Pub Date : 2022-06-30DOI: 10.32345/2664-4738.2.2022.04
M. Khaitovych, N. Kysil, О. Temirova, O.M. Holovnia, D. Turchak, V.O. Polovynka
Relevance. Acute perianal abscess mainly occurs in boys in the first year of life, but can occur in girls and in older age, often progressing to anal fistula. After surgery and drainage, it is advisable to administer antibiotics because antibiotic therapy reduces the risk of fistula. Objective is to evaluate the possibility of using antibacterial drugs, mainly Access and Watch groups with a narrow spectrum of action, in the treatment of children with perianal abscess. Materials and methods. A retrospective analysis of the results of treatment of 26 boys and 4 girls aged 3 months to 17 years. The study of biological material was performed by the culture method. Species identification of microorganisms was performed on automatic microbiological analyzers Vitek2Compact (bioMerieux) and VitekMS (bioMerieux). All children underwent surgical removal of the crypt and drainage of the abscess. Antibacterial therapy was prescribed for a period of 3 to 12 days, depending on the course of the disease and the results of microbiological monitoring. Results. A total of 48 prescriptions of antibacterial agents were made, of which 33 (68.7%) were antibacterial agents from the Access group. 16 children were treated only with Access group antibacterial drugs. Of these, 14 children, mostly in the first year of life, received only narrow-spectrum antibacterial agents (amikacin in monotherapy or in combination with metronidazole, clindamycin). In the scheme of treatment of children 14 children, mostly older people included a drug from the group of cephalosporins of the third generation. Half of these patients also received amikacin and 3 received metronidazole. Conclusions. Children with acute perianal abscess in the first year of life should be treated as mono- or combination therapy with narrow-spectrum drugs from the Access group, while older children - with the inclusion of a combination of antimicrobial drugs broad-spectrum drugs Watch group.
{"title":"PRE-AUTHORIZATION OF ANTIBACTERIAL DRUGS IN THE TREATMENT OF CHILDREN WITH ACUTE PERIANAL ABSCESS","authors":"M. Khaitovych, N. Kysil, О. Temirova, O.M. Holovnia, D. Turchak, V.O. Polovynka","doi":"10.32345/2664-4738.2.2022.04","DOIUrl":"https://doi.org/10.32345/2664-4738.2.2022.04","url":null,"abstract":"Relevance. Acute perianal abscess mainly occurs in boys in the first year of life, but can occur in girls and in older age, often progressing to anal fistula. After surgery and drainage, it is advisable to administer antibiotics because antibiotic therapy reduces the risk of fistula. \u0000Objective is to evaluate the possibility of using antibacterial drugs, mainly Access and Watch groups with a narrow spectrum of action, in the treatment of children with perianal abscess. \u0000Materials and methods. A retrospective analysis of the results of treatment of 26 boys and 4 girls aged 3 months to 17 years. The study of biological material was performed by the culture method. Species identification of microorganisms was performed on automatic microbiological analyzers Vitek2Compact (bioMerieux) and VitekMS (bioMerieux). All children underwent surgical removal of the crypt and drainage of the abscess. Antibacterial therapy was prescribed for a period of 3 to 12 days, depending on the course of the disease and the results of microbiological monitoring. \u0000Results. A total of 48 prescriptions of antibacterial agents were made, of which 33 (68.7%) were antibacterial agents from the Access group. 16 children were treated only with Access group antibacterial drugs. Of these, 14 children, mostly in the first year of life, received only narrow-spectrum antibacterial agents (amikacin in monotherapy or in combination with metronidazole, clindamycin). In the scheme of treatment of children 14 children, mostly older people included a drug from the group of cephalosporins of the third generation. Half of these patients also received amikacin and 3 received metronidazole. \u0000Conclusions. Children with acute perianal abscess in the first year of life should be treated as mono- or combination therapy with narrow-spectrum drugs from the Access group, while older children - with the inclusion of a combination of antimicrobial drugs broad-spectrum drugs Watch group.","PeriodicalId":52737,"journal":{"name":"Medichna nauka Ukrayini","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42149879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-30DOI: 10.32345/2664-4738.2.2022.06
Olena Barabash
Relevance. The study is conditioned by a steady tendency of demographic aging of the population. On the part of the dental system, one of the most common age-related disorders is the tooth loss and the necessity to replace dentition defects. Changes in dental status can affect the course of oxidative reactions and antiradical protection of the oral fluid. Objective is to investigate the age peculiarities of the prooxidant-antioxidant balance of the oral fluid against the background of intact dentitions, partial and complete anodontia and their correction. Material and methods. There were examined 103 patients aged from 16 to 89, with intact dentitions, under the conditions of partial anodontia and correction with bridges or partial removable laminar dentures and complete anodontia and correction with complete removable laminar dentures. The intensity of the processes of free radical oxidation of lipids in oral fluid was assessed by the content of diene conjugates (DC) and products that respond to thiobarbituric acid (TBA-AP). The antioxidant reserve of the oral fluid was characterized according to the activity of superoxide dismutase (SOD), glutathione peroxidase (GP) and glutathione reductase (GR). Results. There was a significant increase of the indices of lipid peroxidation in the oral fluid, especially in middle-aged patients, which is confirmed by an increase in the content of DC and TBA-AP 5.9- and 4.5-fold, respectively, compared with data in adolescents. Such changes were consistent with a decrease in the activity of SOD, GP, GR of the oral fluid at 41.7-48.8% (p<0.05) relative to the values in adolescence. In elderly and senile patients, the level of lipid peroxidation tended to decrease. The activity of antioxidant enzymes in elderly patients decreased at 28.6-49.8% (p<0.05), in the senile patients – at 29.6-63.6% (p<0.05) relative to the values in the middle-aged patients. There has been an increase in the level of oxidative processes against the background of suppression of antiradical protection of the oral fluid in patients with partial or complete anodontia according to the data in the studied patients with intact dentitions, especially for people who use dentures. Conclusions. Prooxidant-antioxidant balance of the oral fluid depends on age and dental status. The most significant changes in oxidative processes in the oral fluid are observed in the middle-aged people with a tendency to decrease in the elderly and senile patients. The level of free radical processes increases under the conditions of partial and complete anodontia, correction of various types of denture designs and depends on the material they were made of. Such changes occur against the background of suppression of the antioxidant reserve of the oral fluid (especially the glutathione system).
{"title":"AGE PECULIARITIES OF PROOXIDANT-ANTIOXIDANT BALANCE OF THE ORAL FLUID IN PATIENTS AGAINST THE BACKGROUND OF INTAKT DENTITIONS, PARTIAL AND COMPLETE ANODONTIA","authors":"Olena Barabash","doi":"10.32345/2664-4738.2.2022.06","DOIUrl":"https://doi.org/10.32345/2664-4738.2.2022.06","url":null,"abstract":"Relevance. The study is conditioned by a steady tendency of demographic aging of the population. On the part of the dental system, one of the most common age-related disorders is the tooth loss and the necessity to replace dentition defects. Changes in dental status can affect the course of oxidative reactions and antiradical protection of the oral fluid. \u0000Objective is to investigate the age peculiarities of the prooxidant-antioxidant balance of the oral fluid against the background of intact dentitions, partial and complete anodontia and their correction. \u0000Material and methods. There were examined 103 patients aged from 16 to 89, with intact dentitions, under the conditions of partial anodontia and correction with bridges or partial removable laminar dentures and complete anodontia and correction with complete removable laminar dentures. The intensity of the processes of free radical oxidation of lipids in oral fluid was assessed by the content of diene conjugates (DC) and products that respond to thiobarbituric acid (TBA-AP). The antioxidant reserve of the oral fluid was characterized according to the activity of superoxide dismutase (SOD), glutathione peroxidase (GP) and glutathione reductase (GR). \u0000Results. There was a significant increase of the indices of lipid peroxidation in the oral fluid, especially in middle-aged patients, which is confirmed by an increase in the content of DC and TBA-AP 5.9- and 4.5-fold, respectively, compared with data in adolescents. Such changes were consistent with a decrease in the activity of SOD, GP, GR of the oral fluid at 41.7-48.8% (p<0.05) relative to the values in adolescence. In elderly and senile patients, the level of lipid peroxidation tended to decrease. The activity of antioxidant enzymes in elderly patients decreased at 28.6-49.8% (p<0.05), in the senile patients – at 29.6-63.6% (p<0.05) relative to the values in the middle-aged patients. There has been an increase in the level of oxidative processes against the background of suppression of antiradical protection of the oral fluid in patients with partial or complete anodontia according to the data in the studied patients with intact dentitions, especially for people who use dentures. \u0000Conclusions. Prooxidant-antioxidant balance of the oral fluid depends on age and dental status. The most significant changes in oxidative processes in the oral fluid are observed in the middle-aged people with a tendency to decrease in the elderly and senile patients. The level of free radical processes increases under the conditions of partial and complete anodontia, correction of various types of denture designs and depends on the material they were made of. Such changes occur against the background of suppression of the antioxidant reserve of the oral fluid (especially the glutathione system).","PeriodicalId":52737,"journal":{"name":"Medichna nauka Ukrayini","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44108122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-30DOI: 10.32345/2664-4738.1.2022.07
M. Khaitovych, O. Misiura
Relevance. Posttraumatic stress disorder (PTSD) occurs in people who have suffered a traumatic event (during war, natural disaster, domestic violence, etc.) sometimes even many years after the injury, causing changes in psychological and behavioral levels. Objective is to consider current data on the prevalence, pathophysiology and therapy of patients with PTSD. Methods. Analysis of data presented by PubMed by keywords "posttraumatic stress", "prevalence", "pathophysiology", "psychotherapy", "psychopharmacology". Results. PTSD is observed in 5-10% of the population, twice as often in women than in men, among children PTSD is found in 10%, in girls 4 times more often than in boys. During the war, PTSD is most often associated with stressful events such as bombing, homelessness, sieges, and combat. The highest prevalence of PTSD was among widows and widowers, divorcees, the unemployed and retirees. Hereditary sources of PTSD risk are shown on the basis of general genomic and epigenomic associations, transcriptomic and neuroimaging studies. Changes in the amygdala, islet, hippocampus, anterior cingulate cortex, and prefrontal cortex demonstrate that emotional dysregulation in PTSD occurs due to complications in the large neural network. Methods of non-pharmacological therapy of PTSD are presented and the effectiveness of drugs of different groups (antidepressants; antipsychotics; drugs that affect sympathetic activity, endocannabinoid system, etc.) is described. Conclusions. Posttraumatic stress disorder is a common disorder that is often undiagnosed, leading to significant psychological and behavioral disorders, increasing the risk of suicide. The review presents modern ideas about its pathophysiology and treatment options.
{"title":"EPIDEMIOLOGY, PATHOPHYSIOLOGY AND TREATMENT OF POSTTRAUMATIC STRESS DISORDER. Review","authors":"M. Khaitovych, O. Misiura","doi":"10.32345/2664-4738.1.2022.07","DOIUrl":"https://doi.org/10.32345/2664-4738.1.2022.07","url":null,"abstract":"Relevance. Posttraumatic stress disorder (PTSD) occurs in people who have suffered a traumatic event (during war, natural disaster, domestic violence, etc.) sometimes even many years after the injury, causing changes in psychological and behavioral levels. \u0000Objective is to consider current data on the prevalence, pathophysiology and therapy of patients with PTSD. \u0000Methods. Analysis of data presented by PubMed by keywords \"posttraumatic stress\", \"prevalence\", \"pathophysiology\", \"psychotherapy\", \"psychopharmacology\". \u0000Results. PTSD is observed in 5-10% of the population, twice as often in women than in men, among children PTSD is found in 10%, in girls 4 times more often than in boys. During the war, PTSD is most often associated with stressful events such as bombing, homelessness, sieges, and combat. The highest prevalence of PTSD was among widows and widowers, divorcees, the unemployed and retirees. Hereditary sources of PTSD risk are shown on the basis of general genomic and epigenomic associations, transcriptomic and neuroimaging studies. Changes in the amygdala, islet, hippocampus, anterior cingulate cortex, and prefrontal cortex demonstrate that emotional dysregulation in PTSD occurs due to complications in the large neural network. Methods of non-pharmacological therapy of PTSD are presented and the effectiveness of drugs of different groups (antidepressants; antipsychotics; drugs that affect sympathetic activity, endocannabinoid system, etc.) is described. \u0000Conclusions. Posttraumatic stress disorder is a common disorder that is often undiagnosed, leading to significant psychological and behavioral disorders, increasing the risk of suicide. The review presents modern ideas about its pathophysiology and treatment options.","PeriodicalId":52737,"journal":{"name":"Medichna nauka Ukrayini","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45211457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-30DOI: 10.32345/2664-4738.1.2022.08
M.V. Khaytovich, O. Misiura
Relevance. Mental health disorders are one of the most important side effects of the COVID-19 pandemic, and psychorehabilitation is seen as a key challenge in the fight against the pandemic. Objective is to study modern approaches to the psychorehabilitation of people affected by the COVID-19 pandemic. Methods. Analysis of data presented in PubMed by keywords "COVID psychological effects" and "rehabilitation", 2020-2021. Results. During isolation due to the COVID-19 pandemic, the number of people with mental health desorders increased by 12.9%, and the number of people with depressive symptoms increased by 10%. After the acute phase of COVID-19, “COVID-19-Long Syndrome” developed - a set of persistent physical, cognitive and / or psychological symptoms that lasted more than 12 weeks after illness and could not be explained by an alternative diagnosis. Healthcare workers who experienced physical pain, psychological distress, and death were more likely to develop secondary traumatic stress. The combination of burnout, injury, and frustration caused in medical staff to feel "hopeless with compassion." At the same time, the risk of developing anxiety was higher than in the general population. Patients with COVID-19 may need even more psychological support than regular intensive care patients. Therefore, rehabilitation, especially of critically ill patients, should be carried out by a multidisciplinary team. First, a short telephone sorting is performed. After the initial screening, patients are identified who need further assessment of mental health. At the 2nd stage of screening, patients who need psychorehabilitation are identified by telephone testing. The patient is met online or offline for 4 weeks with a mental health professional, if necessary - cognitive testing, and therapy is started. With regard to medical workers, the use of a strategy of psychological crisis intervention is envisaged. Conclusions. Patients with "long-term COVID" have a wide range of physical and mental / psychological symptoms. The most common are fatigue, shortness of breath, memory loss, anxiety and sleep disorders, and poor quality of life. It is better to use online interventions to rehabilitate patients with mild and moderate mental disorders. The most effective interventions: dosed information with or without professional psychological support and, to a lesser extent, in combination with psychopharmacological support.
{"title":"PSYCHOREHABILITATION IN THE COVID-19 PANDEMIC. Review","authors":"M.V. Khaytovich, O. Misiura","doi":"10.32345/2664-4738.1.2022.08","DOIUrl":"https://doi.org/10.32345/2664-4738.1.2022.08","url":null,"abstract":"Relevance. Mental health disorders are one of the most important side effects of the COVID-19 pandemic, and psychorehabilitation is seen as a key challenge in the fight against the pandemic. \u0000Objective is to study modern approaches to the psychorehabilitation of people affected by the COVID-19 pandemic. \u0000Methods. Analysis of data presented in PubMed by keywords \"COVID psychological effects\" and \"rehabilitation\", 2020-2021. \u0000Results. During isolation due to the COVID-19 pandemic, the number of people with mental health desorders increased by 12.9%, and the number of people with depressive symptoms increased by 10%. After the acute phase of COVID-19, “COVID-19-Long Syndrome” developed - a set of persistent physical, cognitive and / or psychological symptoms that lasted more than 12 weeks after illness and could not be explained by an alternative diagnosis. Healthcare workers who experienced physical pain, psychological distress, and death were more likely to develop secondary traumatic stress. The combination of burnout, injury, and frustration caused in medical staff to feel \"hopeless with compassion.\" At the same time, the risk of developing anxiety was higher than in the general population. \u0000Patients with COVID-19 may need even more psychological support than regular intensive care patients. Therefore, rehabilitation, especially of critically ill patients, should be carried out by a multidisciplinary team. First, a short telephone sorting is performed. After the initial screening, patients are identified who need further assessment of mental health. At the 2nd stage of screening, patients who need psychorehabilitation are identified by telephone testing. The patient is met online or offline for 4 weeks with a mental health professional, if necessary - cognitive testing, and therapy is started. With regard to medical workers, the use of a strategy of psychological crisis intervention is envisaged. \u0000Conclusions. Patients with \"long-term COVID\" have a wide range of physical and mental / psychological symptoms. The most common are fatigue, shortness of breath, memory loss, anxiety and sleep disorders, and poor quality of life. \u0000It is better to use online interventions to rehabilitate patients with mild and moderate mental disorders. The most effective interventions: dosed information with or without professional psychological support and, to a lesser extent, in combination with psychopharmacological support.","PeriodicalId":52737,"journal":{"name":"Medichna nauka Ukrayini","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44037857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-30DOI: 10.32345/2664-4738.1.2022.02
O. Samchuk, O.S. Kapustynska, E.Ya. Sklyarov E.Ya.
Relevance. Tissue plays a complex physiological role and may therefore progress to COVID-19 and heart failure. Objective is to evaluate the definition and myocardial biomarkers in a patient with viral disease in combination with obesity and heart failure. Materials and methods. 89 patients with coronavirus COVID-19 and heart failure were examined. All patients underwent anthropometric measurements and calculation of body mass index, general clinical treatment, levels of reactive protein, ferritin, procalcitonin, interleukin-6, as well as myocardial markers NTproBNP and troponin I. Results. Among 89 patients, obesity and overweight were diagnosed in 60.7% of cases (41.6% and 19.1%, respectively) and only 39.3% of the weight was in the normal range. Against the background of obesity on COVID-19 pneumonia and heart failure, a statistical increase in the level of C-reactive protein (87.79 ± 16.16 mg / l) was found in patients with COVID-19 pneumonia and non-obesity heart failure (48.79 ± 8.3; mg / l p = 0.036). The statistical value of the level of troponin I (0.04 (0.00; 0.09) on a gas mask in obese patients was noted) (0.01 (0.00; 0.05) ng / ml; p = 0.024). Conclusion. The growth of C-reactive protein in the body with obesity in pneumonia COVID-19 and heart failure confirms the important role of adipose tissue in induction and maintenance. Ectopic fat depots located in the thickness of the heart may also be involved in the development of inflammatory changes in the myocardium, a laboratory sign that is the growth of troponin I.
{"title":"THE ROLE OF OBESITY IN THE DEVELOPMENT OF INFLAMMATION AND PROGRESSION OF HEART FAILURE IN CORONAVIRUS DISEASE","authors":"O. Samchuk, O.S. Kapustynska, E.Ya. Sklyarov E.Ya.","doi":"10.32345/2664-4738.1.2022.02","DOIUrl":"https://doi.org/10.32345/2664-4738.1.2022.02","url":null,"abstract":"Relevance. Tissue plays a complex physiological role and may therefore progress to COVID-19 and heart failure. \u0000Objective is to evaluate the definition and myocardial biomarkers in a patient with viral disease in combination with obesity and heart failure. \u0000Materials and methods. 89 patients with coronavirus COVID-19 and heart failure were examined. All patients underwent anthropometric measurements and calculation of body mass index, general clinical treatment, levels of reactive protein, ferritin, procalcitonin, interleukin-6, as well as myocardial markers NTproBNP and troponin I. \u0000Results. Among 89 patients, obesity and overweight were diagnosed in 60.7% of cases (41.6% and 19.1%, respectively) and only 39.3% of the weight was in the normal range. Against the background of obesity on COVID-19 pneumonia and heart failure, a statistical increase in the level of C-reactive protein (87.79 ± 16.16 mg / l) was found in patients with COVID-19 pneumonia and non-obesity heart failure (48.79 ± 8.3; mg / l p = 0.036). The statistical value of the level of troponin I (0.04 (0.00; 0.09) on a gas mask in obese patients was noted) (0.01 (0.00; 0.05) ng / ml; p = 0.024). \u0000Conclusion. The growth of C-reactive protein in the body with obesity in pneumonia COVID-19 and heart failure confirms the important role of adipose tissue in induction and maintenance. Ectopic fat depots located in the thickness of the heart may also be involved in the development of inflammatory changes in the myocardium, a laboratory sign that is the growth of troponin I.","PeriodicalId":52737,"journal":{"name":"Medichna nauka Ukrayini","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49200948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-30DOI: 10.32345/2664-4738.1.2022.09
T. Hrydina
Relevance. The goal of the WHO Global Strategy on Hepatitis Agents, in particular hepatitis C virus, is to identify infected people early for treatment and prevention of chronic infection. Early detection and treatment of this infection with direct antiviral drugs significantly reduces the incidence of liver cirrhosis and subsequent deaths. Development of an effective hepatitis C vaccine that can primarily protect at-risk individuals is ongoing. Objective: to determine the main approaches for the treatment and prevention of hepatitis C, proposed by WHO, which can lead to the prevention of the formation of chronic forms of the disease and the development of hepatocarcinoma. Methods. Analysis of publications from scientometric databases PubMed, Google Scolar, Cohrane Database by keywords. Search depth is 10 years (2011–2021). Results. Analysis of literature sources about the peculiarities of the treatment of C viral hepatitis showed the feasibility of using drugs with direct antiviral action. Selection of such drugs in order the structural features of the pathogen and specificity of inhibition of the stages of viral reproduction process is discussed and justified. The specificity of the action of these drugs and the main targets of their application are considered. Today, WHO recommends the using of thirteen antiviral drugs with direct action. Two preparations are inhibitors of viral polymerase and the other eleven drugs inhibit of the viral proteases activity. Two direct-acting drugs with a different mechanism of activity are used in the therapeutic schemes. The genotype of the virus, the age and state of health of the patients, especially liver state, have to be considered during the treatment process. This treatment allows to get a positive result without using of interferon, which can cause some complication. Prospects with using new technologies for the creation of effective drugs for the specific prevention of hepatitis C, such as recombinant vaccines, nanovaccines, mRNA containing modified vaccines are considered. Such vaccines will allow to provide specific prophylaxis, especially among people from risk groups, including those with immunodeficiency states. Conclusions. The application of the global strategy proposed by WHO such as early detection and treatment of acute hepatitis C for prevention of the development of chronic forms will lead to a decrease in the incidence of hepatitis in the world.
{"title":"PECULIARITIES OF TREATMENT AND PREVENTION OF INFECTION CAUSED BY HEPATITIS C VIRUS. Review","authors":"T. Hrydina","doi":"10.32345/2664-4738.1.2022.09","DOIUrl":"https://doi.org/10.32345/2664-4738.1.2022.09","url":null,"abstract":"Relevance. The goal of the WHO Global Strategy on Hepatitis Agents, in particular hepatitis C virus, is to identify infected people early for treatment and prevention of chronic infection. Early detection and treatment of this infection with direct antiviral drugs significantly reduces the incidence of liver cirrhosis and subsequent deaths. Development of an effective hepatitis C vaccine that can primarily protect at-risk individuals is ongoing. \u0000Objective: to determine the main approaches for the treatment and prevention of hepatitis C, proposed by WHO, which can lead to the prevention of the formation of chronic forms of the disease and the development of hepatocarcinoma. \u0000Methods. Analysis of publications from scientometric databases PubMed, Google Scolar, Cohrane Database by keywords. Search depth is 10 years (2011–2021). \u0000Results. Analysis of literature sources about the peculiarities of the treatment of C viral hepatitis showed the feasibility of using drugs with direct antiviral action. Selection of such drugs in order the structural features of the pathogen and specificity of inhibition of the stages of viral reproduction process is discussed and justified. The specificity of the action of these drugs and the main targets of their application are considered. Today, WHO recommends the using of thirteen antiviral drugs with direct action. Two preparations are inhibitors of viral polymerase and the other eleven drugs inhibit of the viral proteases activity. Two direct-acting drugs with a different mechanism of activity are used in the therapeutic schemes. The genotype of the virus, the age and state of health of the patients, especially liver state, have to be considered during the treatment process. This treatment allows to get a positive result without using of interferon, which can cause some complication. Prospects with using new technologies for the creation of effective drugs for the specific prevention of hepatitis C, such as recombinant vaccines, nanovaccines, mRNA containing modified vaccines are considered. Such vaccines will allow to provide specific prophylaxis, especially among people from risk groups, including those with immunodeficiency states. \u0000Conclusions. The application of the global strategy proposed by WHO such as early detection and treatment of acute hepatitis C for prevention of the development of chronic forms will lead to a decrease in the incidence of hepatitis in the world.","PeriodicalId":52737,"journal":{"name":"Medichna nauka Ukrayini","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43659954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-30DOI: 10.32345/2664-4738.1.2022.04
Удк, Перебіг Генералізованих, Форм Менінгококової Інфекції, У Дітей, Львівщини Протягом
Relevance. Meningococcal infection (MI) is one of the most significant bacterial infections in children, it is characterized by life-threatening and unpredictable fulminant course in the structure of infectious diseases. Objective. To analyze the clinical and laboratory features of generalized forms of MI in children of Lviv region during 2011-2019. Materials and methods. Retrospective analysis of 254 case reports of patients with generalized forms of MI, hospitalized in regional infectious diseases clinical hospital during 2011 -2019 years, was conducted, as well as 14 protocols for post-mortem examination of deceased from generalized forms of MI children during 2011-2019. 203 medical records with confirmed diagnosis of the disease were selected. Results. Meningitis as a clinical form was diagnosed in 48 children (23.6%), meningoencephalitis in 6 (3%), meningococcemia − in 82 (40.4%), combined form − in 67 children (33%). In children aged 1 month to 1 year and aged 1 to 3 years the combined form of the disease occurred significantly more often than the isolated clinical form. Analysis of clinical symptoms and major laboratory parameters in various clinical forms of MI were exemplified. 12 children from 5 months up to 4 years 10 months diagnosed with MI generalized form: meningococcemia fulminant form, and one 6-year-old child with purulent meningoencephalitis had died. Conclusions. Despite of gradual decrease of morbidity level and respectively amount of hospitalized patients throughout 2011-2019, a difficult course of generalized forms of MI with development of toxische Schocksyndrom in 77,9% in patients with meningoccocemia were observed. Mortality in meningococcemia was 8,1%, most of the deceased were children aged 3-5 years. Misdiagnosis at the primary level were observed in 14,3%.
{"title":"THE COURSE OF GENERALIZED FORMS OF MENINGOCOCCAL INFECTION IN CHILDREN OF THE LVIV REGION DURING 2011-2019","authors":"Удк, Перебіг Генералізованих, Форм Менінгококової Інфекції, У Дітей, Львівщини Протягом","doi":"10.32345/2664-4738.1.2022.04","DOIUrl":"https://doi.org/10.32345/2664-4738.1.2022.04","url":null,"abstract":"Relevance. Meningococcal infection (MI) is one of the most significant bacterial infections in children, it is characterized by life-threatening and unpredictable fulminant course in the structure of infectious diseases. \u0000Objective. To analyze the clinical and laboratory features of generalized forms of MI in children of Lviv region during 2011-2019. \u0000Materials and methods. Retrospective analysis of 254 case reports of patients with generalized forms of MI, hospitalized in regional infectious diseases clinical hospital during 2011 -2019 years, was conducted, as well as 14 protocols for post-mortem examination of deceased from generalized forms of MI children during 2011-2019. 203 medical records with confirmed diagnosis of the disease were selected. \u0000Results. Meningitis as a clinical form was diagnosed in 48 children (23.6%), meningoencephalitis in 6 (3%), meningococcemia − in 82 (40.4%), combined form − in 67 children (33%). \u0000In children aged 1 month to 1 year and aged 1 to 3 years the combined form of the disease occurred significantly more often than the isolated clinical form. Analysis of clinical symptoms and major laboratory parameters in various clinical forms of MI were exemplified. \u000012 children from 5 months up to 4 years 10 months diagnosed with MI generalized form: meningococcemia fulminant form, and one 6-year-old child with purulent meningoencephalitis had died. \u0000Conclusions. Despite of gradual decrease of morbidity level and respectively amount of hospitalized patients throughout 2011-2019, a difficult course of generalized forms of MI with development of toxische Schocksyndrom in 77,9% in patients with meningoccocemia were observed. Mortality in meningococcemia was 8,1%, most of the deceased were children aged 3-5 years. Misdiagnosis at the primary level were observed in 14,3%.","PeriodicalId":52737,"journal":{"name":"Medichna nauka Ukrayini","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47891488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-30DOI: 10.32345/2664-4738.1.2022.10
O. Iaremenko, D. Koliadenko
Relevance. HIV infection is characterized by a wide spectrum of clinical manifestations, including musculoskeletal symptoms, which can occur at any stage of the disease. Objective: to analyze own clinical cases with rheumatologic manifestations of HIV infection in context of literature data on the spectrum of musculoskeletal manifestations of HIV infection, approaches to diagnosis and treatment. Methods. Presentation of own clinical cases and review of scientific publications in the international electronic scientometric database PubMed using keywords «HIV infection», «arthritis», «musculoskeletal manifestations» over the period 2000-2021 years. Results. The prevalence of musculoskeletal symptoms in HIV-infected individuals ranges from 10 to 45%. Articular manifestations of HIV infection can be divided into 3 main groups: 1) related to HIV (arthralgias, painful articular syndrome, HIV-associated arthritis, septic arthritis); 2) inflammatory arthritis (rheumatoid arthritis, reactive arthritis, psoriatic arthritis, undifferentiated spondyloarthritis); 3) associated with antiretroviral therapy (aseptic necrosis, osteoporosis, osteomalacia, immune reconstitution inflammatory syndrome, gout). For treatment of articular manifestations analgesics, nonsteroidal anti-inflammatory drugs (drug of choice - indomethacin), intraarticular or oral glucocorticoids, disease-modifying antirheumatic drugs (drug of choice - hydroxychloroquine) may be used. Conditions for initiation of therapy with disease-modifying antirheumatic drugs: a controlled steady course of HIV with antiretroviral therapy performed, the number of CD4+ cells >200/ml, undetectable viral load. Our clinical cases confirm that indications for HIV testing in rheumatologic patients are reactive arthritis of unknown etiology, atypical lupus, persistent leukopenia, unreasonable weight loss, lack of an adequate response to traditional therapy of rheumatological diseases. Conclusions. Articular syndrome in HIV-infected individuals may be a separate manifestation of HIV infection and result of antiretroviral therapy. Treatment of articular manifestations in HIV-infected individuals primarily involves the treatment of HIV infection, and it depends on its clinical stage, use of antiretroviral therapy, the severity of articular syndrome and involvement of other organs. Our clinical observations demonstrate the possibility of articular manifestations at various stages of HIV infection: before diagnosis, during prolonged stable antiretroviral therapy, as well as after a change in antiretroviral therapy.
{"title":"HIV-ASSOCIATED ARTHRITIS. Review and clinical cases","authors":"O. Iaremenko, D. Koliadenko","doi":"10.32345/2664-4738.1.2022.10","DOIUrl":"https://doi.org/10.32345/2664-4738.1.2022.10","url":null,"abstract":"Relevance. HIV infection is characterized by a wide spectrum of clinical manifestations, including musculoskeletal symptoms, which can occur at any stage of the disease. \u0000Objective: to analyze own clinical cases with rheumatologic manifestations of HIV infection in context of literature data on the spectrum of musculoskeletal manifestations of HIV infection, approaches to diagnosis and treatment. \u0000Methods. Presentation of own clinical cases and review of scientific publications in the international electronic scientometric database PubMed using keywords «HIV infection», «arthritis», «musculoskeletal manifestations» over the period 2000-2021 years. \u0000Results. The prevalence of musculoskeletal symptoms in HIV-infected individuals ranges from 10 to 45%. Articular manifestations of HIV infection can be divided into 3 main groups: 1) related to HIV (arthralgias, painful articular syndrome, HIV-associated arthritis, septic arthritis); 2) inflammatory arthritis (rheumatoid arthritis, reactive arthritis, psoriatic arthritis, undifferentiated spondyloarthritis); 3) associated with antiretroviral therapy (aseptic necrosis, osteoporosis, osteomalacia, immune reconstitution inflammatory syndrome, gout). For treatment of articular manifestations analgesics, nonsteroidal anti-inflammatory drugs (drug of choice - indomethacin), intraarticular or oral glucocorticoids, disease-modifying antirheumatic drugs (drug of choice - hydroxychloroquine) may be used. Conditions for initiation of therapy with disease-modifying antirheumatic drugs: a controlled steady course of HIV with antiretroviral therapy performed, the number of CD4+ cells >200/ml, undetectable viral load. Our clinical cases confirm that indications for HIV testing in rheumatologic patients are reactive arthritis of unknown etiology, atypical lupus, persistent leukopenia, unreasonable weight loss, lack of an adequate response to traditional therapy of rheumatological diseases. \u0000Conclusions. Articular syndrome in HIV-infected individuals may be a separate manifestation of HIV infection and result of antiretroviral therapy. Treatment of articular manifestations in HIV-infected individuals primarily involves the treatment of HIV infection, and it depends on its clinical stage, use of antiretroviral therapy, the severity of articular syndrome and involvement of other organs. Our clinical observations demonstrate the possibility of articular manifestations at various stages of HIV infection: before diagnosis, during prolonged stable antiretroviral therapy, as well as after a change in antiretroviral therapy.","PeriodicalId":52737,"journal":{"name":"Medichna nauka Ukrayini","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45240263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-30DOI: 10.32345/2664-4738.1.2022.06
M. Khaitovych, V. Sova, K. Kyrylchuk, І.М. Sytnyk, V.O. Polovynka, О.А. Теmіrоvа, D. Turchak
Relevance. The development of medical and pharmaceutical technologies has allowed ensuring the quality of life of children even with severe chronic diseases, but often the treatment of such children is associated with polypharmacy. Objective is to assess the risks of drug interactions in children with polypharmacy. Materials and methods. The course of pharmacotherapy of 54 children with atopic diseases, diseases of the gastrointestinal tract, parasitic infestation, inflammatory diseases of the genital organs, etc. aged from birth to 17 years, who received simultaneously from 5 to 11 drugs (average 6.4 ± 1.5 drugs) Results. Problematic polypharmacy was founded in 31 children (75.0% of schoolchildren and 38.5% of preschool children) with polypharmacy. Among them, 22 patients (71.0%) had pharmacokinetic risks, and 17 children (54.8%) had pharmacodynamic interactions. Among the causes of pharmacokinetic interaction – the use of inhibitors (omeprazole, etc.) and inducers (phenobarbital, St. John's wort, etc.) metabolism, pharmacodynamic interaction – the simultaneous use of several glucocorticoids, drugs with similar organ toxicity, and more. Conclusions. Outpatient use of 5 or more drugs is combined in more than half of children at risk of their interaction, development of side effects or reduced effectiveness of treatment.
{"title":"PROBLEMATIC POLYPHARMACY IN OUTPATIENT THERAPY OF CHILDREN: POTENTIAL RISKS OF DRUG INTERACTIONS","authors":"M. Khaitovych, V. Sova, K. Kyrylchuk, І.М. Sytnyk, V.O. Polovynka, О.А. Теmіrоvа, D. Turchak","doi":"10.32345/2664-4738.1.2022.06","DOIUrl":"https://doi.org/10.32345/2664-4738.1.2022.06","url":null,"abstract":"Relevance. The development of medical and pharmaceutical technologies has allowed ensuring the quality of life of children even with severe chronic diseases, but often the treatment of such children is associated with polypharmacy. \u0000Objective is to assess the risks of drug interactions in children with polypharmacy. \u0000Materials and methods. The course of pharmacotherapy of 54 children with atopic diseases, diseases of the gastrointestinal tract, parasitic infestation, inflammatory diseases of the genital organs, etc. aged from birth to 17 years, who received simultaneously from 5 to 11 drugs (average 6.4 ± 1.5 drugs) \u0000Results. Problematic polypharmacy was founded in 31 children (75.0% of schoolchildren and 38.5% of preschool children) with polypharmacy. Among them, 22 patients (71.0%) had pharmacokinetic risks, and 17 children (54.8%) had pharmacodynamic interactions. Among the causes of pharmacokinetic interaction – the use of inhibitors (omeprazole, etc.) and inducers (phenobarbital, St. John's wort, etc.) metabolism, pharmacodynamic interaction – the simultaneous use of several glucocorticoids, drugs with similar organ toxicity, and more. \u0000Conclusions. Outpatient use of 5 or more drugs is combined in more than half of children at risk of their interaction, development of side effects or reduced effectiveness of treatment.","PeriodicalId":52737,"journal":{"name":"Medichna nauka Ukrayini","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46967551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-30DOI: 10.32345/2664-4738.1.2022.11
D. Turchak, M. Khaitovych
Relevance. It is known that 12.5% of women suffer from infertility. Correction of menstrual disorders is an important way to maintain a woman's reproductive health. Objective is to consider current data on the physiology, etiopathogenesis and pharmacotherapy of women with ovarian-menstrual disorders. Methods. Analysis of the data presented in PubMed, by keywords "ovarian-menstrual cycle", "pharmacological support". Results. Modern data on physiology, humoral regulation of the ovarian-menstrual cycle are presented. The role of positive and negative feedback between estradiol and progesterone levels and the activity of anterior pituitary gonadotropic hormones and insulin regulatory pathways is emphasized. The main changes of the central nervous system and behavioral features depending on the phase of the menstrual cycle are described. The directions of pharmacological support and stimulation of ovulation are described. The mechanisms of action and indications for the use of oral hypoglycemic and gonadotropic drugs, the benefits and place of each in the maintenance and stimulation of the ovarian-menstrual cycle are presented. Metformin is effective in clomiphene-resistant women and may be combined with clomiphene, particularly in the treatment of polycystic ovary syndrome (PCOS). Sitagliptin improves ovulation in PCOS, is more effective in combination with metformin. Gonadotropins stimulate the ovaries, promoting the production and maturation of eggs, progesterone prepares the inner layer of the uterus to fix the embryo and helps to bear fruit. They are mainly used in women with PCOS in whom other drugs are ineffective.Some results of pharmacogenetic researches, efficiency, in particular, use of follicle-stimulating hormone depending on genetic polymorphisms of its receptor are noted. Conclusions. In modern conditions, the use of pharmacological agents is an important area of support and stimulation of the ovarian-menstrual cycle to improve female reproductive function.
{"title":"CLINICO-PHARMACOLOGICAL ASPECTS OF OVARIAN-MENSTRUAL CYCLE SUPPORT. Review","authors":"D. Turchak, M. Khaitovych","doi":"10.32345/2664-4738.1.2022.11","DOIUrl":"https://doi.org/10.32345/2664-4738.1.2022.11","url":null,"abstract":"Relevance. It is known that 12.5% of women suffer from infertility. Correction of menstrual disorders is an important way to maintain a woman's reproductive health. \u0000Objective is to consider current data on the physiology, etiopathogenesis and pharmacotherapy of women with ovarian-menstrual disorders. \u0000Methods. Analysis of the data presented in PubMed, by keywords \"ovarian-menstrual cycle\", \"pharmacological support\". \u0000Results. Modern data on physiology, humoral regulation of the ovarian-menstrual cycle are presented. The role of positive and negative feedback between estradiol and progesterone levels and the activity of anterior pituitary gonadotropic hormones and insulin regulatory pathways is emphasized. The main changes of the central nervous system and behavioral features depending on the phase of the menstrual cycle are described. The directions of pharmacological support and stimulation of ovulation are described. The mechanisms of action and indications for the use of oral hypoglycemic and gonadotropic drugs, the benefits and place of each in the maintenance and stimulation of the ovarian-menstrual cycle are presented. Metformin is effective in clomiphene-resistant women and may be combined with clomiphene, particularly in the treatment of polycystic ovary syndrome (PCOS). Sitagliptin improves ovulation in PCOS, is more effective in combination with metformin. Gonadotropins stimulate the ovaries, promoting the production and maturation of eggs, progesterone prepares the inner layer of the uterus to fix the embryo and helps to bear fruit. They are mainly used in women with PCOS in whom other drugs are ineffective.Some results of pharmacogenetic researches, efficiency, in particular, use of follicle-stimulating hormone depending on genetic polymorphisms of its receptor are noted. \u0000Conclusions. In modern conditions, the use of pharmacological agents is an important area of support and stimulation of the ovarian-menstrual cycle to improve female reproductive function.","PeriodicalId":52737,"journal":{"name":"Medichna nauka Ukrayini","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46635152","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：