Pub Date : 2022-03-30DOI: 10.32345/2664-4738.1.2022.03
Комплексна Оцінка, Статусу Вітаміну, D. У. Дітей, дошкільного віку, З Рекурентними, Респіраторними Інфекціями
Relevance. Vitamin D has a wide range of biological effects. The immunomodulatory properties of this vitamin and the higher incidence rate of respiratory infections against the background of its lack are of particular interest. Objective to determine the relationship between 25-hydroxycalciferol serum concentration, the main parameters of clinical blood test, the particular features of undifferentiated connective tissue dysplasia and the burden indicators of acute respiratory infections among preschool children. Materials and methods. Seventy-four children (34 boys and 40 girls) aged one to six years old, undergoing inpatient treatment on acute respiratory infection, were involved in the clinical study. Two markers of acute respiratory infections recurrence (infectious index, resistance index) and dolichostenomelia integral indicator were calculated in the patients. The main erythrocyte and platelet parameters of clinical blood test and 25-hydroxycalciferol serum concentration were quantified as well. Results. The inverse interdependence was revealed between the resistance index and the variation coefficient of erythrocytes in terms of their volume (ρ =-0,312; p=0,011). The regression dependence of infectious index on the dolichostenomelia integral indicator was found. The results obtained gave preconditions for further research on the problem of recurrent respiratory infections in pediatric practice. Conclusions. The examined children, who had lower categorical levels of 25-hydroxycalciferol concentration, also had higher maximum body temperature against the background of acute inflammatory process in respiratory system (H=10,079; p=0,018). The highly close relationship was established between the distribution categories of the patients according to the concentration of 25-hydroxycalciferol and the value of dolichostenomelia integral indicator (φс=0,624; p=0,004). The inverse moderate correlation was found between the concentration of 25-hydroxycalciferol and the resistance index (ρ=-0,347; p=0,043). Partial correlation analysis showed the interdependence of 25-hydroxycalciferol concentration with platelets number (ρ(xy-z)=0,336; p=0,048) and platelet Crit value (ρ(xy-z)=0,342; p=0,043) without taking into account the patients’ age.
{"title":"COMPREHENSIVE ASSESSMENT OF VITAMIN D STATUS IN PRESCHOOL CHILDREN SUFFERING FROM RECURRENT RESPIRATORY INFECTIONS","authors":"Комплексна Оцінка, Статусу Вітаміну, D. У. Дітей, дошкільного віку, З Рекурентними, Респіраторними Інфекціями","doi":"10.32345/2664-4738.1.2022.03","DOIUrl":"https://doi.org/10.32345/2664-4738.1.2022.03","url":null,"abstract":"Relevance. Vitamin D has a wide range of biological effects. The immunomodulatory properties of this vitamin and the higher incidence rate of respiratory infections against the background of its lack are of particular interest. \u0000Objective to determine the relationship between 25-hydroxycalciferol serum concentration, the main parameters of clinical blood test, the particular features of undifferentiated connective tissue dysplasia and the burden indicators of acute respiratory infections among preschool children. \u0000Materials and methods. Seventy-four children (34 boys and 40 girls) aged one to six years old, undergoing inpatient treatment on acute respiratory infection, were involved in the clinical study. Two markers of acute respiratory infections recurrence (infectious index, resistance index) and dolichostenomelia integral indicator were calculated in the patients. The main erythrocyte and platelet parameters of clinical blood test and 25-hydroxycalciferol serum concentration were quantified as well. \u0000Results. The inverse interdependence was revealed between the resistance index and the variation coefficient of erythrocytes in terms of their volume (ρ =-0,312; p=0,011). The regression dependence of infectious index on the dolichostenomelia integral indicator was found. The results obtained gave preconditions for further research on the problem of recurrent respiratory infections in pediatric practice. \u0000Conclusions. The examined children, who had lower categorical levels of 25-hydroxycalciferol concentration, also had higher maximum body temperature against the background of acute inflammatory process in respiratory system (H=10,079; p=0,018). The highly close relationship was established between the distribution categories of the patients according to the concentration of 25-hydroxycalciferol and the value of dolichostenomelia integral indicator (φс=0,624; p=0,004). The inverse moderate correlation was found between the concentration of 25-hydroxycalciferol and the resistance index (ρ=-0,347; p=0,043). Partial correlation analysis showed the interdependence of 25-hydroxycalciferol concentration with platelets number (ρ(xy-z)=0,336; p=0,048) and platelet Crit value (ρ(xy-z)=0,342; p=0,043) without taking into account the patients’ age.","PeriodicalId":52737,"journal":{"name":"Medichna nauka Ukrayini","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69516571","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: 10.32345/2664-4738.1.2022.05
O. Legenchuk, Y. Nemyrovych
Relevance. In acute leukemia, the phagocytic activity of leukocytes changes. But the extend and details of these changes are still insufficiently studied. Objective: to assess the state of phagocytic activity of phagocytic cells (neutrophils and macrophages) in terms of phagocytic index, phagocytic number and oxygen-dependent phagocytosis in children with acute forms of leukemia. Materials and methods. We examined 35 children aged 6 to 16 years, who were at different stages of treatment of the underlying disease. The children were divided into two groups depending on the form of leukemia: Group I – nineteen children with acute lymphoblastic leukemia (ALL), nine of them at the stage of the first acute period, four at the stage of clinical remission, six at the stage of relapse; Group II - sixteen children with acute myeloid leukemia (AML), seven of them - at the stage of the first acute period, four -in the period of the clinical remission, five - at the stage of relapse. Control Group – fifteen practically healthy children. In oral fluid, the phagocytic activity of granulocytes was determined: phagocytic number (PN) – the percentage of phagocytic neutrophils; phagocytic index (PI) – the number (in conditional units) of phagocytosed microorganisms by one neutrophil; oxygen-dependent phagocytosis according to the NBT test (Nitroblue Tetrazolium) – the percentage of the maximum activity of neutrophils. Results. PN in the control group - 70.0±5.1%. In children with acute lymphoblastic leukemia at the stage of the first acute period of PN - 85.7±5.8%, at the stage of remission - 73.8 ±6.1%, during the relapse period - 88.3% ±4.8. In children with acute myeloblastic leukemia at the stage of treatment of the first acute period, PN was 87.2±6.0%, at the stage of remission - 72.6±5.9%, at the stage of relapse - 89.1±5.1%. PI in the control group – 3.9±0.6 In children with acute myeloid leukemia at the stage of treatment of the first acute period, PI was 21.1±0.7, at the stage of relapse – 25.3±0.4 In children with acute myeloblastic leukemia at the stage of treatment of the first acute period, PI was 16.1±0.5, during remission – 10.1±0.4, during the relapse period – 18.5±0.2. The indicator of oxygen-dependent cell activity, according to the NBT test, in practically healthy children was 17.6±1.23%. In children with acute myeloblastic leukemia at the stage of treatment of the first acute period, the percentage of cell activity was 40.4±1.86%, at the stage of relapse - 46.4±2.0%, during remission - 23.7±1.56%. In children with acute myeloblastic leukemia at the stage of treatment of the first acute period, the percentage of cell activity was 41.6±1.34%, during the period of relapse - 48.5±1.05%, at the stage of remission - 27.9±1.86%. Conclusion. The dependence of phagocytic activity of neutrophils in the oral fluid on the stage of treatment of acute leukemia in children was revealed. The phagocytic number, phagocytic index and oxygen-dependent phagocy
{"title":"PHAGOCYTIC ACTIVITY OF NEUTROPHILIC GRANULOCYTES OF ORAL FLUID IN CHILDREN WITH ACUTE FORMS OF LEUKEMIA","authors":"O. Legenchuk, Y. Nemyrovych","doi":"10.32345/2664-4738.1.2022.05","DOIUrl":"https://doi.org/10.32345/2664-4738.1.2022.05","url":null,"abstract":"Relevance. In acute leukemia, the phagocytic activity of leukocytes changes. But the extend and details of these changes are still insufficiently studied. \u0000Objective: to assess the state of phagocytic activity of phagocytic cells (neutrophils and macrophages) in terms of phagocytic index, phagocytic number and oxygen-dependent phagocytosis in children with acute forms of leukemia. \u0000Materials and methods. We examined 35 children aged 6 to 16 years, who were at different stages of treatment of the underlying disease. The children were divided into two groups depending on the form of leukemia: Group I – nineteen children with acute lymphoblastic leukemia (ALL), nine of them at the stage of the first acute period, four at the stage of clinical remission, six at the stage of relapse; Group II - sixteen children with acute myeloid leukemia (AML), seven of them - at the stage of the first acute period, four -in the period of the clinical remission, five - at the stage of relapse. Control Group – fifteen practically healthy children. In oral fluid, the phagocytic activity of granulocytes was determined: phagocytic number (PN) – the percentage of phagocytic neutrophils; phagocytic index (PI) – the number (in conditional units) of phagocytosed microorganisms by one neutrophil; oxygen-dependent phagocytosis according to the NBT test (Nitroblue Tetrazolium) – the percentage of the maximum activity of neutrophils. \u0000Results. PN in the control group - 70.0±5.1%. In children with acute lymphoblastic leukemia at the stage of the first acute period of PN - 85.7±5.8%, at the stage of remission - 73.8 ±6.1%, during the relapse period - 88.3% ±4.8. In children with acute myeloblastic leukemia at the stage of treatment of the first acute period, PN was 87.2±6.0%, at the stage of remission - 72.6±5.9%, at the stage of relapse - 89.1±5.1%. \u0000PI in the control group – 3.9±0.6 In children with acute myeloid leukemia at the stage of treatment of the first acute period, PI was 21.1±0.7, at the stage of relapse – 25.3±0.4 In children with acute myeloblastic leukemia at the stage of treatment of the first acute period, PI was 16.1±0.5, during remission – 10.1±0.4, during the relapse period – 18.5±0.2. \u0000The indicator of oxygen-dependent cell activity, according to the NBT test, in practically healthy children was 17.6±1.23%. In children with acute myeloblastic leukemia at the stage of treatment of the first acute period, the percentage of cell activity was 40.4±1.86%, at the stage of relapse - 46.4±2.0%, during remission - 23.7±1.56%. In children with acute myeloblastic leukemia at the stage of treatment of the first acute period, the percentage of cell activity was 41.6±1.34%, during the period of relapse - 48.5±1.05%, at the stage of remission - 27.9±1.86%. \u0000Conclusion. The dependence of phagocytic activity of neutrophils in the oral fluid on the stage of treatment of acute leukemia in children was revealed. The phagocytic number, phagocytic index and oxygen-dependent phagocy","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":"45188002","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: 10.32345/2664-4738.1.2022.01
H. Sklyarova, N. Pokrovska, O. Hrushka, E. Sklyarov
Relevance. Patients with comorbid pathology, including arterial hypertension (AH), coronary artery disease, type 2 diabetes, and cerebrovascular disease have been shown to be at risk for coronavirus disease (COVID-19). Currently, among the pathogenetic mechanisms of vascular endothelial damage are considered direct effects of SARS-COV-2 virus, as well as proinflammatory cytokines, which lead to a «cytokine storm» with unpredictable consequences for the patient. In this aspect, the role of leukotriene B4 (LTB4) – one of the first candidates to provoke a hyperimmune inflammatory response in the progression of COVID-19 – was insufficiently elucidated. Objective: to investigate the level of leukotriene B4 (LTB4) in patients with AH with and without coronavirus disease 2019. Methods. 78 people with AH and overweight or obesity who were treated at the Lviv Emergency Hospital were examined. All patients were divided into 2 groups: group 1 (n=37) – persons with AH (stage І-ІІІ, grade 1-3); group 2 (n=41) – patients with AH (stage І-ІІІ, grade 1-3), COVID -19 and interstitial lung disease. Anthropometric measurements with a determination of body mass index (BMI), echocardiography, a blood test, biochemical blood test with determination of glucose, alanine aminotransferase, aspartate aminotransferase, creatinine, and urea were performed. Serum blood samples for the examination of LTB4 (Elabscience Elisa Kit) were taken and processed using ELISA method. Results. Saturation was significantly lower in patients of group 2, while heart rate and body temperature were higher (p < 0,01) compared to group 1. There was a significant decrease in hemoglobin level, increase in ESR, glucose, and LTB4 in individuals with AH and COVID-19, which is probably due to the presence of inflammation in the lung tissue in coronavirus infection. The concentration of LTB4 ranged from 370 to 3600 pg/l in patients of group 2. 19 individuals (46,3%) of group 2 had a higher level of LTB4 than the median value, which is probably associated with a more severe course of coronavirus infection. A positive correlation between LTB4 and BMI (rs= 0,369; p < 0,05) was found in individuals with AH. Conclusions. The level of LTB4 is higher in patients with AH and COVID – 19 than in individuals with AH, due to the severity of the inflammation process in this comorbid pathology.
{"title":"THE LEVEL OF LEUKOTRIENE B4 IN PATIENTS WITH ARTERIAL HYPERTENSION AND CORONAVIRUS DISEASE","authors":"H. Sklyarova, N. Pokrovska, O. Hrushka, E. Sklyarov","doi":"10.32345/2664-4738.1.2022.01","DOIUrl":"https://doi.org/10.32345/2664-4738.1.2022.01","url":null,"abstract":"Relevance. Patients with comorbid pathology, including arterial hypertension (AH), coronary artery disease, type 2 diabetes, and cerebrovascular disease have been shown to be at risk for coronavirus disease (COVID-19). Currently, among the pathogenetic mechanisms of vascular endothelial damage are considered direct effects of SARS-COV-2 virus, as well as proinflammatory cytokines, which lead to a «cytokine storm» with unpredictable consequences for the patient. In this aspect, the role of leukotriene B4 (LTB4) – one of the first candidates to provoke a hyperimmune inflammatory response in the progression of COVID-19 – was insufficiently elucidated. \u0000Objective: to investigate the level of leukotriene B4 (LTB4) in patients with AH with and without coronavirus disease 2019. \u0000Methods. 78 people with AH and overweight or obesity who were treated at the Lviv Emergency Hospital were examined. All patients were divided into 2 groups: group 1 (n=37) – persons with AH (stage І-ІІІ, grade 1-3); group 2 (n=41) – patients with AH (stage І-ІІІ, grade 1-3), COVID -19 and interstitial lung disease. \u0000Anthropometric measurements with a determination of body mass index (BMI), echocardiography, a blood test, biochemical blood test with determination of glucose, alanine aminotransferase, aspartate aminotransferase, creatinine, and urea were performed. Serum blood samples for the examination of LTB4 (Elabscience Elisa Kit) were taken and processed using ELISA method. \u0000Results. Saturation was significantly lower in patients of group 2, while heart rate and body temperature were higher (p < 0,01) compared to group 1. There was a significant decrease in hemoglobin level, increase in ESR, glucose, and LTB4 in individuals with AH and COVID-19, which is probably due to the presence of inflammation in the lung tissue in coronavirus infection. The concentration of LTB4 ranged from 370 to 3600 pg/l in patients of group 2. 19 individuals (46,3%) of group 2 had a higher level of LTB4 than the median value, which is probably associated with a more severe course of coronavirus infection. A positive correlation between LTB4 and BMI (rs= 0,369; p < 0,05) was found in individuals with AH. \u0000Conclusions. The level of LTB4 is higher in patients with AH and COVID – 19 than in individuals with AH, due to the severity of the inflammation process in this comorbid pathology.","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":"49058293","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 : 2021-12-30DOI: 10.32345/2664-4738.4.2021.03
N. Pokrovska, H.M. Shcherbata, O.S. Kapustynska, Y. Sklyarov
Relevance. The combination of coronavirus disease (COVID-19) with arterial hypertension (AH) and chronic obstructive pulmonary disease (COPD) is associated with decreased saturation, general clinical signs of inflammation, coagulopathies and worsens the course and prognosis of the disease. That is why it is important to identify all possible risk factors for complicated pathology for the prevention and timely treatment of this category of patients. Objective: to study the feature of coronavirus disease in patients with AH and COPD. Materials and methods. A total of 101 patients aged 30 to 80 years with COVID-19 were examined. The first group included 26 people with COVID-19 and COPD (GOLD 2, groups A, B), and the second group included 75 patients with COVID-19 and AH (I-III stages, 1-3 grade). The parameters of the general blood test, biochemical blood test, coagulation testing, D-dimer, C-reactive protein (CRP), and ferritin in the blood were studied. Results. Patients with COVID-19 and COPD had higher erythrocyte sedimentation rate (p> 0,05) and leukocytosis (p <0,05), as well as increased concentrations of creatinine (p < 0,05) and urea (p < 0,01) that indicates the presence of renal pathology. Patients with COVID-19 and AH had significantly lower prothrombin time (p < 0,05) and international normalized ratio (p < 0,05), as well as a higher prothrombin index (p <0,05), which indicates the benefits of the procoagulant properties of blood in this category of patients. The level of D-dimer (p> 0,05), CRP (p> 0,05), and ferritin (p <0,05) was higher in patients of the 2nd group, which indicates a more severe course of coronavirus disease, as well as more high risks of thromboembolic complications. Conclusions. The features of coronavirus disease in patients with hypertension indicate a more severe course of the pathology and a high risk of thromboembolic complications, as evidenced by the procoagulant properties of blood and a high level of D-dimer, CRP, and ferritin. According to the data of clinical and laboratory examinations in patients with COPD and COVID-19, there was a significant increase in creatinine, urea, and leukocytosis, which may indicate the addition of renal pathology.
{"title":"FEATURE OF CORONAVIRUS DISEASE IN PATIENTS WITH ARTERIAL HYPERTENSION AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE","authors":"N. Pokrovska, H.M. Shcherbata, O.S. Kapustynska, Y. Sklyarov","doi":"10.32345/2664-4738.4.2021.03","DOIUrl":"https://doi.org/10.32345/2664-4738.4.2021.03","url":null,"abstract":"Relevance. The combination of coronavirus disease (COVID-19) with arterial hypertension (AH) and chronic obstructive pulmonary disease (COPD) is associated with decreased saturation, general clinical signs of inflammation, coagulopathies and worsens the course and prognosis of the disease. That is why it is important to identify all possible risk factors for complicated pathology for the prevention and timely treatment of this category of patients. Objective: to study the feature of coronavirus disease in patients with AH and COPD. Materials and methods. A total of 101 patients aged 30 to 80 years with COVID-19 were examined. The first group included 26 people with COVID-19 and COPD (GOLD 2, groups A, B), and the second group included 75 patients with COVID-19 and AH (I-III stages, 1-3 grade). The parameters of the general blood test, biochemical blood test, coagulation testing, D-dimer, C-reactive protein (CRP), and ferritin in the blood were studied. Results. Patients with COVID-19 and COPD had higher erythrocyte sedimentation rate (p> 0,05) and leukocytosis (p <0,05), as well as increased concentrations of creatinine (p < 0,05) and urea (p < 0,01) that indicates the presence of renal pathology. Patients with COVID-19 and AH had significantly lower prothrombin time (p < 0,05) and international normalized ratio (p < 0,05), as well as a higher prothrombin index (p <0,05), which indicates the benefits of the procoagulant properties of blood in this category of patients. The level of D-dimer (p> 0,05), CRP (p> 0,05), and ferritin (p <0,05) was higher in patients of the 2nd group, which indicates a more severe course of coronavirus disease, as well as more high risks of thromboembolic complications. Conclusions. The features of coronavirus disease in patients with hypertension indicate a more severe course of the pathology and a high risk of thromboembolic complications, as evidenced by the procoagulant properties of blood and a high level of D-dimer, CRP, and ferritin. According to the data of clinical and laboratory examinations in patients with COPD and COVID-19, there was a significant increase in creatinine, urea, and leukocytosis, which may indicate the addition of renal pathology.","PeriodicalId":52737,"journal":{"name":"Medichna nauka Ukrayini","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48472226","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 : 2021-12-30DOI: 10.32345/2664-4738.4.2021.07
O. Dronov, І.О. Кovalska, I. Nastashenko, L. Levchenko, I. Shchigel, M.O. Onishchenko, A.O. Malish
Relevance. The feasibility of preoperative billiary decompression (PBD) remains controversial in patients with malignant billiary obstruction (MOJ), due to the increased risk of multidrug-resistant (MDR), in most cases, catheter-associated microflora and postoperative infection complications. Analysis of biliary infection (BI) and its antibiotic sensitivity is an important aspect of clinical management of patients with resectable tumors of the pancreatobiliary region, which will improve treatment outcomes and reduce postoperative complications. Objective: to assess the nature of the microbial flora at the stages of treatment in patients with MOJ. Мaterials and methods. Prospective single-center cohort study of 136 patients with OJ. Patients were divided into two groups depending on the conduct of biliary decompression in the preoperative stage: group A (n = 84) – patients who underwent biliary decompression; group B (n = 52) – patients who did not perform biliary decompression. Collection of material (bile, drainage) for bacteriological examination was carried out in group A in three stages: 1) during PBD (stage I); 2) during the main surgery – ductus choledochus or endobiliary stent culture (stage II – intraoperative) and in the postoperative period for 3-5 days – culture of exudate from the drainage lumen (stage III – postoperative). In group B, material collection was performed – intraoperatively and postoperatively. The object of the study – microbial isolates, which were isolated in the above terms from the bile, which were identified by conventional methods of bacteriological laboratory. Aerobic and facultative anaerobic flora were studied. The taxonomic structure of microorganism (MO) was assessed by the level of acquired antimicrobial resistance, which is stratified by the European Center for Disease Control. During the bacteriological study, the sensitivity of MO to the following antibiotics was tested: ampicillin-sulbactam, ceftazidime, cefoperazone-sulbactam, ciprofloxacin, levofloxacin, piperacillin-tazobactam, meropenem, vancomycin. Results. BI identified in I stage of the study was represented by monomicrobial in 54.8% of patients and in 45.2% of cases by polymicrobial flora. At the II and III stages of treatment, mixed flora prevailed - 89.3% and 85.7% of cases, respectively. In group A, E. coli was most often sown at the PDB stage (44.5%). E.coli (34.1% and 26.8%) and Kl.pneumoniae were sown most often at the intra- and postoperative stages (20.8% and 28.0%). In group B, monomicrobial flora was presented in 96.2% of cases at the intraoperative stage, while in the postoperative period only in 42.3% of cases. The flora that prevailed in stages II-III of group B was represented by E. coli (31.5% and 29.4%), E. faecalis (18.5% and 15.3%), C.frendii (16.7% and 11.8%). Conclusions. Bacterial infection that causes cholangitis in patients with MOJ, detected primarily during interventional methods of
{"title":"EVALUATION OF THE CHARACTER OF MICROBIAL FLORA AT THE STAGES OF TREATMENT IN PATIENTS WITH MALIGNANT OBSTRUCTIVE JAUNDICE","authors":"O. Dronov, І.О. Кovalska, I. Nastashenko, L. Levchenko, I. Shchigel, M.O. Onishchenko, A.O. Malish","doi":"10.32345/2664-4738.4.2021.07","DOIUrl":"https://doi.org/10.32345/2664-4738.4.2021.07","url":null,"abstract":"Relevance. The feasibility of preoperative billiary decompression (PBD) remains controversial in patients with malignant billiary obstruction (MOJ), due to the increased risk of multidrug-resistant (MDR), in most cases, catheter-associated microflora and postoperative infection complications. Analysis of biliary infection (BI) and its antibiotic sensitivity is an important aspect of clinical management of patients with resectable tumors of the pancreatobiliary region, which will improve treatment outcomes and reduce postoperative complications. \u0000Objective: to assess the nature of the microbial flora at the stages of treatment in patients with MOJ. \u0000Мaterials and methods. Prospective single-center cohort study of 136 patients with OJ. Patients were divided into two groups depending on the conduct of biliary decompression in the preoperative stage: group A (n = 84) – patients who underwent biliary decompression; group B (n = 52) – patients who did not perform biliary decompression. Collection of material (bile, drainage) for bacteriological examination was carried out in group A in three stages: 1) during PBD (stage I); 2) during the main surgery – ductus choledochus or endobiliary stent culture (stage II – intraoperative) and in the postoperative period for 3-5 days – culture of exudate from the drainage lumen (stage III – postoperative). In group B, material collection was performed – intraoperatively and postoperatively. The object of the study – microbial isolates, which were isolated in the above terms from the bile, which were identified by conventional methods of bacteriological laboratory. Aerobic and facultative anaerobic flora were studied. The taxonomic structure of microorganism (MO) was assessed by the level of acquired antimicrobial resistance, which is stratified by the European Center for Disease Control. During the bacteriological study, the sensitivity of MO to the following antibiotics was tested: ampicillin-sulbactam, ceftazidime, cefoperazone-sulbactam, ciprofloxacin, levofloxacin, piperacillin-tazobactam, meropenem, vancomycin. \u0000Results. BI identified in I stage of the study was represented by monomicrobial in 54.8% of patients and in 45.2% of cases by polymicrobial flora. At the II and III stages of treatment, mixed flora prevailed - 89.3% and 85.7% of cases, respectively. In group A, E. coli was most often sown at the PDB stage (44.5%). E.coli (34.1% and 26.8%) and Kl.pneumoniae were sown most often at the intra- and postoperative stages (20.8% and 28.0%). In group B, monomicrobial flora was presented in 96.2% of cases at the intraoperative stage, while in the postoperative period only in 42.3% of cases. The flora that prevailed in stages II-III of group B was represented by E. coli (31.5% and 29.4%), E. faecalis (18.5% and 15.3%), C.frendii (16.7% and 11.8%). \u0000Conclusions. Bacterial infection that causes cholangitis in patients with MOJ, detected primarily during interventional methods of ","PeriodicalId":52737,"journal":{"name":"Medichna nauka Ukrayini","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47194640","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 : 2021-09-30DOI: 10.32345/2664-4738.3.2021.04
M. Timchenko, S. Timchenko, L. Volosevich
Relevance. Until recently, the issues of changes in immunological and microbiological parameters of the oropharynx in vaccinated against viral infections remain insufficiently covered. Objective: to determine the effect of parenteral influenza vaccination on the cellular and microbial composition of the oropharyngeal secretion in patients with chronic inflammatory diseases of the upper respiratory tract with the presence of anamnestic antibodies to vaccine strains of viruses. Materials and methods. Oropharyngeal secretion samples of 18 patients with chronic inflammatory diseases of the upper respiratory tract studied before and 3, 12, and 36 weeks after vaccination with inactivated split influenza vaccine. As control 25 donors were used. The cell composition of the sediment was determined. A microbiological study of the oropharyngeal secretion was performed. Results. At 3 and 12 weeks after vaccination, vaccinated patients significantly changed the relative rates of entry into the oropharyngeal secretion of lymphocytes and the composition of its microbiota while maintaining its total number. After 36 weeks, the cell composition and the representation of pathogenic and opportunistic microflora practically returned to baseline with a significant increase in the total microbiota. Conclusions. Parenteral administration of inactivated split vaccine to persons with chronic inflammatory diseases of the upper respiratory tract with the presence in the blood of anamnestic antibodies to vaccine strains of viruses is accompanied by a simultaneous temporary increase in lymphocyte representation with a simultaneous decrease in the number of transfusion microflora in the oropharyngeal secretion.
{"title":"EFFECT OF PARENTERAL INFLUENZA VACCINATION ON THE CELL COMPOSITION AND ITS MICROBIOTA OF THE OROPHARYNGEAL SECRETION IN PATIENTS WITH CHRONIC INFLAMMATORY DISEASES OF THE UPPER RESPIRATORY TRACT","authors":"M. Timchenko, S. Timchenko, L. Volosevich","doi":"10.32345/2664-4738.3.2021.04","DOIUrl":"https://doi.org/10.32345/2664-4738.3.2021.04","url":null,"abstract":"Relevance. Until recently, the issues of changes in immunological and microbiological parameters of the oropharynx in vaccinated against viral infections remain insufficiently covered. \u0000Objective: to determine the effect of parenteral influenza vaccination on the cellular and microbial composition of the oropharyngeal secretion in patients with chronic inflammatory diseases of the upper respiratory tract with the presence of anamnestic antibodies to vaccine strains of viruses. \u0000Materials and methods. Oropharyngeal secretion samples of 18 patients with chronic inflammatory diseases of the upper respiratory tract studied before and 3, 12, and 36 weeks after vaccination with inactivated split influenza vaccine. As control 25 donors were used. The cell composition of the sediment was determined. A microbiological study of the oropharyngeal secretion was performed. \u0000Results. At 3 and 12 weeks after vaccination, vaccinated patients significantly changed the relative rates of entry into the oropharyngeal secretion of lymphocytes and the composition of its microbiota while maintaining its total number. After 36 weeks, the cell composition and the representation of pathogenic and opportunistic microflora practically returned to baseline with a significant increase in the total microbiota. \u0000Conclusions. Parenteral administration of inactivated split vaccine to persons with chronic inflammatory diseases of the upper respiratory tract with the presence in the blood of anamnestic antibodies to vaccine strains of viruses is accompanied by a simultaneous temporary increase in lymphocyte representation with a simultaneous decrease in the number of transfusion microflora in the oropharyngeal secretion.","PeriodicalId":52737,"journal":{"name":"Medichna nauka Ukrayini","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44517329","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 : 2021-09-30DOI: 10.32345/2664-4738.3.2021.11
Valerii Vasylevkyi, Ihor Stepanov, Roman Koval, M. Soputnyak, N. Liutianska, Vladislav Sheyko, Taras Stavnychyy
Relevance. The current state of medicine is imperfect as in every other field. Some main discrete problems may be separated in diagnostics and disease management. Biomedical data operation difficulties are a serious limiting factor in solving crucial healthcare problems, represented in the statistically significant groups of diseases. Accumulation of life science data creates as possibilities as challenges to effectively utilize it in clinical practice. Machine learning-based tools are necessary for the generation of new insights and the discovery of new hidden patterns especially on big datasets. AI-based decisions may be successfully utilized for diagnosis of diseases, monitoring of general health, prediction of risks, treatment solutions, and biomedical knowledge generation. Objective. To analyze the potential of machine learning algorithms in healthcare on exact existing problems and make a forecast of their development in near future. Method. An analytical review of the literature on keywords from the scientometric databases Scopus, PubMed, Wiley. Search depth 7 years from 2013 to 2020. Results. Analyzing the current general state of the healthcare system we separated the most relevant problems linked to diagnostics, treatment, and systemic management: diagnostics errors, delayed diagnostics (including during emergencies), overdiagnosis, bureaucracy, communication issues, and "handoff" difficulties. We examined details of the convenient decision-making process in the clinical environment in order to define exact points which may be significantly improved by AI-based decisions, among them: diagnosis of diseases, monitoring of general health, prediction of risks, treatment solutions, and biomedical knowledge generation. We defined machine learning algorithms as a prospective tool for disease diagnostics and management, as well as for new utilizable insights generation and big data processing. Conclusion. Machine learning is a group of technologies that can become a cornerstone for dealing with various medical problems. But still, we have some problems to solve before the intense implementation of such tools in the healthcare system.
{"title":"MACHINE LEARNING ALGORITHMS IMPLEMENTATION IN THE HEALTHCARE SYSTEM AS A PROSPECTIVE AREA FOR SCIENCE, HEALTHCARE, AND BUSINESS","authors":"Valerii Vasylevkyi, Ihor Stepanov, Roman Koval, M. Soputnyak, N. Liutianska, Vladislav Sheyko, Taras Stavnychyy","doi":"10.32345/2664-4738.3.2021.11","DOIUrl":"https://doi.org/10.32345/2664-4738.3.2021.11","url":null,"abstract":"Relevance. The current state of medicine is imperfect as in every other field. Some main discrete problems may be separated in diagnostics and disease management. Biomedical data operation difficulties are a serious limiting factor in solving crucial healthcare problems, represented in the statistically significant groups of diseases. Accumulation of life science data creates as possibilities as challenges to effectively utilize it in clinical practice. Machine learning-based tools are necessary for the generation of new insights and the discovery of new hidden patterns especially on big datasets. AI-based decisions may be successfully utilized for diagnosis of diseases, monitoring of general health, prediction of risks, treatment solutions, and biomedical knowledge generation. \u0000Objective. To analyze the potential of machine learning algorithms in healthcare on exact existing problems and make a forecast of their development in near future. \u0000Method. An analytical review of the literature on keywords from the scientometric databases Scopus, PubMed, Wiley. Search depth 7 years from 2013 to 2020. \u0000Results. Analyzing the current general state of the healthcare system we separated the most relevant problems linked to diagnostics, treatment, and systemic management: diagnostics errors, delayed diagnostics (including during emergencies), overdiagnosis, bureaucracy, communication issues, and \"handoff\" difficulties. We examined details of the convenient decision-making process in the clinical environment in order to define exact points which may be significantly improved by AI-based decisions, among them: diagnosis of diseases, monitoring of general health, prediction of risks, treatment solutions, and biomedical knowledge generation. We defined machine learning algorithms as a prospective tool for disease diagnostics and management, as well as for new utilizable insights generation and big data processing. \u0000Conclusion. Machine learning is a group of technologies that can become a cornerstone for dealing with various medical problems. But still, we have some problems to solve before the intense implementation of such tools in the healthcare system.","PeriodicalId":52737,"journal":{"name":"Medichna nauka Ukrayini","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46126083","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 : 2021-09-30DOI: 10.32345/2664-4738.3.2021.02
F. Hladkykh
Relevance. Cryopreserved placenta extract (CPE) increase the resistance of the mucous membrane of the gastrointestinal tract to the damaging effects of nonsteroidal anti-inflammatory drugs. Preventive administration of CPE can reduce the ulcerogenic effect of meloxicam, ibuprofen, diclofenac sodium (DS) and others. There is evidence of CPE's own anti-inflammatory activity, which can be successfully combined with the pharmacological properties of nonsteroidal anti-inflammatory drugs, while improving their safety profile. Objective: to characterize the therapeutic activity of the combined use of CPE and DS according to hematological parameters in the model of experimental rheumatoid arthritis (RA). Materials and methods. Studies were performed on 28 nonlinear laboratory rats. The rats were divided into 4 groups: I (n = 7) – intact rats; II (n = 7) – rats with experimental RA; ІІІ (n = 7) – rats with experimental RA, treated with DN; IV (n = 7) – rats with experimental RA, treated with DN and CPE. Adjuvant arthritis was modeled by subplantar administration of complete Freund's adjuvant. Treatment was performed from 14 to 28 days. CPE was administered on days 14, 17, 20, 23 and 26, and DS – daily. Blood tests were performed on day 28 of the experiment. Results. The combined use of CPE and DS is accompanied by a more pronounced leveling of inflammatory signs by hematological parameters – erythrocyte clotting rate decreased by 72.2% (p<0.001), and the number of leukocytes decreased by 54.81% (p<0.001) relative to rats with adjuvant arthritis without treatment. There was a leveling of signs of anemia of chronic inflammation – the level of hemoglobin and erythrocytes increased (p<0,001) by 17.6% and 36.8%, respectively, relative to rats with adjuvant arthritis without treatment. Conclusions. The combined use of CPE and DS is superior in therapeutic activity to monotherapy with this nonsteroidal anti-inflammatory drug of experimental rheumatoid arthritis.
{"title":"EVALUATION OF THE THERAPEUTIC EFFECT OF THE COMBINED USE OF CRYOPRESERVED PLACENTA EXTRACT AND DICLOFENAC SODIUM IN EXPERIMENTAL RHEUMATOID ARTHRITIS BY HEMATOLOGICAL PARAMETERS","authors":"F. Hladkykh","doi":"10.32345/2664-4738.3.2021.02","DOIUrl":"https://doi.org/10.32345/2664-4738.3.2021.02","url":null,"abstract":"Relevance. Cryopreserved placenta extract (CPE) increase the resistance of the mucous membrane of the gastrointestinal tract to the damaging effects of nonsteroidal anti-inflammatory drugs. Preventive administration of CPE can reduce the ulcerogenic effect of meloxicam, ibuprofen, diclofenac sodium (DS) and others. There is evidence of CPE's own anti-inflammatory activity, which can be successfully combined with the pharmacological properties of nonsteroidal anti-inflammatory drugs, while improving their safety profile. \u0000Objective: to characterize the therapeutic activity of the combined use of CPE and DS according to hematological parameters in the model of experimental rheumatoid arthritis (RA). \u0000Materials and methods. Studies were performed on 28 nonlinear laboratory rats. The rats were divided into 4 groups: I (n = 7) – intact rats; II (n = 7) – rats with experimental RA; ІІІ (n = 7) – rats with experimental RA, treated with DN; IV (n = 7) – rats with experimental RA, treated with DN and CPE. Adjuvant arthritis was modeled by subplantar administration of complete Freund's adjuvant. Treatment was performed from 14 to 28 days. CPE was administered on days 14, 17, 20, 23 and 26, and DS – daily. Blood tests were performed on day 28 of the experiment. \u0000Results. The combined use of CPE and DS is accompanied by a more pronounced leveling of inflammatory signs by hematological parameters – erythrocyte clotting rate decreased by 72.2% (p<0.001), and the number of leukocytes decreased by 54.81% (p<0.001) relative to rats with adjuvant arthritis without treatment. There was a leveling of signs of anemia of chronic inflammation – the level of hemoglobin and erythrocytes increased (p<0,001) by 17.6% and 36.8%, respectively, relative to rats with adjuvant arthritis without treatment. \u0000Conclusions. The combined use of CPE and DS is superior in therapeutic activity to monotherapy with this nonsteroidal anti-inflammatory drug of experimental rheumatoid arthritis.","PeriodicalId":52737,"journal":{"name":"Medichna nauka Ukrayini","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46382765","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 : 2021-09-30DOI: 10.32345/2664-4738.3.2021.01
D. Ziablitsev, O. Dyadyk, S. Ziablitsev
Relevance. Angiotensin converting enzyme-2 (ACE2), which is the gateway to coronavirus, is also an important component of the tissue renin-angiotensin system with a number of anti-inflammatory effects. It is known that ACE2 is expressed in the lungs of patients with coronavirus pneumonia, but it is not clear how this depends on the stages of development and the severity of inflammation. Objective: to establish the effect of acute inflammation on pulmonary expression of angiotensin-converting enzyme-2. Material and methods. In Wistar rats (n=20), in compliance with bioethical standards, a sterile nylon thread 2.5 cm long and 0.2 mm thick to a depth of 2.5 cm was introduced into the trachea. The animals were observed and removed from the experiment at 7, 14, 21 and 28 days, microscopic and immunohistochemical (monoclonal antibodies against ACE2; clone 4G5.1; EMD Millipore Corporation; Temecula, CA US) studies were performed. Results. The microscopic picture of the lungs indicated the development of acute bronchopulmonary inflammation during the first week, the formation of peribronchial and alveolar abscesses in the second week with the onset of resolution of bronchopneumonia with the organization of abscesses in the third week and the development of diffuse fibrosis of the parenchyma and vascular hyalinosis in the fourth week of observation. The exudative phase of acute inflammation was accompanied by inhibition of ACE2 activity in bronchial epithelial cells, type II alveolocytes and vascular endothelium. With the transition of inflammation to the stage of proliferation and fibrosis, ACE2 activity was restored. Conclusion. The detected phase change in ACE2 activity can cause a wavy recurrent course of coronavirus infection, since an increase in the amount of ACE2 protein during attenuation of acute inflammation contributes to an increase in target cell infection.
{"title":"ACTIVITY OF ANGIOTENSIN-CONVERSING ENZYME-2 IN ACUTE PULMONARY INFLAMMATION","authors":"D. Ziablitsev, O. Dyadyk, S. Ziablitsev","doi":"10.32345/2664-4738.3.2021.01","DOIUrl":"https://doi.org/10.32345/2664-4738.3.2021.01","url":null,"abstract":"Relevance. Angiotensin converting enzyme-2 (ACE2), which is the gateway to coronavirus, is also an important component of the tissue renin-angiotensin system with a number of anti-inflammatory effects. It is known that ACE2 is expressed in the lungs of patients with coronavirus pneumonia, but it is not clear how this depends on the stages of development and the severity of inflammation. \u0000Objective: to establish the effect of acute inflammation on pulmonary expression of angiotensin-converting enzyme-2. \u0000Material and methods. In Wistar rats (n=20), in compliance with bioethical standards, a sterile nylon thread 2.5 cm long and 0.2 mm thick to a depth of 2.5 cm was introduced into the trachea. The animals were observed and removed from the experiment at 7, 14, 21 and 28 days, microscopic and immunohistochemical (monoclonal antibodies against ACE2; clone 4G5.1; EMD Millipore Corporation; Temecula, CA US) studies were performed. \u0000Results. The microscopic picture of the lungs indicated the development of acute bronchopulmonary inflammation during the first week, the formation of peribronchial and alveolar abscesses in the second week with the onset of resolution of bronchopneumonia with the organization of abscesses in the third week and the development of diffuse fibrosis of the parenchyma and vascular hyalinosis in the fourth week of observation. The exudative phase of acute inflammation was accompanied by inhibition of ACE2 activity in bronchial epithelial cells, type II alveolocytes and vascular endothelium. With the transition of inflammation to the stage of proliferation and fibrosis, ACE2 activity was restored. \u0000Conclusion. The detected phase change in ACE2 activity can cause a wavy recurrent course of coronavirus infection, since an increase in the amount of ACE2 protein during attenuation of acute inflammation contributes to an increase in target cell infection.","PeriodicalId":52737,"journal":{"name":"Medichna nauka Ukrayini","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45898308","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}
Relevance: The new pandemic crisis caused by the Covid19 virus has led to a global shortage of personal protective equipment including FFP2 masks necessary for the exercise of professionals in direct contact with positive patients. Objective: 3D print a PLA mask similar to the FFP2 mask with the addition of an ULPA filter Methods. The designed mask is based on the general morphology of the FFP2 standard. This is how we downloaded the prototype of the «LOWELL MAKES». We have adapted this prototype to our craniofacial dimensions on the «Meshmixer» software, to finally export the prototype in STL format to print it by fused deposition modeling (FDM) via the 3D printer «XYZ Junior 1.0» equipped with a PLA (polylactic acid) filament. Results. The total duration of the printing of the full mask (the cover, the body of the mask, and the retentive filter grid) was around 4h30 min. Regarding the choice of the filter, we opted for two solutions, the first to cut an FFP2 mask and to use the parts obtained as being filters (doubled), the second being a commercial ULPA or HEPA filter. A ULPA (Ultra Low Penetration Air) filter can theoretically filter dust, pollen, and bacteria from the air with an efficiency of 99.999 % thanks to a size of 0.1 microns. Remember that the average size of the Covid-10 virus is around 0.1 µm and that the porosity of the FFP2 mask allows particles to be filtered with a diameter of around 0.6 µm at 94 %. In order to maximize the filtering effect while wearing this mask, we opted for the interposition of a ULPA filter covered by an FFP2 filter. We tested the tightness of this mask by checking for side leaks by maintaining a stabilized sheet on the outer cover by suction during inhalation. We have also added to the edges of the mask in contact with the face a peripheral silicone seal, polymerized on the face, to avoid any marks or scars after removal of this mask while increasing the comfort of the practitioner. The protocol that we chose by superimposing two filters (the first having a porosity of 0.6µm and the second of 0.1µm) allowed us to potentiate the filtration. This allowed the filter to be used for 40 hours. The total cost price of the mask is around 9 €. Conclusions. The «open source» community makes it possible to popularize 3D printing while making it easier for any 3D printer owner to appropriate their protective equipment at a reduced price, however, intellectual property remains a concern, in particular for medical parts that cannot be procured promptly during a pandemic crisis similar to that caused by the Covid-19 virus.
{"title":"3D PRINTING OF A LOWELL MAKES MASK IN PLA","authors":"Elmoutawakkil Nidal, Seffar Alae-Eddine, Elmoutawakkil Dalal, Hacib Nabil, Bellemkhannate Samira","doi":"10.32345/2664-4738.3.2021.12","DOIUrl":"https://doi.org/10.32345/2664-4738.3.2021.12","url":null,"abstract":"Relevance: The new pandemic crisis caused by the Covid19 virus has led to a global shortage of personal protective equipment including FFP2 masks necessary for the exercise of professionals in direct contact with positive patients. \u0000Objective: 3D print a PLA mask similar to the FFP2 mask with the addition of an ULPA filter \u0000Methods. The designed mask is based on the general morphology of the FFP2 standard. This is how we downloaded the prototype of the «LOWELL MAKES». We have adapted this prototype to our craniofacial dimensions on the «Meshmixer» software, to finally export the prototype in STL format to print it by fused deposition modeling (FDM) via the 3D printer «XYZ Junior 1.0» equipped with a PLA (polylactic acid) filament. \u0000Results. The total duration of the printing of the full mask (the cover, the body of the mask, and the retentive filter grid) was around 4h30 min. Regarding the choice of the filter, we opted for two solutions, the first to cut an FFP2 mask and to use the parts obtained as being filters (doubled), the second being a commercial ULPA or HEPA filter. A ULPA (Ultra Low Penetration Air) filter can theoretically filter dust, pollen, and bacteria from the air with an efficiency of 99.999 % thanks to a size of 0.1 microns. Remember that the average size of the Covid-10 virus is around 0.1 µm and that the porosity of the FFP2 mask allows particles to be filtered with a diameter of around 0.6 µm at 94 %. In order to maximize the filtering effect while wearing this mask, we opted for the interposition of a ULPA filter covered by an FFP2 filter. We tested the tightness of this mask by checking for side leaks by maintaining a stabilized sheet on the outer cover by suction during inhalation. We have also added to the edges of the mask in contact with the face a peripheral silicone seal, polymerized on the face, to avoid any marks or scars after removal of this mask while increasing the comfort of the practitioner. The protocol that we chose by superimposing two filters (the first having a porosity of 0.6µm and the second of 0.1µm) allowed us to potentiate the filtration. This allowed the filter to be used for 40 hours. The total cost price of the mask is around 9 €. \u0000Conclusions. The «open source» community makes it possible to popularize 3D printing while making it easier for any 3D printer owner to appropriate their protective equipment at a reduced price, however, intellectual property remains a concern, in particular for medical parts that cannot be procured promptly during a pandemic crisis similar to that caused by the Covid-19 virus.","PeriodicalId":52737,"journal":{"name":"Medichna nauka Ukrayini","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43177786","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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