Pub Date : 2021-11-29DOI: 10.24061/2413-0737.xxv.3.99.2021.12
Y. Nechytailo, N. Popelyuk, O. Dolzhenko
The goal. Тo analyze the features of treatment and medical expenses in children hospitalized for acute community-acquired pneumonia. Materials and methods. The study analyzed medical records and examined 51 children aged 2 to 17 months hospitalized for pneumonia. In patients studied clinical symptoms, severity, structure and duration of basic treatment measures, their cost. Results. The duration of inpatient treatment was 13.3±0.62 days with subsequent outpatient treatment and rehabilitation. Antibiotics, antipyretics, antihistamines, mucolytics and corticosteroid hormones were used in the treatment. The total cost of treatment for one case averaged 2346.9±145.7 hryvnias. The most expensive were the costs of antibiotics, and the cheapest - the antipyretics. Given the community-acquired nature of the process, the initial use of third- and fourth-generation cephalosporins was irrational and significantly increased the cost of treatment. Conclusions. The introduction of a new model of medicine focuses on the optimization of treatment tactics and the rational choice of antibiotics for acute community-acquired pneumonia. In antibacterial therapy is still inadequate, from a clinical and economic point of view, the choice of drugs. In the treatment of this disease, the role of pathogenetic therapy to restore the processes of mucociliary clearance and prevention of dysbiosis on the background of the use of antibiotics has increased.
{"title":"Pharmaco-economic features of hospital treatment of acute community-acquired pneumonia in children","authors":"Y. Nechytailo, N. Popelyuk, O. Dolzhenko","doi":"10.24061/2413-0737.xxv.3.99.2021.12","DOIUrl":"https://doi.org/10.24061/2413-0737.xxv.3.99.2021.12","url":null,"abstract":"The goal. Тo analyze the features of treatment and medical expenses in children hospitalized for acute community-acquired pneumonia. Materials and methods. The study analyzed medical records and examined 51 children aged 2 to 17 months hospitalized for pneumonia. In patients studied clinical symptoms, severity, structure and duration of basic treatment measures, their cost. Results. The duration of inpatient treatment was 13.3±0.62 days with subsequent outpatient treatment and rehabilitation. Antibiotics, antipyretics, antihistamines, mucolytics and corticosteroid hormones were used in the treatment. The total cost of treatment for one case averaged 2346.9±145.7 hryvnias. The most expensive were the costs of antibiotics, and the cheapest - the antipyretics. Given the community-acquired nature of the process, the initial use of third- and fourth-generation cephalosporins was irrational and significantly increased the cost of treatment. Conclusions. The introduction of a new model of medicine focuses on the optimization of treatment tactics and the rational choice of antibiotics for acute community-acquired pneumonia. In antibacterial therapy is still inadequate, from a clinical and economic point of view, the choice of drugs. In the treatment of this disease, the role of pathogenetic therapy to restore the processes of mucociliary clearance and prevention of dysbiosis on the background of the use of antibiotics has increased.","PeriodicalId":9270,"journal":{"name":"Bukovinian Medical Herald","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80071061","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 : 2021-11-29DOI: 10.24061/2413-0737.xxv.3.99.2021.6
V. Zozulya
Aim of the study - to establish features of damage of the driver and the passenger in salon of the car of a class D at side collision. Material and methods. Cases of road accidents were analyzed from 2008 to 2021 in Zhytomyr, Rivne, Volyn regions of Ukraine. Side impact (right and left) with the fatal outcome of the driver and front passenger of class D cars were considered in the case of an automobile injury. We used general scientific and special methods, namely system-structural analysis, observation, comparison, description. Additionally, a forensic examination of the damage was carried out. Statistical analysis included primary data processing using descriptive statistics and testing the null hypothesis by multivariate analysis.Results. We identified characteristics of damage to the driver and passenger in a side impact. They were different and characterized by dependence on the right or left side of the collision.Conclusions. The resulting set of injuries witch characterize a driver or passenger of class D cars in left and right impact can be used to identify them in a forensic medical examination.
{"title":"Peculiarities of damages of drivers and passengers in cars of class D in a side impact","authors":"V. Zozulya","doi":"10.24061/2413-0737.xxv.3.99.2021.6","DOIUrl":"https://doi.org/10.24061/2413-0737.xxv.3.99.2021.6","url":null,"abstract":"Aim of the study - to establish features of damage of the driver and the passenger in salon of the car of a class D at side collision. Material and methods. Cases of road accidents were analyzed from 2008 to 2021 in Zhytomyr, Rivne, Volyn regions of Ukraine. Side impact (right and left) with the fatal outcome of the driver and front passenger of class D cars were considered in the case of an automobile injury. We used general scientific and special methods, namely system-structural analysis, observation, comparison, description. Additionally, a forensic examination of the damage was carried out. Statistical analysis included primary data processing using descriptive statistics and testing the null hypothesis by multivariate analysis.Results. We identified characteristics of damage to the driver and passenger in a side impact. They were different and characterized by dependence on the right or left side of the collision.Conclusions. The resulting set of injuries witch characterize a driver or passenger of class D cars in left and right impact can be used to identify them in a forensic medical examination.","PeriodicalId":9270,"journal":{"name":"Bukovinian Medical Herald","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90562399","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 : 2021-11-29DOI: 10.24061/2413-0737.xxv.3.99.2021.20
M. Flaksemberg
The purpose of the work. To study the effectiveness of the combined treatment of uterine leiomyoma (UL), taking into account the possibility of realizing reproductive function.Material and methods. The total number of women of reproductive age examined with a large UL (a dominant node more than 50 mm in diameter) was 94. At the first stage, all patients received preoperative preparation. At the first stage all patients received preoperative preparation. 35 patients with concomitant endometrial hyperplasia and/or with the presence of the progesterone receptor gene polymorphism PGR progins received aGn-RH in an average therapeutic dose once in 28 days, 3 injections. 59 patients with the reference genotype without endometrial pathology received mifepristone 50 mg daily for 3 months. After preoperative preparation, the patients underwent conservative myomectomy by laparotomy. Menstrual function, pelvic pain syndrome, size of leiomatous nodules, drug tolerance, frequency of pregnancy and recurrence were assessed. Statistical data processing was performed using Microsoft Excel software. The main statistical indicators such as frequency, mean and standard deviation were taken into account. The results were considered significant at p < 0.05.Results. Excessive menstruation and AUB occurred in 81.9% of patients. Amenorrhea occurred in 79.8% of patients after 1 month of therapy and in all patients after 3 months. Recovery of menstruation was noted in 10.6% of patients a month after the operation, in 59.6% of patients after two months and on the third cycle menstruation resumed in all patients. The frequency of pain syndrome unrelated to the menstrual cycle decreased from 52.1% to 9.6%, dyspareunia from 12.8% to 4.3%, dysmenorrhea from 47.9% to 8.5%. According to ultrasound data, after 1 month in the group of women receiving aGn-RH the size of the nodules decreased by an average of 22.9%, and after mifepristone by 16.9%, and after 3 months by 51.4% and 45.8%. The uterine volume decreased by 28.6% and 30.5%. Starting from the second month of treatment, symptoms caused by estrogen deficiency were noted in 39.4% of patients treated with aGn-RH and 20.3% in the mifepristone group. Overall, the treatment was defined as effective in 88.6% of the women treated with aGn RH and 93.2% of those treated with mifepristone. Relapse occurred in 11.4% of women after aGn-RH and in 5.1% of those in the mifepristone group. Pregnancy occurred in 69.2% of patients and resulted in delivery in 90.8% of cases.Conclusions. The use of preoperative hormonal preparation and a differentiated approach to medication selection leads to normalization of the patient's condition and a reduction in the size of the nodules, which allows organ-preserving surgical treatment with minimal uterine trauma. Preference should be given to anti-gestagens because, with equal efficiency compared to aGn-RH, they are better tolerated by patients and have a more pronounced positive effect on process stabiliz
{"title":"Results of combined treatment of uterine leiomyoma in women of reproductive age","authors":"M. Flaksemberg","doi":"10.24061/2413-0737.xxv.3.99.2021.20","DOIUrl":"https://doi.org/10.24061/2413-0737.xxv.3.99.2021.20","url":null,"abstract":"The purpose of the work. To study the effectiveness of the combined treatment of uterine leiomyoma (UL), taking into account the possibility of realizing reproductive function.Material and methods. The total number of women of reproductive age examined with a large UL (a dominant node more than 50 mm in diameter) was 94. At the first stage, all patients received preoperative preparation. At the first stage all patients received preoperative preparation. 35 patients with concomitant endometrial hyperplasia and/or with the presence of the progesterone receptor gene polymorphism PGR progins received aGn-RH in an average therapeutic dose once in 28 days, 3 injections. 59 patients with the reference genotype without endometrial pathology received mifepristone 50 mg daily for 3 months. After preoperative preparation, the patients underwent conservative myomectomy by laparotomy. Menstrual function, pelvic pain syndrome, size of leiomatous nodules, drug tolerance, frequency of pregnancy and recurrence were assessed. Statistical data processing was performed using Microsoft Excel software. The main statistical indicators such as frequency, mean and standard deviation were taken into account. The results were considered significant at p < 0.05.Results. Excessive menstruation and AUB occurred in 81.9% of patients. Amenorrhea occurred in 79.8% of patients after 1 month of therapy and in all patients after 3 months. Recovery of menstruation was noted in 10.6% of patients a month after the operation, in 59.6% of patients after two months and on the third cycle menstruation resumed in all patients. The frequency of pain syndrome unrelated to the menstrual cycle decreased from 52.1% to 9.6%, dyspareunia from 12.8% to 4.3%, dysmenorrhea from 47.9% to 8.5%. According to ultrasound data, after 1 month in the group of women receiving aGn-RH the size of the nodules decreased by an average of 22.9%, and after mifepristone by 16.9%, and after 3 months by 51.4% and 45.8%. The uterine volume decreased by 28.6% and 30.5%. Starting from the second month of treatment, symptoms caused by estrogen deficiency were noted in 39.4% of patients treated with aGn-RH and 20.3% in the mifepristone group. Overall, the treatment was defined as effective in 88.6% of the women treated with aGn RH and 93.2% of those treated with mifepristone. Relapse occurred in 11.4% of women after aGn-RH and in 5.1% of those in the mifepristone group. Pregnancy occurred in 69.2% of patients and resulted in delivery in 90.8% of cases.Conclusions. The use of preoperative hormonal preparation and a differentiated approach to medication selection leads to normalization of the patient's condition and a reduction in the size of the nodules, which allows organ-preserving surgical treatment with minimal uterine trauma. Preference should be given to anti-gestagens because, with equal efficiency compared to aGn-RH, they are better tolerated by patients and have a more pronounced positive effect on process stabiliz","PeriodicalId":9270,"journal":{"name":"Bukovinian Medical Herald","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89285361","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 : 2021-11-29DOI: 10.24061/2413-0737.xxv.3.99.2021.22
O. Tsyhykalo, R. Dmytrenko, I. Popova, B. Banul
The study of morphogenesis and embryotopography of skull bones is important not only in understanding the normal development of the human embryo but also will improve existing methods of invasive treatment and visualization of various pathologies of the central nervous system in children.The aim was to investigate the peculiarities of morphogenesis and topography of some skull bones during the early stages of human ontogenesis.Material and methods. We have studied 14 series of consecutive histological sections of human embryos and pre-fetuses aged 6 to 11 weeks of intrauterine development by using a set of topical morphological methods (anthropometry, morphometry, histology, three-dimensional reconstruction).Results. The frontal and parietal bones appear at the end of the embryonic period as mesenchymal rudiments that gradually expand upwards from primary points of ossification (starting from the basolateral parts of the head). During 8th week of IUD, the germ of the ectomeningeal capsule is detected in the form of a thin plate, close to the brain. At the beginning of the pre-fetal period, histological signs of membranous ossification are revealed; frontal and parietal bones develop from paired rudiments, which gradually fuse, which was accompanied by active angiogenesis.Conclusions. The primary ossification centers in frontal and parietal bones of the human embryo appear at the beginning of embryological period and develop by membranous type. Two ossification centers appear in frontal and parietal bones and they gradually merge. At the beginning of the prenatal period, the rudiment of a small wing of the sphenoid, spheno-ethmoidal cartilage and signs of merging of both ossification centers in the parietal bone are detected.
{"title":"Features of the formation of certain bones of the skull at the early stages of human ontogenesis","authors":"O. Tsyhykalo, R. Dmytrenko, I. Popova, B. Banul","doi":"10.24061/2413-0737.xxv.3.99.2021.22","DOIUrl":"https://doi.org/10.24061/2413-0737.xxv.3.99.2021.22","url":null,"abstract":"The study of morphogenesis and embryotopography of skull bones is important not only in understanding the normal development of the human embryo but also will improve existing methods of invasive treatment and visualization of various pathologies of the central nervous system in children.The aim was to investigate the peculiarities of morphogenesis and topography of some skull bones during the early stages of human ontogenesis.Material and methods. We have studied 14 series of consecutive histological sections of human embryos and pre-fetuses aged 6 to 11 weeks of intrauterine development by using a set of topical morphological methods (anthropometry, morphometry, histology, three-dimensional reconstruction).Results. The frontal and parietal bones appear at the end of the embryonic period as mesenchymal rudiments that gradually expand upwards from primary points of ossification (starting from the basolateral parts of the head). During 8th week of IUD, the germ of the ectomeningeal capsule is detected in the form of a thin plate, close to the brain. At the beginning of the pre-fetal period, histological signs of membranous ossification are revealed; frontal and parietal bones develop from paired rudiments, which gradually fuse, which was accompanied by active angiogenesis.Conclusions. The primary ossification centers in frontal and parietal bones of the human embryo appear at the beginning of embryological period and develop by membranous type. Two ossification centers appear in frontal and parietal bones and they gradually merge. At the beginning of the prenatal period, the rudiment of a small wing of the sphenoid, spheno-ethmoidal cartilage and signs of merging of both ossification centers in the parietal bone are detected.","PeriodicalId":9270,"journal":{"name":"Bukovinian Medical Herald","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91141279","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 : 2021-11-29DOI: 10.24061/2413-0737.xxv.3.99.2021.10
O. Мazur, O. Plaksyvyi, I. Kalutskyi, K. Yakovets
Aim – to study the species composition and population level of the microbiota of the content of the maxillary sinuses and the role of associations of microorganisms in the development and course of chronic purulent maxillary sinusitis (CPMS) in patients with type 1 diabetes.Material and methods. A microbiological examination of 97 samples of the contents of the cavity of the maxillary sinuses was carried out. The main group consisted of 50 patients with CPMS with type 1 diabetes at the age of 20-67 years (10 patients at the age of 20-31 years, 14 patients - 31-45 years old and 26 - at the age of 45-67 years). Among the patients of the main group, endocrinologists established the course of type 1 diabetes mellitus of moderate severity in 39 patients, and a severe course in 11 patients. The control group consisted of 47 CPMS patients of the same age without type 1 diabetes mellitus (DM).Results. Bacteriological and mycological methods in the content of maxillary sinuses of patients with maxillary sinusitis associated with type 1 diabetes mellitus (DM) 175 strains of different kinds of microorganisms were isolated and identified, belonging to 24 various taxonomic groups which form different by their qualitative content microbial associations in the biotope which consist of three different kinds in 58% of patients, consist of four kinds – in 34,0% and five various taxa – in 8,0% of patients. Chronic purulent maxillary sinusitis in patients with type 1 DM disrupts microbial associations. In patients with CPMS with type 1 DM in comparison with the control group, the number of associations consist of three kinds increases by 2,7 times, but the number of associations composed of 4 types of microorganisms decreases by 11.76%. The number of associations consisting of 5 types in patients is reduced by 3.5 times. The above may indicate the influence of not only the etiological agent but also a certain association of microorganisms on the severity of the course of CPMS associated with type 1 diabetes. All leading pathogens persist in the biotope in association. Associates, depending on their role in normobiocenosis, can inhibit the pathogenetic activity of the leading pathogen or, conversely, activate its pathogenetic role, which must be taken into account when choosing a therapeutic tactics.Conclusions. Chronic purulent maxillary sinusitis in patients with type 1 diabetes disrupts microbial associations. In the content of the cavity of the maxillary sinuses of patients with chronic purulent maxillary sinusitis, combined with type 1 diabetes mellitus, 175 strains of various types of microorganisms belonging to 24 different taxonomic groups were isolated and identified, which in the biotope form microbial associations of different qualitative composition, consisting of 3 different species in 58% of patients, out of 4 species in 34.0% and from five different taxa - in 8.0% of patients. Among the most numerous associations, consisting of 3 types of pathogenic an
{"title":"The role of microorganism association in the development of chronic purulent maxillary sinusitis in patients with type 1 diabetes mellitus","authors":"O. Мazur, O. Plaksyvyi, I. Kalutskyi, K. Yakovets","doi":"10.24061/2413-0737.xxv.3.99.2021.10","DOIUrl":"https://doi.org/10.24061/2413-0737.xxv.3.99.2021.10","url":null,"abstract":"Aim – to study the species composition and population level of the microbiota of the content of the maxillary sinuses and the role of associations of microorganisms in the development and course of chronic purulent maxillary sinusitis (CPMS) in patients with type 1 diabetes.Material and methods. A microbiological examination of 97 samples of the contents of the cavity of the maxillary sinuses was carried out. The main group consisted of 50 patients with CPMS with type 1 diabetes at the age of 20-67 years (10 patients at the age of 20-31 years, 14 patients - 31-45 years old and 26 - at the age of 45-67 years). Among the patients of the main group, endocrinologists established the course of type 1 diabetes mellitus of moderate severity in 39 patients, and a severe course in 11 patients. The control group consisted of 47 CPMS patients of the same age without type 1 diabetes mellitus (DM).Results. Bacteriological and mycological methods in the content of maxillary sinuses of patients with maxillary sinusitis associated with type 1 diabetes mellitus (DM) 175 strains of different kinds of microorganisms were isolated and identified, belonging to 24 various taxonomic groups which form different by their qualitative content microbial associations in the biotope which consist of three different kinds in 58% of patients, consist of four kinds – in 34,0% and five various taxa – in 8,0% of patients. Chronic purulent maxillary sinusitis in patients with type 1 DM disrupts microbial associations. In patients with CPMS with type 1 DM in comparison with the control group, the number of associations consist of three kinds increases by 2,7 times, but the number of associations composed of 4 types of microorganisms decreases by 11.76%. The number of associations consisting of 5 types in patients is reduced by 3.5 times. The above may indicate the influence of not only the etiological agent but also a certain association of microorganisms on the severity of the course of CPMS associated with type 1 diabetes. All leading pathogens persist in the biotope in association. Associates, depending on their role in normobiocenosis, can inhibit the pathogenetic activity of the leading pathogen or, conversely, activate its pathogenetic role, which must be taken into account when choosing a therapeutic tactics.Conclusions. Chronic purulent maxillary sinusitis in patients with type 1 diabetes disrupts microbial associations. In the content of the cavity of the maxillary sinuses of patients with chronic purulent maxillary sinusitis, combined with type 1 diabetes mellitus, 175 strains of various types of microorganisms belonging to 24 different taxonomic groups were isolated and identified, which in the biotope form microbial associations of different qualitative composition, consisting of 3 different species in 58% of patients, out of 4 species in 34.0% and from five different taxa - in 8.0% of patients. Among the most numerous associations, consisting of 3 types of pathogenic an","PeriodicalId":9270,"journal":{"name":"Bukovinian Medical Herald","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72904334","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 : 2021-11-29DOI: 10.24061/2413-0737.xxv.3.99.2021.23
V. Yuzko, O. Yuzko
Оbjective of the study was to conduct a retrospective comparative characterization of patients with infertility who took or did not take melatonin with assisted reproductive technologies (ART).Materials and methods. In our study, we examined 89 women. The first (control) group included 13 healthy women oocyte donors who got pregnant on their own and gave birth to their own healthy children, the second group - 33 patients with infertility, who took 3 mg of the preparation "Vita-melatonin" produced by "Kyiv Vitamin Plant" at the same time before bedtime, two weeks before and during ovulation stimulation, the third group - 43 patients with infertility who did not take melatonin preparation before and during ovulation stimulation. There were no women who worked night shifts among the patients. Medical documentation of women of the control group and those with infertility, data of gynecological, ultrasound examination, hormones blood were analyzed. Ultrasound examination of the pelvic organs was performed on all patients with the device "Mindray DC-80 X-Insight", and measurements were performed using a transvaginal sensor. The thickness and structure of the endometrium were evaluated, and the number of antral follicles (NAF) ranging in size from 2 to 10 mm was counted in each ovary. All patients were tested for serum levels of the anti-mullerian hormone (AMG), follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), prolactin (PRL), progesterone (P), thyroid-stimulating hormone (TSH), triiodothyronine (T4).Results. The average age of women in the first (control) group was 27.08 ± 12.38 years, the second (taking melatonin) - 33.12 ± 8.18 years, the third (not taking melatonin) - 30.95 ± 7.07 years > 0.05), i. e. the age of the patients of the examined groups was equal. It should be noted that in the studied patients of both groups, the occurrence of primary infertility exceeded secondary infertility 2.7 times in the second group (p < 0.05) and 1.7 times in the third (p < 0.05). Infertility factors such as reduced ovarian reserve, habitual miscarriage and infertility of unknown origin were more common in patients of the second group, and endometriosis, tubal factor and male factor in the third, although the difference was not significant. The available extragenital pathology did not differ in the patients of the examined groups. The number of antral follicles was significantly higher in both ovaries of women in the control group compared with patients of the second and third groups. While the thickness of the endometrium did not differ significantly in groups, although in women of the control group it was slightly less. Regarding the study of hormonal status, it should be noted that we did not find a significant difference in the levels of hormones in the blood of women we examined. Exceptionally, there was a significant difference (p < 0.001) in progesterone content between the second (0.62 ± 0.052 nmol/l) and third (181.63 ± 13.87
{"title":"Comparative characteristics of patients with infertility when applying melatonin in complex preparation for assisted reproductive technologies","authors":"V. Yuzko, O. Yuzko","doi":"10.24061/2413-0737.xxv.3.99.2021.23","DOIUrl":"https://doi.org/10.24061/2413-0737.xxv.3.99.2021.23","url":null,"abstract":"Оbjective of the study was to conduct a retrospective comparative characterization of patients with infertility who took or did not take melatonin with assisted reproductive technologies (ART).Materials and methods. In our study, we examined 89 women. The first (control) group included 13 healthy women oocyte donors who got pregnant on their own and gave birth to their own healthy children, the second group - 33 patients with infertility, who took 3 mg of the preparation \"Vita-melatonin\" produced by \"Kyiv Vitamin Plant\" at the same time before bedtime, two weeks before and during ovulation stimulation, the third group - 43 patients with infertility who did not take melatonin preparation before and during ovulation stimulation. There were no women who worked night shifts among the patients. Medical documentation of women of the control group and those with infertility, data of gynecological, ultrasound examination, hormones blood were analyzed. Ultrasound examination of the pelvic organs was performed on all patients with the device \"Mindray DC-80 X-Insight\", and measurements were performed using a transvaginal sensor. The thickness and structure of the endometrium were evaluated, and the number of antral follicles (NAF) ranging in size from 2 to 10 mm was counted in each ovary. All patients were tested for serum levels of the anti-mullerian hormone (AMG), follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), prolactin (PRL), progesterone (P), thyroid-stimulating hormone (TSH), triiodothyronine (T4).Results. The average age of women in the first (control) group was 27.08 ± 12.38 years, the second (taking melatonin) - 33.12 ± 8.18 years, the third (not taking melatonin) - 30.95 ± 7.07 years > 0.05), i. e. the age of the patients of the examined groups was equal. It should be noted that in the studied patients of both groups, the occurrence of primary infertility exceeded secondary infertility 2.7 times in the second group (p < 0.05) and 1.7 times in the third (p < 0.05). Infertility factors such as reduced ovarian reserve, habitual miscarriage and infertility of unknown origin were more common in patients of the second group, and endometriosis, tubal factor and male factor in the third, although the difference was not significant. The available extragenital pathology did not differ in the patients of the examined groups. The number of antral follicles was significantly higher in both ovaries of women in the control group compared with patients of the second and third groups. While the thickness of the endometrium did not differ significantly in groups, although in women of the control group it was slightly less. Regarding the study of hormonal status, it should be noted that we did not find a significant difference in the levels of hormones in the blood of women we examined. Exceptionally, there was a significant difference (p < 0.001) in progesterone content between the second (0.62 ± 0.052 nmol/l) and third (181.63 ± 13.87","PeriodicalId":9270,"journal":{"name":"Bukovinian Medical Herald","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75480341","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 : 2021-11-29DOI: 10.24061/2413-0737.xxv.3.99.2021.2
Y. Bilooka, O. Fediv, H. Stupnytska
The purpose of the work. To evaluate the effectiveness of the use of the probiotic Alflorex and mesalazine in complex therapy in patients with irritable bowel syndrome (IBS) with diarrhea and constipation, combined with obesity, with CT and TT genotypes according to the polymorphic variant C-159T of the CD14 gene. Materials and methods. We examined 48 patients with IBS associated with obesity. In the dynamics of treatment with probiotic Alflorex and mesalazine we determined the content in the serum of C-reactive protein (CRP), tumor necrosis factor-α (TNFα), transforming growth factor-β1 (TGFβ1), interleukin-10 (IL-10), 8 - isoprostane, ceruloplasmin (CP), medium molecular weight peptides and calprotectin in feces. The polymorphic variant of the CD 14 gene (C-159T) was analyzed by polymerase chain reaction. The results of the study. The use of Alflorex and mesalazine in the complex therapy for patients with IBS with diarrhea, combined with obesity, leads to normalization of the IL-10, TGFβ1, medium molecules and a decrease in TNFα (by 37.0%), CRP (1.7 times), 8-isoprostane (by 35.8%), CP (by 44.4%), calprotectin content (by 41.1%). While predominance of constipation in the dynamics of treatment it was showed normalization of IL-10, TGFβ1, medium molecules, CRP, 8-isoprostane, CP, calprotectin and a decrease in TNFα (1.9 times). Conclusions. Probiotic and mesalazine therapy for a month leads to a significant increase in the effectiveness of treatment of patients with IBS with concomitant obesity in the presence of CT and TT genotypes of the polymorphic variant of the CD 14 gene (C-159T) with a predominance of both diarrhea and constipation.
{"title":"Personified treatment of patients with irritable bowel syndrome and obesity","authors":"Y. Bilooka, O. Fediv, H. Stupnytska","doi":"10.24061/2413-0737.xxv.3.99.2021.2","DOIUrl":"https://doi.org/10.24061/2413-0737.xxv.3.99.2021.2","url":null,"abstract":"The purpose of the work. To evaluate the effectiveness of the use of the probiotic Alflorex and mesalazine in complex therapy in patients with irritable bowel syndrome (IBS) with diarrhea and constipation, combined with obesity, with CT and TT genotypes according to the polymorphic variant C-159T of the CD14 gene. Materials and methods. We examined 48 patients with IBS associated with obesity. In the dynamics of treatment with probiotic Alflorex and mesalazine we determined the content in the serum of C-reactive protein (CRP), tumor necrosis factor-α (TNFα), transforming growth factor-β1 (TGFβ1), interleukin-10 (IL-10), 8 - isoprostane, ceruloplasmin (CP), medium molecular weight peptides and calprotectin in feces. The polymorphic variant of the CD 14 gene (C-159T) was analyzed by polymerase chain reaction. The results of the study. The use of Alflorex and mesalazine in the complex therapy for patients with IBS with diarrhea, combined with obesity, leads to normalization of the IL-10, TGFβ1, medium molecules and a decrease in TNFα (by 37.0%), CRP (1.7 times), 8-isoprostane (by 35.8%), CP (by 44.4%), calprotectin content (by 41.1%). While predominance of constipation in the dynamics of treatment it was showed normalization of IL-10, TGFβ1, medium molecules, CRP, 8-isoprostane, CP, calprotectin and a decrease in TNFα (1.9 times). Conclusions. Probiotic and mesalazine therapy for a month leads to a significant increase in the effectiveness of treatment of patients with IBS with concomitant obesity in the presence of CT and TT genotypes of the polymorphic variant of the CD 14 gene (C-159T) with a predominance of both diarrhea and constipation.","PeriodicalId":9270,"journal":{"name":"Bukovinian Medical Herald","volume":"72 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84119924","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 : 2021-11-29DOI: 10.24061/2413-0737.xxv.3.99.2021.18
V. Tashchuk, R. Nesterovska, V. Kalarash
The purpose of the work to investigate the connection between hospital mortality and markers of systemic inflammation in COVID-19 patients with ischemic heart disease (IHD).Material and methods. The data of 52 patients’cases of diseases on COVID-19 with IHD who underwent inpatient treatment were analyzed. The first group included 40 patients who were discharged with recovery, and the second group included 12 patients who died. The degree of systemic inflammation syndrome in the selected groups of patients was estimated by the number of leukocytes and cellular composition of peripheral blood upon admission to the hospital, and based on the data received, the value of hematological integral indices was calculated.Results. It has been established that group II patients who died of cardiovascular complications connected with COVID-19 had significantly higher levels of systemic inflammatory response, which exhibits a significant increase in the total blood white blood cell content and increases in the percentage of neutrophils with a decrease in the percentage of lymphocytes and is substantially higher than the integrated haematological indices: leukocyte shift index, index of the ratio of neutrophils to lymphocytes and index of the ratio of neutrophils to monocytes. During the systemic inflammatory reaction, it has been observed that the inflammatory process aggravates the coronary atherosclerotic plaque making them more susceptible to rupture. Therefore, we can assume that existing IHD combined with an enhanced inflammatory response can lead to heart damage in patients infected with SARS-CoV- 2.Conclusion. Lymphocytopenia, excessive activation of the inflammatory cascade and heart damage are important features of COVID-19 disease and have high predictive value.
{"title":"The connection between hospital mortality and inflamation markers in COVID-19 patients and ischaemic heart disease","authors":"V. Tashchuk, R. Nesterovska, V. Kalarash","doi":"10.24061/2413-0737.xxv.3.99.2021.18","DOIUrl":"https://doi.org/10.24061/2413-0737.xxv.3.99.2021.18","url":null,"abstract":"The purpose of the work to investigate the connection between hospital mortality and markers of systemic inflammation in COVID-19 patients with ischemic heart disease (IHD).Material and methods. The data of 52 patients’cases of diseases on COVID-19 with IHD who underwent inpatient treatment were analyzed. The first group included 40 patients who were discharged with recovery, and the second group included 12 patients who died. The degree of systemic inflammation syndrome in the selected groups of patients was estimated by the number of leukocytes and cellular composition of peripheral blood upon admission to the hospital, and based on the data received, the value of hematological integral indices was calculated.Results. It has been established that group II patients who died of cardiovascular complications connected with COVID-19 had significantly higher levels of systemic inflammatory response, which exhibits a significant increase in the total blood white blood cell content and increases in the percentage of neutrophils with a decrease in the percentage of lymphocytes and is substantially higher than the integrated haematological indices: leukocyte shift index, index of the ratio of neutrophils to lymphocytes and index of the ratio of neutrophils to monocytes. During the systemic inflammatory reaction, it has been observed that the inflammatory process aggravates the coronary atherosclerotic plaque making them more susceptible to rupture. Therefore, we can assume that existing IHD combined with an enhanced inflammatory response can lead to heart damage in patients infected with SARS-CoV- 2.Conclusion. Lymphocytopenia, excessive activation of the inflammatory cascade and heart damage are important features of COVID-19 disease and have high predictive value.","PeriodicalId":9270,"journal":{"name":"Bukovinian Medical Herald","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78355336","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 : 2021-11-29DOI: 10.24061/2413-0737.xxv.3.99.2021.1
T. Antofiichuk, O. Khukhlina, M. Antofiichuk
The prospective study of patients with alcoholic steatohepatitis (ASH) showed that 40 % of patients with ASH were diagnosed with anaemic conditions (AC), among which vitamin B12-deficiency anaemia was registered - in 17.5% of cases, anaemia of chronic disease (ACD) – in 10.0% of cases and hemolytic anemia (HA) - in 12.5% of cases. In patients with SH of mixed (including alcoholic) etiology AC was found in 32.0%: vitamin B12 - deficient - in 16.0%, ACD - in 8.0% and hemolytic - in 8.0 % of patients. In patients with ASH, H. pylori contamination was present in 32 (80.0%) individuals, including 100% of patients with B12-deficient anaemia. Among patients with SH of mixed (including alcoholic) etiology, H. pylori was detected in 100.0% of people with AS. The use of Hepadif in the complex therapy of ASH contributed to the elimination or reduction of the intensity of the main clinical syndromes (astheno-vegetative, dyspeptic, cholestatic, hepato-, splenomegaly, hepatic steatosis) and biochemical syndromes (mesenchymal-inflammatory cholestasis, hepatocellular insufficiency), in the range of 1.3-4.3 times (p <0.05), as well as higher efficiency of treatment of patients with ASH with anaemic syndrome in 6.0 times (p <0.05). The efficiency of eradication of H. pylori in the main and control groups accompanied by the use of the 3-component programme of the first line according to the stool test was the same (85.7% and 84.2% (p> 0.05), respectively), but in 57.9 % of patients in the control group, the symptoms of dyspepsia increased or appeared on the background of antibacterial therapy, while no side effects of the drug were found during the study in the main group.
{"title":"Optimized treatment of patients with alcoholic steatohepatitis taking into account comorbid anaemic conditions and H.pylori contamination","authors":"T. Antofiichuk, O. Khukhlina, M. Antofiichuk","doi":"10.24061/2413-0737.xxv.3.99.2021.1","DOIUrl":"https://doi.org/10.24061/2413-0737.xxv.3.99.2021.1","url":null,"abstract":"The prospective study of patients with alcoholic steatohepatitis (ASH) showed that 40 % of patients with ASH were diagnosed with anaemic conditions (AC), among which vitamin B12-deficiency anaemia was registered - in 17.5% of cases, anaemia of chronic disease (ACD) – in 10.0% of cases and hemolytic anemia (HA) - in 12.5% of cases. In patients with SH of mixed (including alcoholic) etiology AC was found in 32.0%: vitamin B12 - deficient - in 16.0%, ACD - in 8.0% and hemolytic - in 8.0 % of patients. In patients with ASH, H. pylori contamination was present in 32 (80.0%) individuals, including 100% of patients with B12-deficient anaemia. Among patients with SH of mixed (including alcoholic) etiology, H. pylori was detected in 100.0% of people with AS. The use of Hepadif in the complex therapy of ASH contributed to the elimination or reduction of the intensity of the main clinical syndromes (astheno-vegetative, dyspeptic, cholestatic, hepato-, splenomegaly, hepatic steatosis) and biochemical syndromes (mesenchymal-inflammatory cholestasis, hepatocellular insufficiency), in the range of 1.3-4.3 times (p <0.05), as well as higher efficiency of treatment of patients with ASH with anaemic syndrome in 6.0 times (p <0.05). The efficiency of eradication of H. pylori in the main and control groups accompanied by the use of the 3-component programme of the first line according to the stool test was the same (85.7% and 84.2% (p> 0.05), respectively), but in 57.9 % of patients in the control group, the symptoms of dyspepsia increased or appeared on the background of antibacterial therapy, while no side effects of the drug were found during the study in the main group.","PeriodicalId":9270,"journal":{"name":"Bukovinian Medical Herald","volume":"7 Suppl 6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91339809","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 : 2021-11-29DOI: 10.24061/2413-0737.xxv.3.99.2021.21
O. Khaniukov, O. Smolianova
The purpose of the work. To identify the factors that determine the relationship between adherence to treatment and QoL in the elderly with CHF on the background of AH and CKD, and to assess the possibilities of using the obtained data in clinical practice.Material and methods. The study included 93 patients from 60 to 74 years old with CHF on the background of AH and CKD. Clinical and laboratory studies, a questionnaire regarding the presence of side effects, an assessment of the quality of life using the Minnesota questionnaire and adherence to treatment according to the Morisky-Green scale were used in all the patients.Results. Correlation analysis revealed the following relationships: for adherence to QoL - -0.57 (-0.69; -0.42); for systolic blood pressure with QoL - 0.46 (0.28; 0.61) and with adherence - -0.35 (-0.52; -0.16;); for the creatinine with QоL - 0.35 (0.16; 0.52) and with adherence - -0.3 (- 0.47; -0.1); for EPI GFR with QoL - -0.46 (-0.61; -0.28) and with adherence - 0.33 (0.14; 0.5); for the 6-minute walk test with QoL - -0.65 (-0.78; -0.52) and with adherence - 0.49 (0.32; 0.63). For all identified relationships p is <0.05.Conclusions. In the elderly with CHF on the background of AH and CKD, correlations of moderate strength were found between the clinical and laboratory parameters of these diseases, QoL, and adherence to treatment. Identified pathogenetic links can be used to explain to the patient the need to follow the doctor's recommendations. A change in QoL can serve as a marker showing that some revising is needed in a patients’ treatment.
{"title":"Factors determining the relationship between adherence to treatment and quality of life in the elderly with chronic heart failure associated with arterial hypertension and chronic kidney disease: correlation analysis","authors":"O. Khaniukov, O. Smolianova","doi":"10.24061/2413-0737.xxv.3.99.2021.21","DOIUrl":"https://doi.org/10.24061/2413-0737.xxv.3.99.2021.21","url":null,"abstract":"The purpose of the work. To identify the factors that determine the relationship between adherence to treatment and QoL in the elderly with CHF on the background of AH and CKD, and to assess the possibilities of using the obtained data in clinical practice.Material and methods. The study included 93 patients from 60 to 74 years old with CHF on the background of AH and CKD. Clinical and laboratory studies, a questionnaire regarding the presence of side effects, an assessment of the quality of life using the Minnesota questionnaire and adherence to treatment according to the Morisky-Green scale were used in all the patients.Results. Correlation analysis revealed the following relationships: for adherence to QoL - -0.57 (-0.69; -0.42); for systolic blood pressure with QoL - 0.46 (0.28; 0.61) and with adherence - -0.35 (-0.52; -0.16;); for the creatinine with QоL - 0.35 (0.16; 0.52) and with adherence - -0.3 (- 0.47; -0.1); for EPI GFR with QoL - -0.46 (-0.61; -0.28) and with adherence - 0.33 (0.14; 0.5); for the 6-minute walk test with QoL - -0.65 (-0.78; -0.52) and with adherence - 0.49 (0.32; 0.63). For all identified relationships p is <0.05.Conclusions. In the elderly with CHF on the background of AH and CKD, correlations of moderate strength were found between the clinical and laboratory parameters of these diseases, QoL, and adherence to treatment. Identified pathogenetic links can be used to explain to the patient the need to follow the doctor's recommendations. A change in QoL can serve as a marker showing that some revising is needed in a patients’ treatment.","PeriodicalId":9270,"journal":{"name":"Bukovinian Medical Herald","volume":"96 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85618544","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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