periodontal tissue damage was visualized (CPI = (1.6 ± 0.1)). All patients with periodontitis secondary to erosive GERD were elderly (45-59 years, according to WHO). Only 44.4 % of patients with the erosive form of GERD and 100.0 % of patients with non-erosive GERD had no inflammation of periodontal tissue (the average CPI value did not exceed 1.0). \u0000Conclusions. Based on the studies described above, we can come to the conclusion that inflammatory processes in the tissues of the periodontal complex and oral mucosa in patients suffering from gastroesophageal reflux disease are interconnected processes that aggravate each other.","PeriodicalId":502404,"journal":{"name":"Clinical and Preventive Medicine","volume":" 50","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141824960","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 : 2024-07-18DOI: 10.31612/2616-4868.5.2024.12
Natalia I. Zinchenko, Victoria G. Khoperi
Aim. Increasing the efficiency of fine-needle aspiration biopsy (FNA) of thyroid nodules at the pre-analytical stage by optimizing biopsy technology under ultrasound control. Materials and methods. The material for the study was the results of TAP of thyroid nodules of 1960 patients (aged 16 to 82 years). All patients in the period 2015-2022 underwent FNA of nodular formations of the thyroid gland on the basis of the Department of X-ray and Functional Diagnostics with Ultrasound Studies of the Medical Center of the SIS "RPC PCM" SAD. FNA was performed by ultrasound doctors of the highest qualification category using a biopsy gun and exclusively under ultrasound control. Sonographic criteria proposed by the ATA (American Thyroid Association) were used to determine the indications for FNA. For 402 patients, biopsy was performed under ultrasound control and without assessment of aspirate adequacy during manipulation. For 1,552 patients during the biopsy an express cytological method was used to assess the adequacy of aspirates, which was performed by an ultrasound doctor who had mastered the technique of preliminary cytological analysis. The efficiency of both methods was compared according to the criterion of informativeness of the obtained cytomorphological material. Results. In total, among 1,960 cases of FNA of thyroid nodules, cytological results were not informative in 55 cases (2.81%). In the FNA group without express cytological analysis (402 cases), uninformative cytological results were found in 49 cases (12.19%), and with the use of express cytological analysis during biopsy (1558 cases), uninformative cytological findings were found in only 6 patients (0.39%). Conclusions. The application of the optimized technology of FNA of thyroid nodules under ultrasound control with express cytology of aspirate by an ultrasound doctor increases the informativeness of the method and the economic component of FNA.
{"title":"IMPROVEMENT OF INSTRUMENTAL DIAGNOSTICS OF NODAL PATHOLOGY OF THE THYROID GLAND","authors":"Natalia I. Zinchenko, Victoria G. Khoperi","doi":"10.31612/2616-4868.5.2024.12","DOIUrl":"https://doi.org/10.31612/2616-4868.5.2024.12","url":null,"abstract":"Aim. Increasing the efficiency of fine-needle aspiration biopsy (FNA) of thyroid nodules at the pre-analytical stage by optimizing biopsy technology under ultrasound control. \u0000Materials and methods. The material for the study was the results of TAP of thyroid nodules of 1960 patients (aged 16 to 82 years). All patients in the period 2015-2022 underwent FNA of nodular formations of the thyroid gland on the basis of the Department of X-ray and Functional Diagnostics with Ultrasound Studies of the Medical Center of the SIS \"RPC PCM\" SAD. \u0000 FNA was performed by ultrasound doctors of the highest qualification category using a biopsy gun and exclusively under ultrasound control. Sonographic criteria proposed by the ATA (American Thyroid Association) were used to determine the indications for FNA. For 402 patients, biopsy was performed under ultrasound control and without assessment of aspirate adequacy during manipulation. For 1,552 patients during the biopsy an express cytological method was used to assess the adequacy of aspirates, which was performed by an ultrasound doctor who had mastered the technique of preliminary cytological analysis. The efficiency of both methods was compared according to the criterion of informativeness of the obtained cytomorphological material. \u0000Results. In total, among 1,960 cases of FNA of thyroid nodules, cytological results were not informative in 55 cases (2.81%). In the FNA group without express cytological analysis (402 cases), uninformative cytological results were found in 49 cases (12.19%), and with the use of express cytological analysis during biopsy (1558 cases), uninformative cytological findings were found in only 6 patients (0.39%). \u0000Conclusions. The application of the optimized technology of FNA of thyroid nodules under ultrasound control with express cytology of aspirate by an ultrasound doctor increases the informativeness of the method and the economic component of FNA.","PeriodicalId":502404,"journal":{"name":"Clinical and Preventive Medicine","volume":" 38","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141824185","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. Microbial spoilage of food products has been a perennial problem. According to the WHO, the world records between 68.4 to 275 million cases of acute infectious diarrhea annually. The microbiological safety of food products is crucial as one of the criteria for their quality. Aim. Antimicrobial activity detection of organic carbonic acids against the most common causative agents of food-borne toxic infections. Materials and methods. The antimicrobial action detection of organic carbonic acids was carried out on bacterial strains S. aureus, S. typhimurium, E. coli, P. vulgaris, C. freundii, K. pneumoniae, P. aeruginosa by the dilution method in tryptone-soy broth and in a buffer solution of sodium chloride with peptone (pH 7.0). The minimum inhibitory concentration (MIC) was determined by the highest value from three determinations for each culture taken in the study. The pH of the medium was determined using a portable pH meter AMT16V (Amtast USA Inc). Results. The growth of all bacterial species, that were used in the study, stopped in tryptone-soy broth with a formic acid content of 0.0625%, and the concentration of acetic acid for these microorganisms ranged from 0,0625% to 0,125%. Propionic and lactic acids inhibited the growth of the vast majority of investigated bacterial species at the same concentration (0,125%). Citric acid stopped the growth of Salmonella spp. and Klebsiella spp., at a concentration of 0,5%. Therefore, S. aureus, P. vulgaris, and C. freundii demonstrated the highest level of sensitivity to the action of organic acids. On the other hand, Salmonella spp. were the least sensitive to the acid action, as propionic and lactic acids inactivated them at a concentration of 0,25%, but citric acid at 0,5% one. Conclusions. Organic carboxylic acids demonstrate sufficiently high antimicrobial activity and inhibit the growth of bacteria which are the most common causative agents of food-borne infections.
{"title":"ANTIMICROBIAL ACTIVITY ASSESSMENT OF FOOD PRESERVATIVES CONTAINING ORGANIC CARBOXYLIC ACIDS","authors":"Nadiia Fomina, Valentine Kovalchuk, Iryna M. Vovk, Oleksandr Fomin, Iryna Kovalenko","doi":"10.31612/2616-4868.5.2024.10","DOIUrl":"https://doi.org/10.31612/2616-4868.5.2024.10","url":null,"abstract":"Introduction. Microbial spoilage of food products has been a perennial problem. According to the WHO, the world records between 68.4 to 275 million cases of acute infectious diarrhea annually. The microbiological safety of food products is crucial as one of the criteria for their quality. \u0000Aim. Antimicrobial activity detection of organic carbonic acids against the most common causative agents of food-borne toxic infections. \u0000Materials and methods. The antimicrobial action detection of organic carbonic acids was carried out on bacterial strains S. aureus, S. typhimurium, E. coli, P. vulgaris, C. freundii, K. pneumoniae, P. aeruginosa by the dilution method in tryptone-soy broth and in a buffer solution of sodium chloride with peptone (pH 7.0). The minimum inhibitory concentration (MIC) was determined by the highest value from three determinations for each culture taken in the study. The pH of the medium was determined using a portable pH meter AMT16V (Amtast USA Inc). \u0000Results. The growth of all bacterial species, that were used in the study, stopped in tryptone-soy broth with a formic acid content of 0.0625%, and the concentration of acetic acid for these microorganisms ranged from 0,0625% to 0,125%. Propionic and lactic acids inhibited the growth of the vast majority of investigated bacterial species at the same concentration (0,125%). Citric acid stopped the growth of Salmonella spp. and Klebsiella spp., at a concentration of 0,5%. Therefore, S. aureus, P. vulgaris, and C. freundii demonstrated the highest level of sensitivity to the action of organic acids. On the other hand, Salmonella spp. were the least sensitive to the acid action, as propionic and lactic acids inactivated them at a concentration of 0,25%, but citric acid at 0,5% one. \u0000Conclusions. Organic carboxylic acids demonstrate sufficiently high antimicrobial activity and inhibit the growth of bacteria which are the most common causative agents of food-borne infections.","PeriodicalId":502404,"journal":{"name":"Clinical and Preventive Medicine","volume":" 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141824417","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 : 2024-07-18DOI: 10.31612/2616-4868.5.2024.14
O. Skavinska, Z. Rossokha, S. Podolska, O. Ievseienkova, Oleksandr A. Buriak, Volodymyr P. Olkhovych, N. Gorovenko
Introduction. Currently, hydroxymethylglutaryl-coenzyme A reductase inhibitors (statins) are among the most widely used hypolipidemic drugs worldwide. However, to date, the problems of the insufficient effectiveness of statin therapy and the development of unwanted side effects in patients remain not fully resolved. The identification of key variants in genes whose protein products are involved in statin metabolism and their effect on carriers during therapy may improve the efficacy of statin treatment and help prevent unwanted side effects, and therefore may be a valuable tool for clinicians when monitoring the progress of patients. to whom these medicines were prescribed. Aim. To summarize the information available in the literature on variants in genes that affect the effectiveness and safety of statins during treatment. Materials and methods. An assessment of the current literature on the role of genetic variants in the effectiveness and safety of statins was made. The search was performed in Scopus, Web of Science, Google Scholar, and PubMed databases. Results. The chemical structure and metabolism of statins are described. A review of the current literature on the impact of variants in ABCB1, ABCG2, CYP3A4, CYP3A5, and SLCO1B1 genes on the effectiveness of statin therapy and the development of unwanted side effects in patients is presented. These genes have been shown to be associated with the pharmacodynamics and pharmacokinetics of statins, which affect their efficacy and safe use. Conclusions. Since recent studies have demonstrated the influence of protein transporters such as ABCB1, ABCG2, OATP and BCRP, as well as the cytochrome P450 system, on the pharmacokinetics and pharmacodynamics of statins, further large-scale studies focusing on drug transporters are needed. The review focused on finding correlations between polymorphic variants in the genes encoding the aforementioned transporters and CYP enzymes and the efficacy and safety of statins. The presented data of the literature emphasize the importance of pharmacogenetic studies of statins, which can be useful to clinicians to minimize the negative consequences of taking these drugs and improve the effectiveness of treatment of patients who are carriers of risk alleles.
{"title":"THE ROLE OF PHARMACOGENOMIC STUDIES IN INCREASING THE EFFECTIVENESS AND SAFETY OF CLINICAL APPLICATION OF STATINS","authors":"O. Skavinska, Z. Rossokha, S. Podolska, O. Ievseienkova, Oleksandr A. Buriak, Volodymyr P. Olkhovych, N. Gorovenko","doi":"10.31612/2616-4868.5.2024.14","DOIUrl":"https://doi.org/10.31612/2616-4868.5.2024.14","url":null,"abstract":"Introduction. Currently, hydroxymethylglutaryl-coenzyme A reductase inhibitors (statins) are among the most widely used hypolipidemic drugs worldwide. However, to date, the problems of the insufficient effectiveness of statin therapy and the development of unwanted side effects in patients remain not fully resolved. The identification of key variants in genes whose protein products are involved in statin metabolism and their effect on carriers during therapy may improve the efficacy of statin treatment and help prevent unwanted side effects, and therefore may be a valuable tool for clinicians when monitoring the progress of patients. to whom these medicines were prescribed. \u0000Aim. To summarize the information available in the literature on variants in genes that affect the effectiveness and safety of statins during treatment. \u0000Materials and methods. An assessment of the current literature on the role of genetic variants in the effectiveness and safety of statins was made. The search was performed in Scopus, Web of Science, Google Scholar, and PubMed databases. \u0000Results. The chemical structure and metabolism of statins are described. A review of the current literature on the impact of variants in ABCB1, ABCG2, CYP3A4, CYP3A5, and SLCO1B1 genes on the effectiveness of statin therapy and the development of unwanted side effects in patients is presented. These genes have been shown to be associated with the pharmacodynamics and pharmacokinetics of statins, which affect their efficacy and safe use. \u0000Conclusions. Since recent studies have demonstrated the influence of protein transporters such as ABCB1, ABCG2, OATP and BCRP, as well as the cytochrome P450 system, on the pharmacokinetics and pharmacodynamics of statins, further large-scale studies focusing on drug transporters are needed. The review focused on finding correlations between polymorphic variants in the genes encoding the aforementioned transporters and CYP enzymes and the efficacy and safety of statins. The presented data of the literature emphasize the importance of pharmacogenetic studies of statins, which can be useful to clinicians to minimize the negative consequences of taking these drugs and improve the effectiveness of treatment of patients who are carriers of risk alleles.","PeriodicalId":502404,"journal":{"name":"Clinical and Preventive Medicine","volume":" 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141825051","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 : 2024-07-18DOI: 10.31612/2616-4868.5.2024.05
S. Mahiiovych, T. A. Maksymets, Halyna I. Kovalchuk, N. V. Karpyshyn, Zoryana M. Kit, E. Sklyarov
Introduction. Manifestations of kidney damage in coronavirus disease vary from asymptomatic proteinuria to acute kidney damage that requires renal replacement therapy. Decreased glomerular filtration rate (GFR) is associated with worse prognosis and increased in-hospital mortality. Aim. To compare the clinical and laboratory characteristics of the course and the results of the coronavirus disease treatment in hospitalized patients depending on the GFR. Materials and methods. The study included 243 hospitalized patients with moderate and severe coronavirus disease aged from 18 to 88 years, among them 110 females and 133 males. All patients were segregated into two groups depending on GFR: 1st group – 132 individuals with GFR > 60 mL/min per 1.73m2, 2nd group – 111 individuals with GFR <60 mL/min per 1.73m2. A general clinical examination and laboratory tests (PCR for the detection of SARS-CoV-2 virus, general blood test, glucose, liver and kidney markers, coagulation tests, d-dimer, interleukin-6, ferritin, procalcitonin, and determination of albumin and creatinine in urine with calculation of their ratio), instrumental studies (computed tomography or multi-positional radiography of the thoracic organs, pulse oximetry) were performed. The CKD-EPI (2021 update) formula was used to calculate GFR. Comparison of groups was performed by means of the Mann-Whitney U-test. Categorical data were presented as proportions and analyzed using the Chi-square test. The results were considered statistically reliable at p<0.05. Results. Among the cohort of patients with diminished GFR, there was a notable prevalence of symptoms such as hemoptysis, hematuria, hypertension, and pronounced weakness. Additionally, higher levels of serum CRP, interleukin-6, and procalcitonin were significantly more frequent in this group. It was found that 7 patients (5.3%) among the patients of the 1st group died, while 22 patients (19.8%) died in the 2nd group, p=0.0005. Conclusions. In patients with reduced GFR, such symptoms as hemoptysis, hematuria, hypertension and severe general weakness were significantly more often observed. Laboratory indicators included higher levels of CRP, interleukin-6, procalcitonin, and albumin/creatinine ratio, which indicated a more severe course and activity of the inflammatory process. The mortality rate in patients with reduced GFR was 19.8% and was significantly higher than in the group with normal GFR – 5.3%, p=0.0005.
{"title":"THE IMPACT OF THE KIDNEY FUNCTION ON THE PROGRESSION AND OUTCOMES OF CORONAVIRUS TREATMENT","authors":"S. Mahiiovych, T. A. Maksymets, Halyna I. Kovalchuk, N. V. Karpyshyn, Zoryana M. Kit, E. Sklyarov","doi":"10.31612/2616-4868.5.2024.05","DOIUrl":"https://doi.org/10.31612/2616-4868.5.2024.05","url":null,"abstract":"Introduction. Manifestations of kidney damage in coronavirus disease vary from asymptomatic proteinuria to acute kidney damage that requires renal replacement therapy. Decreased glomerular filtration rate (GFR) is associated with worse prognosis and increased in-hospital mortality. \u0000Aim. To compare the clinical and laboratory characteristics of the course and the results of the coronavirus disease treatment in hospitalized patients depending on the GFR. \u0000Materials and methods. The study included 243 hospitalized patients with moderate and severe coronavirus disease aged from 18 to 88 years, among them 110 females and 133 males. All patients were segregated into two groups depending on GFR: 1st group – 132 individuals with GFR > 60 mL/min per 1.73m2, 2nd group – 111 individuals with GFR <60 mL/min per 1.73m2. A general clinical examination and laboratory tests (PCR for the detection of SARS-CoV-2 virus, general blood test, glucose, liver and kidney markers, coagulation tests, d-dimer, interleukin-6, ferritin, procalcitonin, and determination of albumin and creatinine in urine with calculation of their ratio), instrumental studies (computed tomography or multi-positional radiography of the thoracic organs, pulse oximetry) were performed. The CKD-EPI (2021 update) formula was used to calculate GFR. Comparison of groups was performed by means of the Mann-Whitney U-test. Categorical data were presented as proportions and analyzed using the Chi-square test. The results were considered statistically reliable at p<0.05. \u0000Results. Among the cohort of patients with diminished GFR, there was a notable prevalence of symptoms such as hemoptysis, hematuria, hypertension, and pronounced weakness. Additionally, higher levels of serum CRP, interleukin-6, and procalcitonin were significantly more frequent in this group. It was found that 7 patients (5.3%) among the patients of the 1st group died, while 22 patients (19.8%) died in the 2nd group, p=0.0005. \u0000Conclusions. In patients with reduced GFR, such symptoms as hemoptysis, hematuria, hypertension and severe general weakness were significantly more often observed. Laboratory indicators included higher levels of CRP, interleukin-6, procalcitonin, and albumin/creatinine ratio, which indicated a more severe course and activity of the inflammatory process. The mortality rate in patients with reduced GFR was 19.8% and was significantly higher than in the group with normal GFR – 5.3%, p=0.0005.","PeriodicalId":502404,"journal":{"name":"Clinical and Preventive Medicine","volume":" 65","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141825089","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 : 2024-07-18DOI: 10.31612/2616-4868.5.2024.07
Nataliia M. Mykytenko
Introduction. The task of social medicine is to deepen the medical and social aspects of developing mechanisms for improving the quality of medical care in obstetric and gynecological health care institutions and building an effective quality system to ensure the reproductive health of the population. Aim. Update of factors of the effectiveness of the management of the quality system of obstetric and gynecological care in health care institutions and determination of the combinatorics of influencing factors that should be taken into account for the harmonization of its functioning, which characterize the specifics and features of its development. Materials and methods. General scientific and theoretical approaches (system-complex, alarm-process, structural-functional) and methods were used: generalization; analysis and synthesis; grouping, comparison, identification and visual reproduction of results, structural and functional. The theoretical basis is the achievements of foreign and domestic scientists in the field of social medicine, Laws of Ukraine on the organization of the quality system, EU Directives and Recommendations of the Council of Europe on the introduction of standards and maintenance of ethical aspects of reproductive medicine. Results. The conceptual and categorical apparatus of the theory of social medicine was developed by defining the essence of the concept of "resilient system of quality of medical care in health care institutions of the obstetric and gynecological profile" as a complex resource-functional structure, which: has ten subsystems and is built taking into consideration the provisions of the system-complex and the alarm-process approach to determining its goals and prioritizing the performance of three groups of tasks; takes into account the combinatorics of influencing factors; aimed at ensuring stability and adaptability to changing conditions, incorporating into its composition a system of monitoring, analysis and improvement of medical care, ensuring high quality of medical care, safety and meeting the needs of patients in the field of obstetrics and gynecology practice. Conclusions. The urgency has been proven: the introduction into practice of a resilient quality system of medical care; justification of the multi-level system of relative indicators of its evaluation according to a single criterion; determination of priorities for the localization of efforts to eliminate shortcomings and implementation of strategies to achieve the defined goals. Scientific and applied research identified the need for building a resilient quality system of medical care in obstetric and gynecological health care institutions, developing an algorithm of management actions for its formation and putting it into practice with the development of a multidimensional system of relative indicators to assess the effectiveness of its implementation.
{"title":"MODERN ASPECTS OF QUALITY ASSURANCE OF OBSTETRICAL AND GYNECOLOGICAL CARE","authors":"Nataliia M. Mykytenko","doi":"10.31612/2616-4868.5.2024.07","DOIUrl":"https://doi.org/10.31612/2616-4868.5.2024.07","url":null,"abstract":"Introduction. The task of social medicine is to deepen the medical and social aspects of developing mechanisms for improving the quality of medical care in obstetric and gynecological health care institutions and building an effective quality system to ensure the reproductive health of the population. \u0000Aim. Update of factors of the effectiveness of the management of the quality system of obstetric and gynecological care in health care institutions and determination of the combinatorics of influencing factors that should be taken into account for the harmonization of its functioning, which characterize the specifics and features of its development. \u0000Materials and methods. General scientific and theoretical approaches (system-complex, alarm-process, structural-functional) and methods were used: generalization; analysis and synthesis; grouping, comparison, identification and visual reproduction of results, structural and functional. The theoretical basis is the achievements of foreign and domestic scientists in the field of social medicine, Laws of Ukraine on the organization of the quality system, EU Directives and Recommendations of the Council of Europe on the introduction of standards and maintenance of ethical aspects of reproductive medicine. \u0000Results. The conceptual and categorical apparatus of the theory of social medicine was developed by defining the essence of the concept of \"resilient system of quality of medical care in health care institutions of the obstetric and gynecological profile\" as a complex resource-functional structure, which: has ten subsystems and is built taking into consideration the provisions of the system-complex and the alarm-process approach to determining its goals and prioritizing the performance of three groups of tasks; takes into account the combinatorics of influencing factors; aimed at ensuring stability and adaptability to changing conditions, incorporating into its composition a system of monitoring, analysis and improvement of medical care, ensuring high quality of medical care, safety and meeting the needs of patients in the field of obstetrics and gynecology practice. \u0000Conclusions. The urgency has been proven: the introduction into practice of a resilient quality system of medical care; justification of the multi-level system of relative indicators of its evaluation according to a single criterion; determination of priorities for the localization of efforts to eliminate shortcomings and implementation of strategies to achieve the defined goals. Scientific and applied research identified the need for building a resilient quality system of medical care in obstetric and gynecological health care institutions, developing an algorithm of management actions for its formation and putting it into practice with the development of a multidimensional system of relative indicators to assess the effectiveness of its implementation.","PeriodicalId":502404,"journal":{"name":"Clinical and Preventive Medicine","volume":" 38","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141826530","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 : 2024-07-18DOI: 10.31612/2616-4868.5.2024.06
M. D. Diachuk
Introduction. Rehabilitation makes it possible to improve the results of treatment and the quality of a person's life, as well as to reduce health care costs. Evidence-based domestic technologies for the rehabilitation of patients with a surgical profile have not been developed, in particular, for patients with urolithiasis. Aim. To investigate traditional clinical practice for the rehabilitation of a patient with urolithiasis in a multidisciplinary healthcare facility and to justify and develop a typical patient clinical pathway incorporating rehabilitation technologies. Materials and methods. European clinical guidelines for the treatment of urolithiasis, systematic reviews and scientific sources from the PUBMED and NICE databases, administrative data for the years 2019-2023 and 236 medical records of inpatients operated on for urolithiasis were selected as research materials; methods: bibliosemantic, systematic approach and analysis, medical-statistical, descriptive and graphic modeling. Results. It was found that traditional rehabilitation measures on the clinical path of a patient with urolithiasis are fragmentary and limited in content and scope. At the same time, manageable risk factors have been identified that can be targeted for rehabilitation: high levels of chronic non-infectious diseases – circulatory system and endocrine system (respectively, 8,826.7 and 4,809.1 per 10,000 population). In general, there were 1.6 manageable risk factors (irrational diet, overweight, low physical activity, smoking) common to chronic non-communicable diseases per person. The specific weight of urolithiasis in the structure of urological pathology (12.7%) remained stable during the study, and the specific weight of patients with the need for surgical treatment was equal to 90.7%-93.2%. A typical clinical route of a patient with urolithiasis has been substantiated and developed. A feature of the route is the use of a short-term rehabilitation program during conservative treatment, perioperative rehabilitation - in the case of operative treatment, long-term rehabilitation – at the ambulatory stage after conservative and/or operative treatment of urolithiasis. The programs are aimed at reducing the impact of risk factors on the development and/or recurrence of urolithiasis and other most common chronic non-infectious diseases. The programs are carried out by multidisciplinary teams of specialist doctors. The interaction of doctors is ensured by the local medical information system. Conclusions. A typical clinical pathway for a patient with urolithiasis includes short-term, perioperative and long-term rehabilitation programs. They have the potential to affect not only the health of an individual, but also the entire contingent of the population being served.
{"title":"JUSTIFICATION OF APPROACHES TO THE ORGANIZATION OF REHABILITATION OF PATIENTS WITH UROLITHIASIS","authors":"M. D. Diachuk","doi":"10.31612/2616-4868.5.2024.06","DOIUrl":"https://doi.org/10.31612/2616-4868.5.2024.06","url":null,"abstract":"Introduction. Rehabilitation makes it possible to improve the results of treatment and the quality of a person's life, as well as to reduce health care costs. Evidence-based domestic technologies for the rehabilitation of patients with a surgical profile have not been developed, in particular, for patients with urolithiasis. \u0000Aim. To investigate traditional clinical practice for the rehabilitation of a patient with urolithiasis in a multidisciplinary healthcare facility and to justify and develop a typical patient clinical pathway incorporating rehabilitation technologies. \u0000Materials and methods. European clinical guidelines for the treatment of urolithiasis, systematic reviews and scientific sources from the PUBMED and NICE databases, administrative data for the years 2019-2023 and 236 medical records of inpatients operated on for urolithiasis were selected as research materials; methods: bibliosemantic, systematic approach and analysis, medical-statistical, descriptive and graphic modeling. \u0000Results. It was found that traditional rehabilitation measures on the clinical path of a patient with urolithiasis are fragmentary and limited in content and scope. At the same time, manageable risk factors have been identified that can be targeted for rehabilitation: high levels of chronic non-infectious diseases – circulatory system and endocrine system (respectively, 8,826.7 and 4,809.1 per 10,000 population). In general, there were 1.6 manageable risk factors (irrational diet, overweight, low physical activity, smoking) common to chronic non-communicable diseases per person. The specific weight of urolithiasis in the structure of urological pathology (12.7%) remained stable during the study, and the specific weight of patients with the need for surgical treatment was equal to 90.7%-93.2%. A typical clinical route of a patient with urolithiasis has been substantiated and developed. A feature of the route is the use of a short-term rehabilitation program during conservative treatment, perioperative rehabilitation - in the case of operative treatment, long-term rehabilitation – at the ambulatory stage after conservative and/or operative treatment of urolithiasis. The programs are aimed at reducing the impact of risk factors on the development and/or recurrence of urolithiasis and other most common chronic non-infectious diseases. The programs are carried out by multidisciplinary teams of specialist doctors. The interaction of doctors is ensured by the local medical information system. \u0000Conclusions. A typical clinical pathway for a patient with urolithiasis includes short-term, perioperative and long-term rehabilitation programs. They have the potential to affect not only the health of an individual, but also the entire contingent of the population being served.","PeriodicalId":502404,"journal":{"name":"Clinical and Preventive Medicine","volume":" 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141824429","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 : 2024-07-18DOI: 10.31612/2616-4868.5.2024.08
O. Oriekhova, Oleksandr I. Pavlenko, Denys V. Varyvonchyk, Kateryna D. Kopach
Introduction. Extraction of iron ore is accompanied by the formation of significant volumes of mine waters, which are characterized by high mineralization. In the process of draining mine waters into surface reservoirs without their proper purification from pollutants and demineralization, it poses a significant environmental hazard and a threat to human health. The high incidence of malignant neoplasms in the population of Ukraine requires new approaches to the development of ways and methods of prevention, taking into account all determinants, including environmental factors. Aim. Establishing the risk of developing malignant neoplasms in the population when re-using mine water. Materials and methods. The methodological approach to the comprehensive assessment of the state of mine waters of the Kryvyi Rih iron ore basin involved the use of a complex of hygienic, experimental, epidemiological and medical-statistical research methods. Results. We found that the concentrations of chemical substances exceed the maximum permissible levels for total mineralization by 22–25 times, by chloride content by 31–37 times, by suspended substances by 140–156 times, by iron by 4,4–4,9 times, and leads to changes in smell, colour, taste and increased aggressiveness of water to metals. Mine water of the Kryvyi Rih iron ore basin belongs to brines and is characterized as chloride-sulfate. The level of biochemical oxygen demand exceeds the maximum allowable standards by 2,64–2,76 times, and chemical oxygen consumption by 10–11 times, which can lead to a decrease in the oxygen content in natural reservoirs and create unsuitable conditions for the life of living organisms. The probability of developing malignant neoplasms for residents of the city of Kryvyi Rih is 0,05935, which is 15,71–23,62 times higher than the similar indicator for residents of the Dnipropetrovsk and Chernivtsi regions respectively. The additional (attributable risk) caused by environmental pollution is 0,05683 for residents of the city of Kryvyi Rih, while this indicator for residents of the Dnipropetrovsk region is 0,001264, which is 44,96 times lower. The need for a comprehensive approach to risk management is proven, which is based on a probabilistic assessment of the negative consequences of the impact of environmental factors on health and consists of certain stages: data collection and evaluation, impact and hazard assessment, environmental risk characterization. Conclusions. Taking into consideration the indicators of the content of chemicals in mine water and the analysis of the levels of morbidity of the population with malignant neoplasms, the need for mandatory cleaning and demineralization of mine water when it is reused is scientifically substantiated.
{"title":"ASSESSMENT OF THE RISKS OF MALIGNANT NEOPLASMS IN THE POPULATION WHEN REUSING MINE WATER","authors":"O. Oriekhova, Oleksandr I. Pavlenko, Denys V. Varyvonchyk, Kateryna D. Kopach","doi":"10.31612/2616-4868.5.2024.08","DOIUrl":"https://doi.org/10.31612/2616-4868.5.2024.08","url":null,"abstract":"Introduction. Extraction of iron ore is accompanied by the formation of significant volumes of mine waters, which are characterized by high mineralization. In the process of draining mine waters into surface reservoirs without their proper purification from pollutants and demineralization, it poses a significant environmental hazard and a threat to human health. The high incidence of malignant neoplasms in the population of Ukraine requires new approaches to the development of ways and methods of prevention, taking into account all determinants, including environmental factors. \u0000Aim. Establishing the risk of developing malignant neoplasms in the population when re-using mine water. \u0000Materials and methods. The methodological approach to the comprehensive assessment of the state of mine waters of the Kryvyi Rih iron ore basin involved the use of a complex of hygienic, experimental, epidemiological and medical-statistical research methods. \u0000Results. We found that the concentrations of chemical substances exceed the maximum permissible levels for total mineralization by 22–25 times, by chloride content by 31–37 times, by suspended substances by 140–156 times, by iron by 4,4–4,9 times, and leads to changes in smell, colour, taste and increased aggressiveness of water to metals. Mine water of the Kryvyi Rih iron ore basin belongs to brines and is characterized as chloride-sulfate. The level of biochemical oxygen demand exceeds the maximum allowable standards by 2,64–2,76 times, and chemical oxygen consumption by 10–11 times, which can lead to a decrease in the oxygen content in natural reservoirs and create unsuitable conditions for the life of living organisms. The probability of developing malignant neoplasms for residents of the city of Kryvyi Rih is 0,05935, which is 15,71–23,62 times higher than the similar indicator for residents of the Dnipropetrovsk and Chernivtsi regions respectively. The additional (attributable risk) caused by environmental pollution is 0,05683 for residents of the city of Kryvyi Rih, while this indicator for residents of the Dnipropetrovsk region is 0,001264, which is 44,96 times lower. The need for a comprehensive approach to risk management is proven, which is based on a probabilistic assessment of the negative consequences of the impact of environmental factors on health and consists of certain stages: data collection and evaluation, impact and hazard assessment, environmental risk characterization. \u0000Conclusions. Taking into consideration the indicators of the content of chemicals in mine water and the analysis of the levels of morbidity of the population with malignant neoplasms, the need for mandatory cleaning and demineralization of mine water when it is reused is scientifically substantiated.","PeriodicalId":502404,"journal":{"name":"Clinical and Preventive Medicine","volume":" 95","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141824503","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 : 2024-07-18DOI: 10.31612/2616-4868.5.2024.02
Ervin Asanov, V. Shatilo, I. Dyba, Yu.I. Holubova, Volodymyr H. Slipchenko, Liubov Poliahushko
Introduction. Treatment of chronic obstructive pulmonary disease (COPD) in elderly patients is often limited, leading to inadequate disease control. To enhance treatment effectiveness in elderly individuals with COPD, attention has been drawn to non-pharmacological methods, including hypoxic training and respiratory training with positive end-expiratory pressure (PEEP). Aim. To assess the duration and effectiveness of combined application of hypoxic training and respiratory training with PEEP on lung ventilation function and pulmonary gas exchange in elderly patients with COPD. Materials and methods. Forty-six elderly patients with COPD were examined: a group (15 individuals) with the application of respiratory training with PEEP, a group (15 individuals) with the application of hypoxic training, and a group (16 individuals) with the application of respiratory training with PEEP and hypoxic training. Before training, immediately after the training course, one month, and three months after the course of hypoxic and/or respiratory training with PEEP, lung ventilation function, bronchial patency, and blood saturation were determined. Results. The application of hypoxic training and/or respiratory training with PEEP in elderly patients with COPD led to increased speed parameters reflecting bronchial patency. Also, after the course of hypoxic and/or respiratory training with PEEP, the FVC parameter increased in the examined patients, mainly due to ERV. Hypoxic training, compared to respiratory training with PEEP, had slight advantages in its effect on lung ventilation function in elderly patients with COPD. Application of INGT and/or breathing training with PEER resulted in an increase in SpO2. The combined application of hypoxic training and respiratory training with PEEP in elderly patients with COPD led to increased effectiveness and duration of therapeutic effect. The impact on bronchial patency and SpO2 of respiratory training with PEEP and/or hypoxic training was greater in patients with pronounced disease symptoms. Conclusions. Separate application of respiratory training with PEEP or hypoxic training contributes to increased ventilation, decreased bronchial obstruction and increasing blood saturation, but the therapeutic effect is short-term and lasts no longer than a month. Meanwhile, the combined application of hypoxic training and respiratory training with PEEP in elderly patients with COPD leads to more significant improvement in ventilation and bronchial patency. At the same time, the duration of the therapeutic effect persists for three months. The effectiveness of respiratory training with PEEP and/or hypoxic training in elderly patients with COPD depends on the clinical symptoms of the disease: the more pronounced the symptoms, the greater the impact.
简介。老年慢性阻塞性肺病（COPD）患者的治疗往往受到限制，导致疾病控制不充分。为了提高慢性阻塞性肺病老年患者的治疗效果，人们开始关注非药物治疗方法，包括缺氧训练和呼气末正压（PEEP）呼吸训练。研究目的评估联合应用低氧训练和 PEEP 呼吸训练对老年慢性阻塞性肺疾病患者肺通气功能和肺气体交换的持续时间和有效性。材料和方法。研究对象为 46 名老年慢性阻塞性肺疾病患者：应用 PEEP 呼吸训练组（15 人）、应用低氧训练组（15 人）和应用 PEEP 呼吸训练及低氧训练组（16 人）。分别在训练前、训练课程结束后、缺氧训练和/或 PEEP 呼吸训练课程结束后一个月和三个月测定肺通气功能、支气管通畅度和血饱和度。结果显示对老年慢性阻塞性肺病患者进行低氧训练和/或带 PEEP 的呼吸训练可提高反映支气管通畅度的速度参数。此外，在进行缺氧训练和/或带 PEEP 的呼吸训练后，受试者的 FVC 参数有所提高，这主要是由于 ERV 的作用。与使用 PEEP 的呼吸训练相比，低氧训练对慢性阻塞性肺疾病老年患者肺通气功能的影响略胜一筹。应用 INGT 和/或 PEER 呼吸训练可提高 SpO2。在老年慢性阻塞性肺病患者中联合应用缺氧训练和带 PEEP 的呼吸训练可提高疗效并延长疗效持续时间。在有明显疾病症状的患者中，使用 PEEP 和/或低氧训练对支气管通畅性和 SpO2 的影响更大。结论是单独应用带 PEEP 或低氧训练的呼吸训练有助于增加通气量、减少支气管阻塞和增加血饱和度，但治疗效果是短期的，持续时间不超过一个月。同时，在老年慢性阻塞性肺病患者中联合应用低氧训练和 PEEP 呼吸训练，通气量和支气管通畅性的改善更为显著。同时，疗效持续时间长达三个月。对老年慢性阻塞性肺病患者进行带 PEEP 的呼吸训练和/或低氧训练的效果取决于该疾病的临床症状：症状越明显，影响越大。
{"title":"LUNG VENTILATION FUNCTION AND PULMONARY GAS EXCHANGE IN ELDERLY PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE DURING COMBINED APPLICATION OF HYPOXIC TRAINING AND RESPIRATORY TRAINING WITH POSITIVE END-EXPIRATORY PRESSURE","authors":"Ervin Asanov, V. Shatilo, I. Dyba, Yu.I. Holubova, Volodymyr H. Slipchenko, Liubov Poliahushko","doi":"10.31612/2616-4868.5.2024.02","DOIUrl":"https://doi.org/10.31612/2616-4868.5.2024.02","url":null,"abstract":"Introduction. Treatment of chronic obstructive pulmonary disease (COPD) in elderly patients is often limited, leading to inadequate disease control. To enhance treatment effectiveness in elderly individuals with COPD, attention has been drawn to non-pharmacological methods, including hypoxic training and respiratory training with positive end-expiratory pressure (PEEP). \u0000Aim. To assess the duration and effectiveness of combined application of hypoxic training and respiratory training with PEEP on lung ventilation function and pulmonary gas exchange in elderly patients with COPD. \u0000Materials and methods. Forty-six elderly patients with COPD were examined: a group (15 individuals) with the application of respiratory training with PEEP, a group (15 individuals) with the application of hypoxic training, and a group (16 individuals) with the application of respiratory training with PEEP and hypoxic training. Before training, immediately after the training course, one month, and three months after the course of hypoxic and/or respiratory training with PEEP, lung ventilation function, bronchial patency, and blood saturation were determined. \u0000Results. The application of hypoxic training and/or respiratory training with PEEP in elderly patients with COPD led to increased speed parameters reflecting bronchial patency. Also, after the course of hypoxic and/or respiratory training with PEEP, the FVC parameter increased in the examined patients, mainly due to ERV. Hypoxic training, compared to respiratory training with PEEP, had slight advantages in its effect on lung ventilation function in elderly patients with COPD. Application of INGT and/or breathing training with PEER resulted in an increase in SpO2. The combined application of hypoxic training and respiratory training with PEEP in elderly patients with COPD led to increased effectiveness and duration of therapeutic effect. The impact on bronchial patency and SpO2 of respiratory training with PEEP and/or hypoxic training was greater in patients with pronounced disease symptoms. \u0000Conclusions. Separate application of respiratory training with PEEP or hypoxic training contributes to increased ventilation, decreased bronchial obstruction and increasing blood saturation, but the therapeutic effect is short-term and lasts no longer than a month. Meanwhile, the combined application of hypoxic training and respiratory training with PEEP in elderly patients with COPD leads to more significant improvement in ventilation and bronchial patency. At the same time, the duration of the therapeutic effect persists for three months. The effectiveness of respiratory training with PEEP and/or hypoxic training in elderly patients with COPD depends on the clinical symptoms of the disease: the more pronounced the symptoms, the greater the impact.","PeriodicalId":502404,"journal":{"name":"Clinical and Preventive Medicine","volume":" 87","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141825082","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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