Pub Date : 2023-12-19DOI: 10.31612/2616-4868.6.2023.09
Bogdan Y. Gryshchuk, Ihor V. Boiko
Introduction. An experimental study comparing the duration of partial resection of 500 mm3 of meniscus by a combination of arthroscopic punchers with a radiofrequency ablator and a radiofrequency resection tool "Meniscus Resector" was conducted in isolated laboratory conditions. The aim of the study. To determine and compare the duration of partial meniscus resection using arthroscopic punchers, radiofrequency ablator and Meniscus Resector radiofrequency resection tool in isolated laboratory conditions. Materials and methods. The study was conducted on 30 macropreparations of human knee menisci obtained during total knee arthroplasty, which were divided into two groups: Group 1 – 15 macroscopic specimens, partial resection of which was performed using an arthroscopic biter, and the contours of the meniscus surface after resection were treated with a radiofrequency ablator; Group 2 – 15 macroscopic specimens, partial resection of which was performed using the Meniscus Resector radiofrequency resection tool. In both groups, the same volume of meniscus was resected – 500 mm3. Visualization and timing were performed using an arthroscopic system (Smith & Nephew, USA; Loran, China). Statistical processing of the study data was performed using the licensed software IBM SPSS Statistics Base v 22. MedCalc (Healthcare Technology, USA). Results and Discussion. In group 1, the mean duration (median, interquartile range) of partial resection of a 500 mm3 fragment was 11.8 (10.2-12.9) seconds, in group 2, the mean duration of partial resection of a 500 mm3 fragment was 1.9 (1.4-2.3) seconds (p=0.000061). Thus, the use of the Meniscus Resector (group 2) contributed to an average of 6.2 times faster partial meniscus resection compared to arthroscopic punchers and radiofrequency ablator (group 1). Conclusions. The study suggests that the use of the Meniscus Resector provides a faster method of radiofrequency meniscus resection compared to arthroscopic punchers and radiofrequency ablators. Further studies and trials are needed to confirm these results and evaluate safety in different clinical settings.
{"title":"EXPERIMENTAL STUDY COMPARING THE DURATION OF PARTIAL MENISCUS RESECTION USING ARTHROSCOPIC PUNCHERS, RADIOFREQUENCY ABLATOR AND RADIOFREQUENCY INSTRUMENT FOR MENISCUS RESECTION \"MENISCUS RESECTOR\"","authors":"Bogdan Y. Gryshchuk, Ihor V. Boiko","doi":"10.31612/2616-4868.6.2023.09","DOIUrl":"https://doi.org/10.31612/2616-4868.6.2023.09","url":null,"abstract":"Introduction. An experimental study comparing the duration of partial resection of 500 mm3 of meniscus by a combination of arthroscopic punchers with a radiofrequency ablator and a radiofrequency resection tool \"Meniscus Resector\" was conducted in isolated laboratory conditions. The aim of the study. To determine and compare the duration of partial meniscus resection using arthroscopic punchers, radiofrequency ablator and Meniscus Resector radiofrequency resection tool in isolated laboratory conditions. Materials and methods. The study was conducted on 30 macropreparations of human knee menisci obtained during total knee arthroplasty, which were divided into two groups: Group 1 – 15 macroscopic specimens, partial resection of which was performed using an arthroscopic biter, and the contours of the meniscus surface after resection were treated with a radiofrequency ablator; Group 2 – 15 macroscopic specimens, partial resection of which was performed using the Meniscus Resector radiofrequency resection tool. In both groups, the same volume of meniscus was resected – 500 mm3. Visualization and timing were performed using an arthroscopic system (Smith & Nephew, USA; Loran, China). Statistical processing of the study data was performed using the licensed software IBM SPSS Statistics Base v 22. MedCalc (Healthcare Technology, USA). Results and Discussion. In group 1, the mean duration (median, interquartile range) of partial resection of a 500 mm3 fragment was 11.8 (10.2-12.9) seconds, in group 2, the mean duration of partial resection of a 500 mm3 fragment was 1.9 (1.4-2.3) seconds (p=0.000061). Thus, the use of the Meniscus Resector (group 2) contributed to an average of 6.2 times faster partial meniscus resection compared to arthroscopic punchers and radiofrequency ablator (group 1). Conclusions. The study suggests that the use of the Meniscus Resector provides a faster method of radiofrequency meniscus resection compared to arthroscopic punchers and radiofrequency ablators. Further studies and trials are needed to confirm these results and evaluate safety in different clinical settings.","PeriodicalId":502404,"journal":{"name":"Clinical and Preventive Medicine","volume":"72 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139171589","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 : 2023-12-19DOI: 10.31612/2616-4868.6.2023.01
Vasyl Z. Netiazhenko, O. Tkachyshyn, Nataliia Yu. Tkachyshyna, Olha M. Plenova
Introduction. Hemorrhagic stroke is a serious and devastating complication of arterial hypertension, which leads to increased mortality in survivors even after the early recovery period. Being other target organs for arterial hypertension, kidneys take part in blood pressure regulation. Investigation of their peculiarities in such patients may provide valuable data on possible reasons of poor long-term prognosis in this category of patients. The aim of the study: to compare kidney ultrasound parameters and renal blood biochemistry tests between the post-hemorrhagic stroke hypertensive subjects in a stable phase of recovery period and the patients with arterial hypertension who had no cerebrovascular and cardiovascular events. Materials and methods. There were 100 subjects enrolled into the study. They formed two investigatory groups: the main (n=64; age – 52,2±8,41 years, M±SD years) and the control (n=36; age – 51,8±5,92 years) one. Hypertensive patients of the main group developed hemorrhagic stroke – subarachnoid hemorrhage (SAH) (n=42) or intracerebral hemorrhage (ICH) (n=22) – ≥6 months prior to the examination conducted at this study. The control group consisted of patients with non-complicated arterial hypertension. In both groups of patients, the kidney ultrasound parameters and blood plasma urea, creatinine and uric acid concentration levels were determined. Estimated glomerular filtration rate (eGFR) was calculated. Results. The indices of kidney ultrasound parameters in the main group and the control group were the following ones, respectively: the pole-to-pole size of the right kidney was 9,96±1,05 and 11,63±1,26 cm, the same size of the left kidney – 10,39±0,93 and 11,95±1,23 cm, p<0,01 for both pairs. Among the biochemistry blood plasma indices, uric acid concentration reached significant difference as well – 411,21±60,36 and 360,91±75,3 µmol/L in the relevant groups, respectively (p=0,04). On the other hand, eGFR did not show the difference between the study groups. The main group was characterized by a higher prevalence of kidney stone formation – OR 5,00 (95% CI, 1,83-13,65). The statistically significant higher incidence rate of calculus development was identified in two subgroups of the main group as well: for SAH – OR 3,08 (95% CI, 1,05-9,02), for ICH – OR 13,33 (95% CI, 3,69-48,15). When comparing to the control group, kidney cyst identification rate in the SAH subgroup referred to OR 3,08 (95% CI, 1,05-9,02), while kidney pelvis/calyces enlargement incidence rate was higher in the ICH subgroup OR 9,17 (95% CI, 2,15-39,06). Conclusions. The obtained data indicate the smaller pole-to-pole dimension of both kidneys in hypertensive subjects who suffered hemorrhagic stroke, accompanying higher incidence rate of kidney calculus formation in view of the increased blood plasma uric acid concentration. The same is typical for the SAH individuals subgroup but with the addition of prevalence of kidney cysts incidence rate. As for t
{"title":"KIDNEY ULTRASOUND PARAMETERS AND RENAL BLOOD BIOCHEMISTRY MARKERS IN POST-HEMORRHAGIC STROKE HYPERTENSIVE SURVIVORS","authors":"Vasyl Z. Netiazhenko, O. Tkachyshyn, Nataliia Yu. Tkachyshyna, Olha M. Plenova","doi":"10.31612/2616-4868.6.2023.01","DOIUrl":"https://doi.org/10.31612/2616-4868.6.2023.01","url":null,"abstract":"Introduction. Hemorrhagic stroke is a serious and devastating complication of arterial hypertension, which leads to increased mortality in survivors even after the early recovery period. Being other target organs for arterial hypertension, kidneys take part in blood pressure regulation. Investigation of their peculiarities in such patients may provide valuable data on possible reasons of poor long-term prognosis in this category of patients. The aim of the study: to compare kidney ultrasound parameters and renal blood biochemistry tests between the post-hemorrhagic stroke hypertensive subjects in a stable phase of recovery period and the patients with arterial hypertension who had no cerebrovascular and cardiovascular events. Materials and methods. There were 100 subjects enrolled into the study. They formed two investigatory groups: the main (n=64; age – 52,2±8,41 years, M±SD years) and the control (n=36; age – 51,8±5,92 years) one. Hypertensive patients of the main group developed hemorrhagic stroke – subarachnoid hemorrhage (SAH) (n=42) or intracerebral hemorrhage (ICH) (n=22) – ≥6 months prior to the examination conducted at this study. The control group consisted of patients with non-complicated arterial hypertension. In both groups of patients, the kidney ultrasound parameters and blood plasma urea, creatinine and uric acid concentration levels were determined. Estimated glomerular filtration rate (eGFR) was calculated. Results. The indices of kidney ultrasound parameters in the main group and the control group were the following ones, respectively: the pole-to-pole size of the right kidney was 9,96±1,05 and 11,63±1,26 cm, the same size of the left kidney – 10,39±0,93 and 11,95±1,23 cm, p<0,01 for both pairs. Among the biochemistry blood plasma indices, uric acid concentration reached significant difference as well – 411,21±60,36 and 360,91±75,3 µmol/L in the relevant groups, respectively (p=0,04). On the other hand, eGFR did not show the difference between the study groups. The main group was characterized by a higher prevalence of kidney stone formation – OR 5,00 (95% CI, 1,83-13,65). The statistically significant higher incidence rate of calculus development was identified in two subgroups of the main group as well: for SAH – OR 3,08 (95% CI, 1,05-9,02), for ICH – OR 13,33 (95% CI, 3,69-48,15). When comparing to the control group, kidney cyst identification rate in the SAH subgroup referred to OR 3,08 (95% CI, 1,05-9,02), while kidney pelvis/calyces enlargement incidence rate was higher in the ICH subgroup OR 9,17 (95% CI, 2,15-39,06). Conclusions. The obtained data indicate the smaller pole-to-pole dimension of both kidneys in hypertensive subjects who suffered hemorrhagic stroke, accompanying higher incidence rate of kidney calculus formation in view of the increased blood plasma uric acid concentration. The same is typical for the SAH individuals subgroup but with the addition of prevalence of kidney cysts incidence rate. As for t","PeriodicalId":502404,"journal":{"name":"Clinical and Preventive Medicine","volume":"203 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139172270","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 : 2023-12-19DOI: 10.31612/2616-4868.6.2023.04
A. P. Oshurko, Ihor Yu. Oliinyk, T. Kerimova, E. Pompii
Introduction. Ensuring control over regenerative processes by using the patient's blood is a unique concept of an autogenous transplant product, a universal and safe method of application that contains growth factors and cytokines stored in the fibrin matrix and provides stimulating properties of tissue regeneration through the processes of angiogenesis, proliferation, cell migration, and extracellular matrix synthesis. The aim. To substantiate the effectiveness of the protocol for collecting, preparing, and forming autocellular mesoconcentrate products in the analysis of the results of their electron microscopic examination. Materials and methods. Based on our own clinical experience of using the Endoret-PRGF technique (Human Technology, BTI, Spain) to collect, prepare, and form autocellular transplant products rationally, we used the method of morphological study of objects using a stream of electrons that passed through thin films under high voltage, allowing us to study the structure of these objects at the macromolecular and subcellular levels – transmission electron microscopy, which contributed to the study of the density (number of occurrences in 10 μm2 ), diameter (Ø) of the formed fibrin fibers in the PRGF – F1 and F2 fractions of mesoconcentrate products, namely, isolating membranes (M) and obturating blocks (B). An equally important step in PRGF technology is to follow the step-by-step instructions for preparing and using autocellular transplants. Results. Protocol for the collection, preparation, and formation of autocellular transplants using the KMU15 kit (Human Technology, BTI) for the application of the Endoret – PRGF technique, platelet-rich plasma, as a unique and first scientifically proven technique recognized worldwide and patented by the Institute of Human Biotechnology, Spain. The results of the clinical application of mesoconcentrate products, namely isolating membranes widely used in targeted tissue regeneration and obturating blocks, confirm their biological effectiveness. The results of the median (Me) and interquartile range (IQR) during the statistical analysis were obtained, where F1-M = 0.196 (0.176; 0.286) compared to F1-B = 0.344 (0.325; 0.394); F2-M = 0.180 (0.168; 0.214) - F2-B = 0.254 (0.202; 0.338), which gives us the right to assert the reliability of the data set and confirms the quantitative characterization of interfraction differences, and, accordingly, the quality in the sequence of protocol stages. Conclusions. The protocol for the efficiency of autocellular graft collection and formation is synchronized with the analysis of electron microscopic images characterizing the density and diameter of fibrin fibers, which differ in the fractional products of the mesoconcentrate and are higher in the obturating blocks than in the isolating membranes, indicating its completeness and compliance.
{"title":"CLINICAL PROTOCOL FOR THE PREPARATION AND ELECTRON MICROSCOPIC ANALYSIS OF THE OBTAINED PRODUCTS OF AUTOLOGOUS MESOCONCENTRATE – PLASMA RICH IN GROWTH FACTORS (PRGF)","authors":"A. P. Oshurko, Ihor Yu. Oliinyk, T. Kerimova, E. Pompii","doi":"10.31612/2616-4868.6.2023.04","DOIUrl":"https://doi.org/10.31612/2616-4868.6.2023.04","url":null,"abstract":"Introduction. Ensuring control over regenerative processes by using the patient's blood is a unique concept of an autogenous transplant product, a universal and safe method of application that contains growth factors and cytokines stored in the fibrin matrix and provides stimulating properties of tissue regeneration through the processes of angiogenesis, proliferation, cell migration, and extracellular matrix synthesis. The aim. To substantiate the effectiveness of the protocol for collecting, preparing, and forming autocellular mesoconcentrate products in the analysis of the results of their electron microscopic examination. Materials and methods. Based on our own clinical experience of using the Endoret-PRGF technique (Human Technology, BTI, Spain) to collect, prepare, and form autocellular transplant products rationally, we used the method of morphological study of objects using a stream of electrons that passed through thin films under high voltage, allowing us to study the structure of these objects at the macromolecular and subcellular levels – transmission electron microscopy, which contributed to the study of the density (number of occurrences in 10 μm2 ), diameter (Ø) of the formed fibrin fibers in the PRGF – F1 and F2 fractions of mesoconcentrate products, namely, isolating membranes (M) and obturating blocks (B). An equally important step in PRGF technology is to follow the step-by-step instructions for preparing and using autocellular transplants. Results. Protocol for the collection, preparation, and formation of autocellular transplants using the KMU15 kit (Human Technology, BTI) for the application of the Endoret – PRGF technique, platelet-rich plasma, as a unique and first scientifically proven technique recognized worldwide and patented by the Institute of Human Biotechnology, Spain. The results of the clinical application of mesoconcentrate products, namely isolating membranes widely used in targeted tissue regeneration and obturating blocks, confirm their biological effectiveness. The results of the median (Me) and interquartile range (IQR) during the statistical analysis were obtained, where F1-M = 0.196 (0.176; 0.286) compared to F1-B = 0.344 (0.325; 0.394); F2-M = 0.180 (0.168; 0.214) - F2-B = 0.254 (0.202; 0.338), which gives us the right to assert the reliability of the data set and confirms the quantitative characterization of interfraction differences, and, accordingly, the quality in the sequence of protocol stages. Conclusions. The protocol for the efficiency of autocellular graft collection and formation is synchronized with the analysis of electron microscopic images characterizing the density and diameter of fibrin fibers, which differ in the fractional products of the mesoconcentrate and are higher in the obturating blocks than in the isolating membranes, indicating its completeness and compliance.","PeriodicalId":502404,"journal":{"name":"Clinical and Preventive Medicine","volume":"148 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139172608","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 : 2023-12-19DOI: 10.31612/2616-4868.6.2023.14
О. P. Yavorovsky, Yu. M. Skaletsky, R. Brukhno, Оlexandr V. Ivanko, Sergіy V. Kravchenko, Valentin I. Bugro, Andriy V. Shkurba, T.O. Zinchenko, N. D. Kozak
Introduction. WHO widely draws the attention of the world community to safety culture as an effective basis for ensuring safety in the hospital environment. However, WHO warns that "changing culture is more difficult than introducing new structural and organizational mechanisms". Therefore, systems for assessing patient safety culture in hospitals are widely used in many countries today. The aim of the study. To analyze and compare the dynamics of patient safety culture in Ukraine and the USA healthcare facilities. Materials and methods. The study utilized bibliographic, statistical, and sociological research methods. The research material consisted of a questionnaire survey of medical personnel on patient safety culture in 2016 (163 surveys from 3 healthcare facilities) and a questionnaire survey conducted in 2023 (174 surveys from 4 healthcare facilities). Results of patient safety culture monitoring in US hospitals for 2014 and 2021 were used for comparison. The survey of medical personnel was conducted using the AHRQ leadership questionnaire. Results. The percentage of positive responses for 5 out of the 12 characteristics of patient safety culture that we investigated in domestic healthcare facilities in 2023 was significantly lower than in 2016. The main reason for this negative trend in patient safety culture within domestic healthcare facilities can be attributed to the COVID-19 pandemic and Russia's military aggression, but the primary cause lies in the absence of a comprehensive strategy for improving this culture. Over the past 8 years, the proportion of respondents willing to disclose errors in their professional activities, as well as the mistakes of their colleagues and other incidents, without fearing that their mistakes and incident reports will harm them, has remained largely unchanged. The slight trend toward improvement in patient safety culture indicators in US hospitals, despite significant attention to it, indicates the challenges we face in the journey towards forming a positive safety culture. Conclusions. The prevailing reactive safety culture in domestic healthcare, along with the lack of positive changes, hinders the implementation of modern safety strategies in the medical field. The data from our own research and scientific literature highlight the urgent need for in-depth examination of the state of patient safety culture in domestic healthcare facilities and the development of a methodological framework adapted to international standards for evaluating safety culture in medical institutions. The formation of a positive national culture in general, and safety culture within healthcare facilities in particular, should be regarded as a crucial prerequisite for the post-war reconstruction of the country and its integration into the civilized, economically developed global community.
{"title":"COMPARATIVE ANALYSIS OF PATIENT SAFETY CULTURE DYNAMICS IN UKRAINE AND THE USA HEALTHCARE FACILITIES REFERENCE TO ESTABLISHING SAFE HOSPITAL ENVIRONMENT","authors":"О. P. Yavorovsky, Yu. M. Skaletsky, R. Brukhno, Оlexandr V. Ivanko, Sergіy V. Kravchenko, Valentin I. Bugro, Andriy V. Shkurba, T.O. Zinchenko, N. D. Kozak","doi":"10.31612/2616-4868.6.2023.14","DOIUrl":"https://doi.org/10.31612/2616-4868.6.2023.14","url":null,"abstract":"Introduction. WHO widely draws the attention of the world community to safety culture as an effective basis for ensuring safety in the hospital environment. However, WHO warns that \"changing culture is more difficult than introducing new structural and organizational mechanisms\". Therefore, systems for assessing patient safety culture in hospitals are widely used in many countries today. The aim of the study. To analyze and compare the dynamics of patient safety culture in Ukraine and the USA healthcare facilities. Materials and methods. The study utilized bibliographic, statistical, and sociological research methods. The research material consisted of a questionnaire survey of medical personnel on patient safety culture in 2016 (163 surveys from 3 healthcare facilities) and a questionnaire survey conducted in 2023 (174 surveys from 4 healthcare facilities). Results of patient safety culture monitoring in US hospitals for 2014 and 2021 were used for comparison. The survey of medical personnel was conducted using the AHRQ leadership questionnaire. Results. The percentage of positive responses for 5 out of the 12 characteristics of patient safety culture that we investigated in domestic healthcare facilities in 2023 was significantly lower than in 2016. The main reason for this negative trend in patient safety culture within domestic healthcare facilities can be attributed to the COVID-19 pandemic and Russia's military aggression, but the primary cause lies in the absence of a comprehensive strategy for improving this culture. Over the past 8 years, the proportion of respondents willing to disclose errors in their professional activities, as well as the mistakes of their colleagues and other incidents, without fearing that their mistakes and incident reports will harm them, has remained largely unchanged. The slight trend toward improvement in patient safety culture indicators in US hospitals, despite significant attention to it, indicates the challenges we face in the journey towards forming a positive safety culture. Conclusions. The prevailing reactive safety culture in domestic healthcare, along with the lack of positive changes, hinders the implementation of modern safety strategies in the medical field. The data from our own research and scientific literature highlight the urgent need for in-depth examination of the state of patient safety culture in domestic healthcare facilities and the development of a methodological framework adapted to international standards for evaluating safety culture in medical institutions. The formation of a positive national culture in general, and safety culture within healthcare facilities in particular, should be regarded as a crucial prerequisite for the post-war reconstruction of the country and its integration into the civilized, economically developed global community.","PeriodicalId":502404,"journal":{"name":"Clinical and Preventive Medicine","volume":"159 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139171940","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 : 2023-12-19DOI: 10.31612/2616-4868.6.2023.03
Vasyl R. Antoniv, Oleg V. Shulyarenko, Taras M. Galyga, Larysa V. Shulyarenko, V. M. Perepadia
Introduction. The basic principles of high-efficient and safe thyroid surgery were established by 1920: identification and ligation of vessels, identification and preservation of laryngeal nerves, and parathyroid glands. Bleeding remains one of the major intraoperative complications of thyroid surgery. The aim of this study is to evaluate the benefits of the Harmonic when compared with bipolar coagulation for open thyroidectomy. Materials and methods: We enrolled 85 patients who underwent total thyroidectomy for multinodular disease from 2019 till 2022 years. Patients were randomly assigned to either the group 1 (43 patients in which the operation was performed entirely using the Harmonic scalpel (HS) and no other haemostatic tool) or the group 2 (42 patients in which the operation was performed using classic technique of resorbable ligature, bipolar coagulation). The inclusion criteria were scheduled total thyroidectomy for multinodular goiter. Results. There were no significant differences between two groups regarding age, gender, ASA distribution, so two groups are comparable. The mean operating time in the group 1 was 62.84±0.66 (M±m) minutes, and that in the group 2 was 75.19±0.42 (M±m) minutes for thyroidectomy, and there was 19.65% (i.e. 12.35 minutes) statistically significant reduction in the operating time using the Harmonic scalpel device (p<0.05). The 48 hours mean total amount of drainage was 69.05±0.88 (M±m) ml for group 1 and 81.40±0.64 (M±m) ml for group 2, which was statistically significant (p<0.05). The rate of postoperative complications was comparable among the two groups (pχ2>0,05). Conclusions. The use of Harmonic scalpel in thyroid surgery is safe and effective and is associated with a significant reduction in operative time without increasing complications rate, may also permit a better view of structures to preserve nerves, vessels of parathyroid glands and parathyroid glands when operating. Other benefits include significantly lower blood loss, efficient hemostasis and sectioning in a single instrument.
{"title":"HARMONIC SCALPEL COMPARED TO BIPOLAR COAGULATION FOR THYROIDECTOMY","authors":"Vasyl R. Antoniv, Oleg V. Shulyarenko, Taras M. Galyga, Larysa V. Shulyarenko, V. M. Perepadia","doi":"10.31612/2616-4868.6.2023.03","DOIUrl":"https://doi.org/10.31612/2616-4868.6.2023.03","url":null,"abstract":"Introduction. The basic principles of high-efficient and safe thyroid surgery were established by 1920: identification and ligation of vessels, identification and preservation of laryngeal nerves, and parathyroid glands. Bleeding remains one of the major intraoperative complications of thyroid surgery. The aim of this study is to evaluate the benefits of the Harmonic when compared with bipolar coagulation for open thyroidectomy. Materials and methods: We enrolled 85 patients who underwent total thyroidectomy for multinodular disease from 2019 till 2022 years. Patients were randomly assigned to either the group 1 (43 patients in which the operation was performed entirely using the Harmonic scalpel (HS) and no other haemostatic tool) or the group 2 (42 patients in which the operation was performed using classic technique of resorbable ligature, bipolar coagulation). The inclusion criteria were scheduled total thyroidectomy for multinodular goiter. Results. There were no significant differences between two groups regarding age, gender, ASA distribution, so two groups are comparable. The mean operating time in the group 1 was 62.84±0.66 (M±m) minutes, and that in the group 2 was 75.19±0.42 (M±m) minutes for thyroidectomy, and there was 19.65% (i.e. 12.35 minutes) statistically significant reduction in the operating time using the Harmonic scalpel device (p<0.05). The 48 hours mean total amount of drainage was 69.05±0.88 (M±m) ml for group 1 and 81.40±0.64 (M±m) ml for group 2, which was statistically significant (p<0.05). The rate of postoperative complications was comparable among the two groups (pχ2>0,05). Conclusions. The use of Harmonic scalpel in thyroid surgery is safe and effective and is associated with a significant reduction in operative time without increasing complications rate, may also permit a better view of structures to preserve nerves, vessels of parathyroid glands and parathyroid glands when operating. Other benefits include significantly lower blood loss, efficient hemostasis and sectioning in a single instrument.","PeriodicalId":502404,"journal":{"name":"Clinical and Preventive Medicine","volume":"131 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139171190","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 : 2023-12-19DOI: 10.31612/2616-4868.6.2023.02
A. Pletenetska, Svitlana O. Lytvak, Maksym V. Yamkovyi, Oleksandr O. Sadovskyi, Tetyana M. Lukash, Lilia V. Chobitko
Introduction. The relevance of conducting this study is determined by the necessity to create organizational conditions and optimize the clinical-diagnostic aspect of medical care for patients with traumatic brain injury (TBI) and acute stroke. This aims to improve patients' quality of life by enhancing the effectiveness of medical care provision in Ukraine. This improvement is based on identifying the causes and analyzing deficiencies in medical care for these conditions. The aim of the research is to investigate the specificity of deficiencies in providing medical care to patients with isolated traumatic brain injury and acute hemorrhagic stroke due to the rupture of cerebral arterial aneurysms based on a retrospective analysis of medical documentation, as well as the results of patient treatment in cases of discrepancies between clinical and forensic diagnoses concerning the primary, concomitant diseases, and their complications. Materials and methods. Clinical assessment of the results of providing care to patients with traumatic brain injury and stroke was conducted through a retrospective analysis of medical documentation of patients who were hospitalized with these pathologies. The applied methods include clinical and laboratory investigations of homeostasis and metabolism parameters, and instrumental techniques. Results. In the identified influence of the timing of the operation (within the first few days) and the breakthrough of blood in the subarachnoid space of the brain, including with intracranial hemorrhage as a result of a re-rupture of a cerebral arterial aneurysm, on the risk of lethal outcomes of surgical treatment, a rationale for searching ways to optimize therapeutic tactics in this category of patients was provided. This includes identifying defects and shortcomings in the organizational aspect of medical care. Conclusions. Based on the analysis and identification of the most informative factors influencing the results of surgical treatment of cerebral aneurysms, a prediction system has been developed that allows calculating the probability of its outcome. The application of the forecast is advisable to consider in the prevention and timely detection of possible deficiencies in providing medical care to patients with stroke.
{"title":"EXPERT AND CLINICAL ASSESSMENT OF DEFICIENCIES IN PROVIDING CARE TO PATIENTS WITH TRAUMATIC BRAIN INJURY AND HEMORRHAGIC STROKE DUE TO THE RUPTURE OF CEREBRAL ANEURYSM","authors":"A. Pletenetska, Svitlana O. Lytvak, Maksym V. Yamkovyi, Oleksandr O. Sadovskyi, Tetyana M. Lukash, Lilia V. Chobitko","doi":"10.31612/2616-4868.6.2023.02","DOIUrl":"https://doi.org/10.31612/2616-4868.6.2023.02","url":null,"abstract":"Introduction. The relevance of conducting this study is determined by the necessity to create organizational conditions and optimize the clinical-diagnostic aspect of medical care for patients with traumatic brain injury (TBI) and acute stroke. This aims to improve patients' quality of life by enhancing the effectiveness of medical care provision in Ukraine. This improvement is based on identifying the causes and analyzing deficiencies in medical care for these conditions. The aim of the research is to investigate the specificity of deficiencies in providing medical care to patients with isolated traumatic brain injury and acute hemorrhagic stroke due to the rupture of cerebral arterial aneurysms based on a retrospective analysis of medical documentation, as well as the results of patient treatment in cases of discrepancies between clinical and forensic diagnoses concerning the primary, concomitant diseases, and their complications. Materials and methods. Clinical assessment of the results of providing care to patients with traumatic brain injury and stroke was conducted through a retrospective analysis of medical documentation of patients who were hospitalized with these pathologies. The applied methods include clinical and laboratory investigations of homeostasis and metabolism parameters, and instrumental techniques. Results. In the identified influence of the timing of the operation (within the first few days) and the breakthrough of blood in the subarachnoid space of the brain, including with intracranial hemorrhage as a result of a re-rupture of a cerebral arterial aneurysm, on the risk of lethal outcomes of surgical treatment, a rationale for searching ways to optimize therapeutic tactics in this category of patients was provided. This includes identifying defects and shortcomings in the organizational aspect of medical care. Conclusions. Based on the analysis and identification of the most informative factors influencing the results of surgical treatment of cerebral aneurysms, a prediction system has been developed that allows calculating the probability of its outcome. The application of the forecast is advisable to consider in the prevention and timely detection of possible deficiencies in providing medical care to patients with stroke.","PeriodicalId":502404,"journal":{"name":"Clinical and Preventive Medicine","volume":"27 24","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139171252","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 : 2023-12-19DOI: 10.31612/2616-4868.6.2023.10
H. Lazarenko, S. Savosko, M. Guzyk, Igor V. Boiko
Introduction. The theme of metal hypersensitivity (MHS) reactions is among the most controversial and complex issues in orthopedic and trauma practice. MHS diagnoses are diagnostically challenging because they are exclusionary diagnoses. It is currently uncertain which biomarkers can reliably predict a potential pathological response to implants. The aim of this research is to investigate hypersensitivity reactions to orthopedic implants containing nickel (Ni). Materials and methods. This research was conducted on female Wistar rats in accordance with the standards of bioethical principles. To obtain conclusive results, the animals were divided into two experimental groups: with prior sensitization to Freund's adjuvant containing Ni and without it. Nickel plates with a total surface area of 24 mm2 were implanted in the rats under general anesthesia. Five months after the intervention, the animals were removed from the experiment, and histological examination of the obtained samples was conducted. Extracted implants were examined using electron microscopy to assess the implant surface. The local elemental composition of the implants was analyzed using an energy-dispersive spectrometer. Results. Under the experimental conditions, it was demonstrated that after 5 months following the operation, a dense connective tissue capsule with an inflammatory infiltrate in the capsule lumen had formed around the implants in the rats. This suggests a possible manifestation of hypersensitivity reactions to implants containing Ni. Electron microscopy of the surface of the extracted implants revealed corrosion phenomena in all the samples. The degree of corrosion was more pronounced in the group of animals with prior sensitization to Ni, and distant particles of Ni were detected, which can be characterized as the beginning of implant degradation. Conclusions. A connective tissue capsule forms around the implants, and it was found to be 34.8% denser in animals sensitized to Ni prior to implantation, which may indicate tissue reactions with signs of hypersensitivity. Further research will provide a deeper understanding of the fundamental inflammatory and immunological reactions to metals present in implants. This, in turn, will facilitate the identification of clinically useful applications necessary for the development of diagnostic or prognostic tests for patients with metal implants.
{"title":"FEATURES OF USING ORTHOPEDIC IMPLANTS ON AN EXPERIMENTAL MODEL OF SENSITIZATION TO NICKEL (NI)","authors":"H. Lazarenko, S. Savosko, M. Guzyk, Igor V. Boiko","doi":"10.31612/2616-4868.6.2023.10","DOIUrl":"https://doi.org/10.31612/2616-4868.6.2023.10","url":null,"abstract":"Introduction. The theme of metal hypersensitivity (MHS) reactions is among the most controversial and complex issues in orthopedic and trauma practice. MHS diagnoses are diagnostically challenging because they are exclusionary diagnoses. It is currently uncertain which biomarkers can reliably predict a potential pathological response to implants. The aim of this research is to investigate hypersensitivity reactions to orthopedic implants containing nickel (Ni). Materials and methods. This research was conducted on female Wistar rats in accordance with the standards of bioethical principles. To obtain conclusive results, the animals were divided into two experimental groups: with prior sensitization to Freund's adjuvant containing Ni and without it. Nickel plates with a total surface area of 24 mm2 were implanted in the rats under general anesthesia. Five months after the intervention, the animals were removed from the experiment, and histological examination of the obtained samples was conducted. Extracted implants were examined using electron microscopy to assess the implant surface. The local elemental composition of the implants was analyzed using an energy-dispersive spectrometer. Results. Under the experimental conditions, it was demonstrated that after 5 months following the operation, a dense connective tissue capsule with an inflammatory infiltrate in the capsule lumen had formed around the implants in the rats. This suggests a possible manifestation of hypersensitivity reactions to implants containing Ni. Electron microscopy of the surface of the extracted implants revealed corrosion phenomena in all the samples. The degree of corrosion was more pronounced in the group of animals with prior sensitization to Ni, and distant particles of Ni were detected, which can be characterized as the beginning of implant degradation. Conclusions. A connective tissue capsule forms around the implants, and it was found to be 34.8% denser in animals sensitized to Ni prior to implantation, which may indicate tissue reactions with signs of hypersensitivity. Further research will provide a deeper understanding of the fundamental inflammatory and immunological reactions to metals present in implants. This, in turn, will facilitate the identification of clinically useful applications necessary for the development of diagnostic or prognostic tests for patients with metal implants.","PeriodicalId":502404,"journal":{"name":"Clinical and Preventive Medicine","volume":"110 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139171617","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 : 2023-12-19DOI: 10.31612/2616-4868.6.2023.08
E. Khoroshun, V. Nehoduiko, V. V. Makarov, Serhiy I. Panasenko, T. Yakymova, S. Tertyshnyi
Introduction. In the structure of combat abdominal trauma during all periods of hostilities (according to ATO/JFO data), gunshot wounds dominated, accounting for 87.1%. An analysis of the distribution of those injured with gunshot wounds by the type of projectile causing the injury showed a prevalence of shrapnel injuries over bullet wounds – more than 80%. The aim of the research was to analyze the macroscopic and microscopic changes in firearm penetrating abdominal injuries with damage to the appendix. Materials and Methods. Eight appendectomies were performed due to firearm penetrating abdominal injuries with damage to the appendix. Complaints, medical history, examination data, ultrasound examination according to the FAST protocol, and radiological examinations were studied in all injured patients. To refine the diagnosis and determine the scope of surgical intervention, the WOLF videoendoscopic system was used. Histological examination of the removed appendices was performed, which were stained with hematoxylin and eosin and with the Van Gieson stain. A complex of pathomorphological studies was conducted using the Primo Star microscope (Carl Zeiss) at a magnification of ×140. Results. All injuries occurred while wearing a bulletproof vest and were characterized as blind, with 1 (12.5%) being gunshot wounds and 7 (87.5%) being shrapnel wounds. The entrance wound in firearm blind penetrating abdominal injuries with appendix damage was located in the right hypochondriac region – 4 (50%), right flank – 1 (12.5%), right inguinal region – 2 (25%), and mesogastric region – 1 (12.5%) cases. The average size of the entrance wound on the skin was 23.3±0.4×12.4±0.3 cm. All skin wounds were outside the bulletproof vest protection area. The injuries to the appendix had an average size of 15.4±1.2×9.3±0.1 cm. All removed foreign bodies were larger than 1 cm in their largest dimension. Conclusions. In most cases of firearm penetrating abdominal injuries, damage to the appendix is noted with an entrance wound predominantly on the right side. Macroscopically, in firearm blind penetrating abdominal injuries with appendix involvement, the wound on the skin is larger than on the appendix. All foreign metal bodies removed from the abdominal cavity after firearm shrapnel blind abdominal injuries with appendix involvement were of large size. Contusional injuries to the appendix tend to undergo destructive transformation, requiring surgical treatment - appendectomy. The increased frequency of appendix injuries can be explained by the widespread use of shrapnel ammunition in abdominal injuries when personal protective equipment does not provide protection for this area.
导言。在所有敌对时期的战斗腹部创伤结构中（根据 ATO/JFO 数据），枪伤居多，占 87.1%。按射弹类型对枪伤伤员分布情况进行的分析表明，弹片伤比子弹伤更普遍--超过 80%。 研究的目的是分析枪支穿透腹部造成阑尾损伤的宏观和微观变化。 材料和方法。8 例阑尾切除术均因腹部火器穿透伤导致阑尾损伤而进行。对所有伤员的主诉、病史、检查数据、根据 FAST 方案进行的超声波检查和放射学检查进行了研究。为了完善诊断并确定手术范围，使用了 WOLF 视频内窥镜系统。 对切除的阑尾进行了组织学检查，并用苏木精、伊红和范吉森染色法进行了染色。使用 Primo Star 显微镜（卡尔蔡司）进行了综合病理形态学研究，放大倍数为 ×140。 结果。所有伤者都是在穿着防弹背心时受伤的，均为盲伤，其中 1 例（12.5%）为枪伤，7 例（87.5%）为弹片伤。附有阑尾损伤的枪械盲穿透性腹部伤害的入口伤口位于右腹下区--4 例（50%）、右翼--1 例（12.5%）、右腹股沟区--2 例（25%）和胃间区--1 例（12.5%）。皮肤入口伤口的平均大小为 23.3±0.4×12.4±0.3 厘米。所有皮肤伤口都在防弹背心保护区域之外。 阑尾伤口的平均大小为 15.4±1.2×9.3±0.1 厘米。所有取出的异物最大尺寸均大于 1 厘米。 结论在大多数枪械腹部穿透伤病例中，阑尾受损的入口伤口主要位于右侧。从宏观上看，在阑尾受累的枪支盲穿性腹部损伤中，皮肤上的伤口要比阑尾上的伤口大。火器弹片盲穿伤腹部并累及阑尾后，从腹腔取出的所有金属异物都很大。阑尾的挫伤往往会发生破坏性转变，需要手术治疗--阑尾切除术。阑尾损伤频率增加的原因是，在腹部损伤中广泛使用弹片弹药，而个人防护装备无法对这一区域提供保护。
{"title":"MACROSCOPIC AND MICROSCOPIC FEATURES OF FIREARM PENETRATING ABDOMINAL INJURIES WITH DAMAGE TO THE APPENDIX","authors":"E. Khoroshun, V. Nehoduiko, V. V. Makarov, Serhiy I. Panasenko, T. Yakymova, S. Tertyshnyi","doi":"10.31612/2616-4868.6.2023.08","DOIUrl":"https://doi.org/10.31612/2616-4868.6.2023.08","url":null,"abstract":"Introduction. In the structure of combat abdominal trauma during all periods of hostilities (according to ATO/JFO data), gunshot wounds dominated, accounting for 87.1%. An analysis of the distribution of those injured with gunshot wounds by the type of projectile causing the injury showed a prevalence of shrapnel injuries over bullet wounds – more than 80%. The aim of the research was to analyze the macroscopic and microscopic changes in firearm penetrating abdominal injuries with damage to the appendix. Materials and Methods. Eight appendectomies were performed due to firearm penetrating abdominal injuries with damage to the appendix. Complaints, medical history, examination data, ultrasound examination according to the FAST protocol, and radiological examinations were studied in all injured patients. To refine the diagnosis and determine the scope of surgical intervention, the WOLF videoendoscopic system was used. Histological examination of the removed appendices was performed, which were stained with hematoxylin and eosin and with the Van Gieson stain. A complex of pathomorphological studies was conducted using the Primo Star microscope (Carl Zeiss) at a magnification of ×140. Results. All injuries occurred while wearing a bulletproof vest and were characterized as blind, with 1 (12.5%) being gunshot wounds and 7 (87.5%) being shrapnel wounds. The entrance wound in firearm blind penetrating abdominal injuries with appendix damage was located in the right hypochondriac region – 4 (50%), right flank – 1 (12.5%), right inguinal region – 2 (25%), and mesogastric region – 1 (12.5%) cases. The average size of the entrance wound on the skin was 23.3±0.4×12.4±0.3 cm. All skin wounds were outside the bulletproof vest protection area. The injuries to the appendix had an average size of 15.4±1.2×9.3±0.1 cm. All removed foreign bodies were larger than 1 cm in their largest dimension. Conclusions. In most cases of firearm penetrating abdominal injuries, damage to the appendix is noted with an entrance wound predominantly on the right side. Macroscopically, in firearm blind penetrating abdominal injuries with appendix involvement, the wound on the skin is larger than on the appendix. All foreign metal bodies removed from the abdominal cavity after firearm shrapnel blind abdominal injuries with appendix involvement were of large size. Contusional injuries to the appendix tend to undergo destructive transformation, requiring surgical treatment - appendectomy. The increased frequency of appendix injuries can be explained by the widespread use of shrapnel ammunition in abdominal injuries when personal protective equipment does not provide protection for this area.","PeriodicalId":502404,"journal":{"name":"Clinical and Preventive Medicine","volume":"87 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139171987","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 : 2023-11-22DOI: 10.31612/2616-4868.5.2023.09
O. H. Buriak, Y. Nechytailo
Introduction. An imbalance in the autonomic nervous system regulation, known as dysautonomia, is one of the most common clinical syndromes that accompany several diseases. The balance between sympathetic and parasympathetic influences on the body can rapidly change during dynamic processes, especially in cases of infectious and acute diseases, where autonomic regulation plays an active role in shaping the immune response. In children with respiratory diseases, the influence of the vagus nerve (n.vagus) on the frequency and depth of breathing is also important but remains relatively understudied. Assessment of vegetative balance in pediatrics is carried out using various methods depending on the child's age and condition, with commonly used approaches including questionnaires, calculation of the Kerdo autonomic index, and orthostatic testing. The aim. To compare the diagnostic capabilities of different methods for assessment of the autonomic nervous system state in school-age children on the model of acute bronchitis. Materials and methods. The paper presents data from a study that assessed the state of the autonomic nervous system in 52 school-age children (12-16 years old) divided into two groups: 30 children with acute bronchitis in the convalescent period and 22 clinically healthy individuals. Three different methods were used: the A.M. Wayne scale, the Kerdo index, and the orthostatic test. Results. The survey based on Wayne's questionnaire did not reveal a significant difference between the groups of healthy children and those affected by bronchitis. Dynamic tests proved to be more suitable for assessing acute pathology, such as Kerdo's autonomic index and the orthostatic test. The autonomic Kerdo index in children with bronchitis was significantly higher (14.2±2.38 points) than in healthy children (6.4±3.18 points, p<0.05). In children with acute bronchitis, dysautonomia with a predominance of sympathicotonia was recorded, which may be attributed to insufficient vagal innervation and a decrease in parasympathetic influence on the formation of an adequate immune response to the inflammatory process in the respiratory tract. Conclusions. Determining the autonomic Kerdo index and conducting the orthostatic test is suitable for diagnosing dysautonomia in children with acute respiratory pathology. These tests are dynamic, functionally based, and easy to perform and evaluate.
{"title":"COMPARATIVE CHARACTERISTICS OF AUTONOMIC IMBALANCE DIAGNOSTIC METHODS IN SCHOOL-AGE CHILDREN","authors":"O. H. Buriak, Y. Nechytailo","doi":"10.31612/2616-4868.5.2023.09","DOIUrl":"https://doi.org/10.31612/2616-4868.5.2023.09","url":null,"abstract":"Introduction. An imbalance in the autonomic nervous system regulation, known as dysautonomia, is one of the most common clinical syndromes that accompany several diseases. The balance between sympathetic and parasympathetic influences on the body can rapidly change during dynamic processes, especially in cases of infectious and acute diseases, where autonomic regulation plays an active role in shaping the immune response. In children with respiratory diseases, the influence of the vagus nerve (n.vagus) on the frequency and depth of breathing is also important but remains relatively understudied. Assessment of vegetative balance in pediatrics is carried out using various methods depending on the child's age and condition, with commonly used approaches including questionnaires, calculation of the Kerdo autonomic index, and orthostatic testing. The aim. To compare the diagnostic capabilities of different methods for assessment of the autonomic nervous system state in school-age children on the model of acute bronchitis. Materials and methods. The paper presents data from a study that assessed the state of the autonomic nervous system in 52 school-age children (12-16 years old) divided into two groups: 30 children with acute bronchitis in the convalescent period and 22 clinically healthy individuals. Three different methods were used: the A.M. Wayne scale, the Kerdo index, and the orthostatic test. Results. The survey based on Wayne's questionnaire did not reveal a significant difference between the groups of healthy children and those affected by bronchitis. Dynamic tests proved to be more suitable for assessing acute pathology, such as Kerdo's autonomic index and the orthostatic test. The autonomic Kerdo index in children with bronchitis was significantly higher (14.2±2.38 points) than in healthy children (6.4±3.18 points, p<0.05). In children with acute bronchitis, dysautonomia with a predominance of sympathicotonia was recorded, which may be attributed to insufficient vagal innervation and a decrease in parasympathetic influence on the formation of an adequate immune response to the inflammatory process in the respiratory tract. Conclusions. Determining the autonomic Kerdo index and conducting the orthostatic test is suitable for diagnosing dysautonomia in children with acute respiratory pathology. These tests are dynamic, functionally based, and easy to perform and evaluate.","PeriodicalId":502404,"journal":{"name":"Clinical and Preventive Medicine","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139248814","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 : 2023-11-22DOI: 10.31612/2616-4868.5.2023.06
H. Lazarenko, O. Lazarenko, V. Shaprynskyi, N. Semenenko
Introduction. The article describes a method of implant surface treatment that reduces the risk of an inflammatory reaction to vascular implants. The aim of the research was to develop a method of coating the surface of vascular implants (stents) to reduce the risk of inflammation reaction (rejection), enhance their biocompatibility, and prevent restenosis. Materials and methods. The research was conducted on 34 male rabbits of the "Flemish Giant" breed weighing 2.5-3.0 kg, following the standards of bioethical principles. The blood vessels of the experimental animals were previously provoked by the administration of endogenous pyrogenic solution according to a predetermined protocol. Under general anesthesia, the animals were endovascularly (via femoral access into the abdominal aorta) implanted with standard Z-shaped stents made of 316L stainless steel. To obtain indicative results, 10 rabbits were implanted with non-treated stents, while another 12 rabbits had stents pre-treated with the adapting composition (AdC) implanted. After 8 weeks, the animals were withdrawn from the experiment. Results and discussion. Vessel wall morphometry revealed that the treatment of stents with AdC before their placement into the vessel resulted in a reduction of vessel wall thickness at the site of their implantation. Conclusions. The developed method involves pre-treatment of stents with AdC , which in turn ensures a reduction in the reaction of the surrounding tissues thanks to the modification of the implant surface, reduces the thickness of neointima growth, which indicates the absence of inflammatory processes and the formation of fibrous tissue around the implant. The clinical application of AdC aimed at improving the biocompatibility properties of implants with respect to the recipient's body is characterized by a 100% (95% CI 78.2% - 100%) likelihood of absence of complications.
{"title":"INFLUENCE OF VASCULAR STENT SURFACE TREATMENT WITH AN ADAPTIVE COMPOSITION (AdC) FOR IMPROVING ITS BIOCOMPATIBILITY AND RESTENOSIS PREVENTION (experimental research)","authors":"H. Lazarenko, O. Lazarenko, V. Shaprynskyi, N. Semenenko","doi":"10.31612/2616-4868.5.2023.06","DOIUrl":"https://doi.org/10.31612/2616-4868.5.2023.06","url":null,"abstract":"Introduction. The article describes a method of implant surface treatment that reduces the risk of an inflammatory reaction to vascular implants. The aim of the research was to develop a method of coating the surface of vascular implants (stents) to reduce the risk of inflammation reaction (rejection), enhance their biocompatibility, and prevent restenosis. Materials and methods. The research was conducted on 34 male rabbits of the \"Flemish Giant\" breed weighing 2.5-3.0 kg, following the standards of bioethical principles. The blood vessels of the experimental animals were previously provoked by the administration of endogenous pyrogenic solution according to a predetermined protocol. Under general anesthesia, the animals were endovascularly (via femoral access into the abdominal aorta) implanted with standard Z-shaped stents made of 316L stainless steel. To obtain indicative results, 10 rabbits were implanted with non-treated stents, while another 12 rabbits had stents pre-treated with the adapting composition (AdC) implanted. After 8 weeks, the animals were withdrawn from the experiment. Results and discussion. Vessel wall morphometry revealed that the treatment of stents with AdC before their placement into the vessel resulted in a reduction of vessel wall thickness at the site of their implantation. Conclusions. The developed method involves pre-treatment of stents with AdC , which in turn ensures a reduction in the reaction of the surrounding tissues thanks to the modification of the implant surface, reduces the thickness of neointima growth, which indicates the absence of inflammatory processes and the formation of fibrous tissue around the implant. The clinical application of AdC aimed at improving the biocompatibility properties of implants with respect to the recipient's body is characterized by a 100% (95% CI 78.2% - 100%) likelihood of absence of complications.","PeriodicalId":502404,"journal":{"name":"Clinical and Preventive Medicine","volume":"624 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139249160","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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