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CHARACTERISTICS OF HEART RHYTHM DISORDERS ACCORDING TO THE DATA OF HOLTER ECG MONITORING IN PATIENTS WITH HEART FAILURE AND ATRIAL FIBRILLATION 心衰合并心房颤动患者动态心电图监测资料分析心律失常特征
Pub Date : 2023-02-23 DOI: 10.24061/2413-0737.27.1.105.2023.2
N. M. Kulaiets
Chronic heart failure (CHF) is one of the most significant medical, economic and social problems of the 21st century and remains the main cause of morbidity and mortality worldwide.The purpose. To study the indicators of Holter ECG monitoring, the dynamics of ischemic changes, heart rate, indicators of heart rhythm variability and blood pressure in patients with heart failure and atrial fibrillation.Material and methods. 150 patients aged 45-65 were examined. All patients were divided into groups: Group I – patients with HF with sinus rhythm or atrial fibrillation (AF) (permanent or persistent form), (n=75). Group II – patients without HF with AF, (n=75). Group III – control group: 36 practically healthy people. All patients underwent a clinical examination, ECG, echocardiography (ECHOKG), Holter ECG monitoring (HM ECG) and daily BP monitoring (DMAT).Research results. The analysis of the ECG of the examined patients indicates the presence of heart rhythm disorders, which is an important risk factor and progression of CHF. The results of XM ECG indicate the presence of ventricular arrhythmias of various gradations along with AF. There was a probable difference in the direction of an increase in the number of ventricular extrasystoles (VAS), both single and, most importantly, extrasystoles of high gradations, in patients with CHF and AF compared with healthy subjects. In addition, the number of SHEs in patients with CHF and AF was likely lower than in patients with CHF with sinus rhythm. Indicators of maximum heart rate, ST segment depression and QT interval dispersion in patients with CHF and AF were significantly higher (p<0.05) than similar parameters in patients without CHF with AF.Conclusions: Ventricular heart rhythm disturbances were detected in the examined patients, which is a predictor of an unfavorable prognosis in patients with chronic heart failure. There was a probable difference in the direction of increased levels of maximum heart rate, maximum depression, ST segment elevation, dispersion of the QT interval, QTc, an increase in the total duration of episodes of myocardial ischemia, in patients with chronic heart failure and atrial fibrillation in comparison with healthy subjects.
慢性心力衰竭(CHF)是21世纪最重要的医学、经济和社会问题之一,也是全世界发病率和死亡率的主要原因。的目的。研究心力衰竭心房颤动患者动态心电图监测指标、缺血性变化动态、心率、心律变异性指标及血压。材料和方法。对150例45-65岁的患者进行了检查。所有患者分为两组:第一组-伴有窦性心律或心房颤动(AF)的HF患者(永久性或持续性),(n=75)。II组:无心衰合并房颤患者(n=75)。第三组-对照组:36名实际健康的人。所有患者均行临床检查、心电图、超声心动图(ECHOKG)、动态心电图监测(HM ECG)和每日血压监测(DMAT)。研究的结果。检查患者的心电图分析表明存在心律失常,这是CHF的重要危险因素和进展。心电XM结果提示心房颤动同时存在不同级别的室性心律失常。与健康受试者相比,CHF和AF患者的单级室性心动过速(VAS)和高级别室性心动过速(VAS)数量增加的方向可能存在差异。此外,CHF和AF患者的she数量可能低于伴有窦性心律的CHF患者。CHF和AF患者的最大心率、ST段压低、QT间期离散度等指标均显著高于非CHF合并AF患者(p<0.05)。结论:在检查的患者中发现室性心律紊乱,这是慢性心力衰竭患者预后不良的预测因素。慢性心力衰竭和心房颤动患者在最大心率、最大降速、ST段抬高、QT间期离散度、QTc、心肌缺血发作总持续时间增加等方面的升高方向可能与健康受试者存在差异。
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引用次数: 0
EDUCATIONAL AND METHODOLOGICAL FUNDAMENTALS OF TEACHING ISSUES OF GENDER DIFFERENTIATION IN THE DEPARTMENTS OF MORPHOLOGY AT MEDICAL UNIVERSITY 医科大学形态学院系性别分化教学问题的教育与方法基础
Pub Date : 2023-02-23 DOI: 10.24061/2413-0737.27.1.105.2023.14
D. Proniaiev, V. Kryvetskyi, O. Boichuk
Introduction. The main problem in teaching the processes of gender differentiation during practical classes is that all biochemical and genetically determined processes of gender differentiation are insufficiently covered or detached from the accompanying morphological transformations. Often, educational programs consist only of topics that highlight the morphological processes of the development of a certain sex, avoiding the main questions - the biochemical causes of morphological transformations.The purpose of the research is to find out the current state of studying the problem of teaching the topic "Gender differentiation" at the medical and biological faculties of higher educational institutions of Ukraine and highlight our own experience in teaching the topic "Sex differentiation" at Bukovinian State Medical University.Material and methods. Educational and methodological practice is based on researched 19 sources of foreign scientific literature from the electronic database "PubMed". The methods of comparative content analysis and information-analytical analysis were used.Research results and their discussion. Sex differentiation in humans and other animals is associated with many biochemical processes that occur at the level of genes and proteins. Here are some biochemical aspects of sex differentiation: Hormones are key factors that influence sex differentiation. In boys, the gonads produce testosterone, and in girls, estrogen. These hormones promote the development of various organs and systems, including the reproductive system. Genetic mechanisms: every organism has two sex chromosomes – X and Y. Males have XY, and females have XX. Genes on these chromosomes affect the development of various aspects of sexual differentiation. Proteins produced by genes play an important role in sex differentiation. For example, the SRY protein is responsible for the development of the testicles in boys, while the FOXL2 protein is responsible for the development of the ovaries in girls.Conclusion. The morphological processes that accompany sex differentiation are certainly only a reflection of the complex biochemical transformations that ensure this process. In our opinion, the study of morphological transformations will not have an effect if we consider them without reference to biochemical and genetic processes at the molecular level.
介绍。在实践课程中教授性别分化过程的主要问题是,所有生物化学和遗传决定的性别分化过程都没有充分涵盖或脱离伴随的形态转变。通常,教育课程只包括强调某一性别发展的形态过程的主题,而回避了主要问题——形态转变的生化原因。研究的目的是了解乌克兰高等教育机构的医学和生物系对"性别分化"专题教学问题的研究现状,并强调我国在布科维尼安国立医科大学"性别分化"专题教学方面的经验。材料和方法。教学和方法实践是基于对PubMed电子数据库中19个来源的国外科学文献的研究。采用比较内容分析法和资料分析法。研究结果及其讨论。人类和其他动物的性别分化与发生在基因和蛋白质水平上的许多生化过程有关。以下是性别分化的一些生化方面:激素是影响性别分化的关键因素。男孩的性腺分泌睾酮,女孩的性腺分泌雌激素。这些激素促进各种器官和系统的发育,包括生殖系统。遗传机制:每个生物都有两条性染色体——X和y。雄性有XY,雌性有XX。这些染色体上的基因影响着性别分化的各个方面的发育。基因产生的蛋白质在性别分化中起着重要作用。例如,SRY蛋白负责男孩睾丸的发育,而FOXL2蛋白负责女孩卵巢的发育。伴随性别分化的形态过程当然只是确保这一过程的复杂生化转化的一种反映。在我们看来,如果我们不考虑分子水平上的生化和遗传过程,形态学转化的研究就不会有效果。
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引用次数: 0
PECULIARITIES OF ENDOTHELIAL DYSFUNCTION AND CAPILLARY BLOOD FLOW IN PATIENTS WITH COVID-19 CORONAVIRUS DISEASE AND CONCOMITANT TYPE 2 DIABETES MELLITUS COVID-19冠状病毒病合并2型糖尿病患者内皮功能障碍和毛细血管血流特点
Pub Date : 2023-02-23 DOI: 10.24061/2413-0737.27.1.105.2023.7
Z. R. Tylishchak
The aim of the study was to investigate the indicators of endothelial dysfunction and capillary blood flow in patients with coronavirus disease (COVID-19) and concomitant type 2 diabetes mellitus.Materials and methods. We examined 60 patients with moderate and severe coronavirus disease (COVID-19): Group I (main) – 30 patients with coronavirus disease (COVID-19) with concomitant type 2 diabetes mellitus, mean age (66.70±1.47) years; Group II (comparison group) – 30 patients with coronavirus disease (COVID-19) without diabetes mellitus, mean age (60.13±2.21) years; control group (practically healthy) - 20 people. Nail capillaroscopy, determination of endothelin-1, D-dimer levels, and coagulation parameters were performed on the 2-3rd day after admission to the hospital.Results. In patients of both groups, a significant increase in the level of D-dimer, endothelin-1 was observed. The average values of D-dimer in patients of group I significantly exceeded the average values in patients of group II: 1543.20±254.01 ng FEU/ml and 522.74±39.45 ng FEU/ml respectively (p<0.001). During capillaroscopy in patients of group I, a high frequency of capillary branching (25.8%), bushy capillaries (25.8%) and tortuosity of capillaries (63.3%) was found, microthrombosis and microbleeding were observed more often. In patients of group II, the most common abnormalities were pericapillary edema (83.3%), capillary dilatation (36.7%), dilated and tortuous capillaries (13.3%), and hemosiderin deposits (36.7%). Conclusions. In patients with coronavirus disease (COVID-19) with concomitant type 2 diabetes mellitus, the levels of D-dimer and endothelin-1 indicated a more pronounced endothelial dysfunction. Changes in nail capillaroscopy indicating microvascular damage associated with COVID-19 were more pronounced in patients with concomitant type 2 diabetes.
本研究旨在探讨冠状病毒病(COVID-19)合并2型糖尿病患者的内皮功能障碍和毛细血管血流指标。材料和方法。我们研究了60例中重度冠状病毒病(COVID-19)患者:第一组(主要)- 30例冠状病毒病(COVID-19)合并2型糖尿病患者,平均年龄(66.70±1.47)岁;第二组(对照组):30例无糖尿病的冠状病毒病(COVID-19)患者,平均年龄(60.13±2.21)岁;对照组(基本健康)- 20人。入院后2 ~ 3天行甲毛细血管镜检查,检测内皮素-1、d -二聚体水平及凝血指标。两组患者均观察到d -二聚体、内皮素-1水平显著升高。I组患者d -二聚体的平均值分别为1543.20±254.01 ng FEU/ml和522.74±39.45 ng FEU/ml,显著高于II组患者(p<0.001)。I组患者在进行毛细管镜检查时,发现毛细血管分支(25.8%)、毛细血管浓密(25.8%)、毛细血管扭曲(63.3%)的频率较高,微血栓形成和微出血较多。在II组患者中,最常见的异常是毛细血管周围水肿(83.3%)、毛细血管扩张(36.7%)、毛细血管扩张和弯曲(13.3%)和含铁血黄素沉积(36.7%)。结论。在冠状病毒病(COVID-19)合并2型糖尿病患者中,d -二聚体和内皮素-1水平表明内皮功能障碍更为明显。伴随2型糖尿病患者的指甲毛细血管镜检查变化表明与COVID-19相关的微血管损伤更为明显。
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引用次数: 0
PREVALENCE OF POLYMORPHISM OF THE IL1RL1 GENE (rs950880) AMONG RESIDENTS OF THE PODILSK REGION OF UKRAINE 乌克兰波季尔斯克地区居民中IL1RL1基因(rs950880)多态性的患病率
Pub Date : 2023-02-23 DOI: 10.24061/2413-0737.27.1.105.2023.1
D.A. Bagriy, V. Zhebel
The study of the "genetic architecture" of essential hypertension (EH) is becoming increasingly relevant, in particular, the study of the genetic component of the production of peptides, which are used as biomarkers in cardiology. Soluble ST2 of the interleukin-1 receptor family is a promising marker of myocardial remodeling. The genetic basis of ST2 production - SNP rs950880 of the IL1RL1 gene requires a detailed analysis. The aim of the study was to study the prevalence of SNR rs950880 polymorphic variants of the IL1RL1 gene among men living in the Podilsk region of Ukraine with essential hypertension (EH) of varying severity. Material and methods. In the course of the work, 170 men aged 40 to 60 years were examined: 70 without cardiovascular diseases and 100 patients with EH of varying severity (50 with asymptomatic EH (AEH) and 50 patients with EG complicated by CHF II A stage (EH+CHF)). Determination of polymorphism rs950880 of IL1RL1 gene was performed using polymerase chain reaction (PCR). The statistical analysis of the research results included the calculation of the odds ratio, the analysis of conjugation tables. Results. It was established that among residents of the Podilsk region of Ukraine, the SNP variant rs950880 of the IL1RL1 gene, which has the C allele, is the most common: among men without cardiovascular diseases, carriers of the CC and AC variants dominate (45.72% and 42.86%, respectively), the prevalence is similar SNP rs950880 and among patients with EH of different severity (among patients with EH homozygous CC 42.00%, heterozygous AC - 46.00%; in the group EH+CHF - 38.00% and 48.00%, respectively). The AA variant is the least common in all groups (11.42% in the control group, 12.00% among patients with AEH, 14.00% in the EH+CHF group). Conclusions. According to the frequency distribution of the rs950880 polymorphism of the IL1RL1 gene, men with EH of different severity do not reliably differ from the general population of residents of the Podilsk region. Carriership of the investigated polymorphism is not associated with an increased risk of developing EH or complications of CHF. Variability is observed in the frequency distribution of SNR rs950880 IL1RL1 gene alleles in different populations.
原发性高血压(EH)的“遗传结构”研究正变得越来越重要,特别是对肽生产的遗传成分的研究,肽在心脏病学中被用作生物标志物。白细胞介素-1受体家族的可溶性ST2是一个很有希望的心肌重构标志物。ST2产生的遗传基础- IL1RL1基因的SNP rs950880需要详细分析。该研究的目的是研究生活在乌克兰Podilsk地区不同严重程度的原发性高血压(EH)男性中IL1RL1基因SNR rs950880多态性变异的患病率。材料和方法。在研究过程中,170名年龄在40 - 60岁的男性接受了检查:70名无心血管疾病和100名不同程度的EH患者(50名无症状EH (AEH)和50名EG合并CHF II A期(EH+CHF))。采用聚合酶链反应(PCR)检测IL1RL1基因rs950880多态性。研究结果的统计分析包括优势比的计算、共轭表的分析。结果。结果表明,在乌克兰Podilsk地区居民中,具有C等位基因的IL1RL1基因的SNP变异rs950880最为常见:在无心血管疾病的男性中,CC和AC变异的携带者占主导地位(分别为45.72%和42.86%),SNP rs950880的患病率与不同严重程度的EH患者相似(EH纯合型CC患者为42.00%,杂合型AC患者为46.00%;EH+CHF组分别为38.00%和48.00%)。AA变异在所有组中最不常见(对照组为11.42%,AEH组为12.00%,EH+CHF组为14.00%)。结论。根据IL1RL1基因rs950880多态性的频率分布,不同严重程度的EH男性与Podilsk地区居民的一般人群无可靠差异。携带所研究的多态性与发生EH或CHF并发症的风险增加无关。不同人群的rs950880 IL1RL1基因SNR等位基因频率分布存在差异。
{"title":"PREVALENCE OF POLYMORPHISM OF THE IL1RL1 GENE (rs950880) AMONG RESIDENTS OF THE PODILSK REGION OF UKRAINE","authors":"D.A. Bagriy, V. Zhebel","doi":"10.24061/2413-0737.27.1.105.2023.1","DOIUrl":"https://doi.org/10.24061/2413-0737.27.1.105.2023.1","url":null,"abstract":"The study of the \"genetic architecture\" of essential hypertension (EH) is becoming increasingly relevant, in particular, the study of the genetic component of the production of peptides, which are used as biomarkers in cardiology. Soluble ST2 of the interleukin-1 receptor family is a promising marker of myocardial remodeling. The genetic basis of ST2 production - SNP rs950880 of the IL1RL1 gene requires a detailed analysis. The aim of the study was to study the prevalence of SNR rs950880 polymorphic variants of the IL1RL1 gene among men living in the Podilsk region of Ukraine with essential hypertension (EH) of varying severity. Material and methods. In the course of the work, 170 men aged 40 to 60 years were examined: 70 without cardiovascular diseases and 100 patients with EH of varying severity (50 with asymptomatic EH (AEH) and 50 patients with EG complicated by CHF II A stage (EH+CHF)). Determination of polymorphism rs950880 of IL1RL1 gene was performed using polymerase chain reaction (PCR). The statistical analysis of the research results included the calculation of the odds ratio, the analysis of conjugation tables. Results. It was established that among residents of the Podilsk region of Ukraine, the SNP variant rs950880 of the IL1RL1 gene, which has the C allele, is the most common: among men without cardiovascular diseases, carriers of the CC and AC variants dominate (45.72% and 42.86%, respectively), the prevalence is similar SNP rs950880 and among patients with EH of different severity (among patients with EH homozygous CC 42.00%, heterozygous AC - 46.00%; in the group EH+CHF - 38.00% and 48.00%, respectively). The AA variant is the least common in all groups (11.42% in the control group, 12.00% among patients with AEH, 14.00% in the EH+CHF group). Conclusions. According to the frequency distribution of the rs950880 polymorphism of the IL1RL1 gene, men with EH of different severity do not reliably differ from the general population of residents of the Podilsk region. Carriership of the investigated polymorphism is not associated with an increased risk of developing EH or complications of CHF. Variability is observed in the frequency distribution of SNR rs950880 IL1RL1 gene alleles in different populations.","PeriodicalId":9270,"journal":{"name":"Bukovinian Medical Herald","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86910625","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}
引用次数: 0
USE OF SURGICAL METHODS OF TREATMENT FOR THROMBOSIS OF THE INFERIOR VENA CAVA SYSTEM 应用外科方法治疗下腔静脉系统血栓形成
Pub Date : 2023-02-23 DOI: 10.24061/2413-0737.27.1.105.2023.8
Y. Khrebtiy, G. I. Khrebtiy
Objective. Develop surgical tactics in the treatment of acute deep venous thrombosis (DVT) of the inferior vena cava system.Materials and methods. We analyzed the results of the surgical treatment of 181 patients with DVT for the period from 2001 to 2014. Among the patients with DVT in our study, 37 (20.4%) patients had thrombosis of the inferior vena cava (IVC). Separately, we selected a group of 44 patients with floating DVT. During the treatment, catheter-directed thrombolysis (CDT) was used in 60 (33.1%) patients, systemic thrombolysis in 30 (16.5%), thrombectomy was performed in 44 (24.3%) patients, and anticoagulants were used in 47 (25.9%) patients. Catheter-directed thrombolysis was performed according to the developed method in 30 patients. Results. In the general assessment of the efficiency of the methods, we found that the efficiency of the patented method is 20.5% greater than the efficiency of thrombolysis in the back vein of the foot and 39% greater than the efficiency of systemic thrombolysis (p<0.001). In our study, out of 60 cases of CDT, hemorrhagic complications occurred in 2 (3.3%) cases. In the treatment of patients with floating DVT, we used active surgical tactics when the length of the floating part was more than 4 cm. In the treatment of occlusive thrombosis of the IVC, catheter-directed thrombolysis was used in 9 patients, systemic thrombolysis in 4 patients, and thrombolysis for pulmonary embolism (PE) in 1 patient. 1 patient with thrombosis of the vena cava inferior died of massive PE during anticoagulant therapy. The use of combined methods of DVT treatment of the IVC system made it possible to obtain good and satisfactory results in the immediate period in 166 (92%) patients and in the long-term period in 90 (49.7%) patients.Conclusions. Treatment tactics for thrombosis of IVC system requires an individual approach in each specific case, taking into account the etiological factors of the disease, anatomical features of the structure of IVC system, terms from the onset of the disease, the risk of pulmonary embolism (PE), the presence of concomitant pathology.
目标。探讨下腔静脉系统急性深静脉血栓(DVT)的外科治疗策略。材料和方法。我们分析了2001年至2014年181例深静脉血栓患者的手术治疗结果。本组DVT患者中,37例(20.4%)患者存在下腔静脉血栓形成。另外,我们选择了44例漂浮性深静脉血栓患者。在治疗过程中,60例(33.1%)患者采用导管溶栓(CDT), 30例(16.5%)患者采用全身溶栓,44例(24.3%)患者采用取栓术,47例(25.9%)患者采用抗凝药物。30例患者采用导管定向溶栓。结果。在对方法效率的总体评估中,我们发现该专利方法的效率比足后静脉溶栓效率高20.5%,比全身溶栓效率高39% (p<0.001)。在我们的研究中,60例CDT中有2例(3.3%)发生出血性并发症。在治疗漂浮性DVT患者时,当漂浮部分长度大于4cm时,我们采用积极的手术策略。在静脉闭塞性血栓的治疗中,导管溶栓9例,全身溶栓4例,肺栓塞(PE)溶栓1例。1例下腔静脉血栓患者在抗凝治疗期间死于大量PE。采用DVT联合方法治疗下腔静脉系统,166例(92%)患者的近期疗效良好,90例(49.7%)患者的长期疗效良好。下腔静脉系统血栓形成的治疗策略需要在每个具体病例中采用单独的方法,考虑到疾病的病因,下腔静脉系统结构的解剖特征,从疾病开始的术语,肺栓塞(PE)的风险,伴随病理的存在。
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引用次数: 0
TELEMEDICINE AS A TOOL FOR OPTIMIZING AND IMPROVING METHODS OF PROVIDING MEDICAL AID TO THE POPULATION 远程医疗作为优化和改进向人口提供医疗援助方法的工具
Pub Date : 2023-02-23 DOI: 10.24061/2413-0737.27.1.105.2023.13
M. Kotsarenko, O. Adamovych, O.P. Adamovych
Today, the population of Ukraine is experiencing significant difficulties in various spheres of life, however, one of the most urgent problems remains to ensure the proper level of health and preserve the life of the nation. Therefore, the quality of medical care needs special attention now, not only as a direct function but also as a kind of criterion of the level of activity of the health care system and state policy as a whole. One of the innovative directions of the provision of medical care to the population in the 21st century is digital, as well as information and telecommunication technologies, the use of which made it possible to create a single medical information space that combines practical and theoretical medicine, ensures the planning of new scientific research and targeted training specialists of various fields of medicine, who later implement knowledge and skills in medical practice. The purpose of our research was to study the directions of using telemedicine technologies in the work of medical institutions and the possibilities of improving the provision of medical care to the population through their use.Research methods. The used methods of the system approach and system analysis made it possible to investigate the possibilities of optimal use of telemedicine technologies and analyze existing problems and propose ways to solve them.The results. Modern sources of professional literature consider telemedicine from different angles: as a set of tools and complexes that provide users with access to current medical resources, including international ones, realize the potential of modern information and telecommunication technologies in health care; as well as a multi-level and multi-component system, which includes both medical organizations with their professional, informational and educational resources, medical diagnostic devices, databases and system users, as well as technical means of access to telecommunication networks, communication channels and network means, transmitters and other converters of medical information into digital electrical signals for further transmission through communication channels. Taking into account the multidisciplinary nature of medicine and a wide range of medical services, the unification of clinical, anamnestic, laboratory, radiation, etc. databases and the possibility of their transmission and reception using equipment from different manufacturers is of particular importance. One of the unified and most widely used standards in the field of medical image transmission today is DICOM (Digital Imaging and Communications in Medicine) - an international standard for processing and transmitting radiological and other medical images from medical devices to a computer, which has found wide application in various industries of medicineConclusions. The analysis of literary sources proves the need for further detailed study of the possibilities of digital and information technologies in medicine to impr
今天,乌克兰人民在生活的各个领域遇到重大困难,然而,最紧迫的问题之一仍然是确保适当的健康水平和维护民族的生命。因此,医疗服务质量不仅是一项直接功能,而且是衡量整个卫生保健系统和国家政策活动水平的一种标准,现在需要特别关注。21世纪向人口提供医疗保健的创新方向之一是数字技术以及信息和电信技术,这些技术的使用使创建一个结合实践医学和理论医学的单一医疗信息空间成为可能,确保规划新的科学研究和有针对性地培训各个医学领域的专家,这些专家后来在医疗实践中运用知识和技能。我们研究的目的是研究在医疗机构的工作中使用远程医疗技术的方向,以及通过使用远程医疗技术改善向人口提供医疗服务的可能性。研究方法。使用系统方法和系统分析的方法,可以调查远程医疗技术优化使用的可能性,分析存在的问题并提出解决方法。结果。现代专业文献从不同角度看待远程医疗:作为一套工具和综合体,为用户提供获取现有医疗资源,包括国际医疗资源的途径,实现现代信息和电信技术在卫生保健方面的潜力;以及一个多层次、多组件的系统,包括医疗机构及其专业、信息和教育资源,医疗诊断设备、数据库和系统用户,以及接入电信网络的技术手段、通信渠道和网络手段,以及将医疗信息转换成数字电信号并通过通信渠道进一步传输的发射机和其他转换器。考虑到医学的多学科性质和广泛的医疗服务,统一临床、记忆、实验室、辐射等数据库以及使用不同制造商的设备传输和接收这些数据库的可能性是特别重要的。DICOM(医学数字成像和通信)是当今医学图像传输领域中使用最广泛的统一标准之一,这是一项处理和传输放射学和其他医学图像从医疗设备到计算机的国际标准,在医学的各个行业中得到了广泛的应用。对文献资料的分析证明,需要进一步详细研究数字和信息技术在医学方面的可能性,以改进在战时向人民提供医疗援助的方法。为了最有效地有针对性地应用信息系统并获得最佳结果,必须清楚地了解信息系统的能力和功能,以实现最终目标-为患者提供及时和高质量的医疗服务。提供可靠的信息存档和恢复系统、各级医疗机构之间的通信系统、优化的移动医疗方案、不同疾病严重程度患者生命指标的监测系统,保证了现代复杂条件下治疗和诊断过程的连续性。
{"title":"TELEMEDICINE AS A TOOL FOR OPTIMIZING AND IMPROVING METHODS OF PROVIDING MEDICAL AID TO THE POPULATION","authors":"M. Kotsarenko, O. Adamovych, O.P. Adamovych","doi":"10.24061/2413-0737.27.1.105.2023.13","DOIUrl":"https://doi.org/10.24061/2413-0737.27.1.105.2023.13","url":null,"abstract":"Today, the population of Ukraine is experiencing significant difficulties in various spheres of life, however, one of the most urgent problems remains to ensure the proper level of health and preserve the life of the nation. Therefore, the quality of medical care needs special attention now, not only as a direct function but also as a kind of criterion of the level of activity of the health care system and state policy as a whole. One of the innovative directions of the provision of medical care to the population in the 21st century is digital, as well as information and telecommunication technologies, the use of which made it possible to create a single medical information space that combines practical and theoretical medicine, ensures the planning of new scientific research and targeted training specialists of various fields of medicine, who later implement knowledge and skills in medical practice. The purpose of our research was to study the directions of using telemedicine technologies in the work of medical institutions and the possibilities of improving the provision of medical care to the population through their use.Research methods. The used methods of the system approach and system analysis made it possible to investigate the possibilities of optimal use of telemedicine technologies and analyze existing problems and propose ways to solve them.The results. Modern sources of professional literature consider telemedicine from different angles: as a set of tools and complexes that provide users with access to current medical resources, including international ones, realize the potential of modern information and telecommunication technologies in health care; as well as a multi-level and multi-component system, which includes both medical organizations with their professional, informational and educational resources, medical diagnostic devices, databases and system users, as well as technical means of access to telecommunication networks, communication channels and network means, transmitters and other converters of medical information into digital electrical signals for further transmission through communication channels. Taking into account the multidisciplinary nature of medicine and a wide range of medical services, the unification of clinical, anamnestic, laboratory, radiation, etc. databases and the possibility of their transmission and reception using equipment from different manufacturers is of particular importance. One of the unified and most widely used standards in the field of medical image transmission today is DICOM (Digital Imaging and Communications in Medicine) - an international standard for processing and transmitting radiological and other medical images from medical devices to a computer, which has found wide application in various industries of medicineConclusions. The analysis of literary sources proves the need for further detailed study of the possibilities of digital and information technologies in medicine to impr","PeriodicalId":9270,"journal":{"name":"Bukovinian Medical Herald","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81092423","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}
引用次数: 0
Determination of antimicrobial activity of dimethylhydrazones 二甲基腙抗菌活性的测定
Pub Date : 2022-12-20 DOI: 10.24061/2413-0737.xxvi.2.102.2022.3
A. Humenna, V. V. Listvan, V. Listvan, N. Yakovychuk, O. Blinder, D. Rotar
Modern methods of treatment and prevention of infectious diseases require the administration of antibiotics and antiseptics. Excessive and uncontrolled use leads to the selection of antibiotic-resistant strains of microorganisms, which dictates the need to find new alternative antimicrobial drugs. We searched for and studied the antimicrobial activity of new dimethylhydrazones. The compounds we studied showed significant antimicrobial activity, especially against gram-positive bacteria, S.aureus ATCC 25923 and lower antimicrobial activity against gramnegative bacteria, indicating the viability of these compounds and the need for more in-depth study of its antimicrobial activity on a wide range of microorganisms.
治疗和预防传染病的现代方法需要使用抗生素和防腐剂。过度和不受控制的使用导致微生物耐抗生素菌株的选择,这表明需要寻找新的替代抗菌药物。我们寻找并研究了新的二甲基腙的抗菌活性。我们研究的化合物显示出显著的抗菌活性,特别是对革兰氏阳性菌金黄色葡萄球菌ATCC 25923的抗菌活性,而对革兰氏阴性菌的抗菌活性较低,表明这些化合物的生存能力,需要更深入地研究其对广泛微生物的抗菌活性。
{"title":"Determination of antimicrobial activity of dimethylhydrazones","authors":"A. Humenna, V. V. Listvan, V. Listvan, N. Yakovychuk, O. Blinder, D. Rotar","doi":"10.24061/2413-0737.xxvi.2.102.2022.3","DOIUrl":"https://doi.org/10.24061/2413-0737.xxvi.2.102.2022.3","url":null,"abstract":"Modern methods of treatment and prevention of infectious diseases require the administration of antibiotics and antiseptics. Excessive and uncontrolled use leads to the selection of antibiotic-resistant strains of microorganisms, which dictates the need to find new alternative antimicrobial drugs. We searched for and studied the antimicrobial activity of new dimethylhydrazones. The compounds we studied showed significant antimicrobial activity, especially against gram-positive bacteria, S.aureus ATCC 25923 and lower antimicrobial activity against gramnegative bacteria, indicating the viability of these compounds and the need for more in-depth study of its antimicrobial activity on a wide range of microorganisms.","PeriodicalId":9270,"journal":{"name":"Bukovinian Medical Herald","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73083496","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}
引用次数: 0
Advantages of simulative training in practice of practical skills and manipulations of future doctors 模拟训练在实践中对未来医生的实用技能和操作的优势
Pub Date : 2022-12-20 DOI: 10.24061/2413-0737.xxvi.2.102.2022.15
I. Kozlovska, O. Kolotylo, Y. Kulachek, O. Rusak, U. Marusyk, V. Smandych
Relevance. The problem of qualitative training of future doctors is an extremely important issue throughout the world and in Ukraine, including. To improve their practical skills and medical manipulations, they must be brought to ideal and automatism, which is possible due to modern methods of training in the conditions of the simulation center, due to the development of skills on standardized patients and simulators.Objective. To compare the quality of education and working out practical skills, manipulations and evaluate the efficiency of training using patients of medical institutions and mannequins or standardized patients in the center of simulation medicine.Material and methods. We compared the efficiency of working out practical skills, medical manipulations and ability to qualitatively apply them in practice, especially in providing emergency medical care to students of 5 and 6 courses.Results. It is not always possible to immediately establish direct contact with the patient, as opposed to a standardized patient, which extremely accurately demonstrates all complaints and positive symptoms that will allow to confirm the diagnosis. Students are not comfortable with the patient in the clinic or afraid to harm the patient and refuse to survey or conduct a certain skill, while on a mannequin or standardized patient without any fear, a practical skill can be repeated with the required number of times. At a standardized patient or virtual mannequin, a teacher can stop a student at any stage of execution, indicate an error or once again explain the technique of manipulation, and a student may repeat a few times, bringing it to full automatism. Another extremely important advantage of simulating learning is the opportunity at the requested moment, and not when there is a suitable patient in the clinic, to create, simulate and beat the desired situation. This is especially important when working out emergency care skills in conditions that are menacing. Conclusion. The medical education process must be effective and secure for all participants, specially patients, which is possible only due to simulation centers. Of course, the development of practical skills and manipulations in the simulating center allows to improve traditional types of education, pay more attention to handling skills, allowing, realizing and correcting mistakes, analyze the situation and draw conclusions.
的相关性。未来医生的质量培训问题是全世界和乌克兰的一个极其重要的问题,包括。为了提高他们的实践技能和医疗操作,必须使他们达到理想和自动化,这是可能的,因为现代训练方法在模拟中心的条件下,由于标准化的病人和模拟器的技能的发展。在模拟医学中心对医疗机构患者和人体模型或标准化患者进行培训,比较培训质量、制定实践技能、操作方法,评价培训效果。材料和方法。我们比较了五、六课学生在实践技能、医学手法的培养效率和在实践中定性应用的能力,特别是在提供急救服务方面。与标准化的病人不同,与病人建立直接接触并不总是可能的,标准化的病人非常准确地显示所有的抱怨和阳性症状,从而可以确认诊断。学生在诊所与病人相处不舒服或害怕伤害病人而拒绝调查或进行某种技能,而在人体模型或标准化的病人身上,没有任何恐惧,可以按照要求的次数重复一项实用技能。在一个标准化的病人或虚拟的人体模型中,老师可以在执行的任何阶段阻止学生,指出错误或再次解释操作技术,学生可能会重复几次,使其完全自动化。模拟学习的另一个极其重要的优势是,在需要的时刻,而不是在诊所里有合适的病人时,有机会创造、模拟和超越理想的情况。当在危险的条件下训练急救技能时,这一点尤为重要。结论。医学教育过程必须对所有参与者,特别是患者有效和安全,这只有通过模拟中心才能实现。当然,在模拟中心发展实践技能和操作,可以改进传统类型的教育,更加注重处理技能,允许,实现和纠正错误,分析情况并得出结论。
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引用次数: 0
Clinical and electroneuromyographic peculiarities of spastic syndrome in children with organic lesions of the nervous system 神经系统器质性病变儿童痉挛综合征的临床和神经肌电图特点
Pub Date : 2022-12-20 DOI: 10.24061/2413-0737.xxvi.2.102.2022.11
I. A. Zorii, N. Vasylieva, I. Krychun, O. M. Nicka, I.B. Kharmanska
Topicality. Organic lesions of the central nervous system (CNS) are a group of neuropsychiatric disorders caused by various pathological factors affecting the brain. Infantile cerebral palsy (ICP) is the most common neurological disease diagnosed in children at an early age. 80 % of children with ICP suffer from spastic forms, the main symptom of which is an abnormal increase in muscle tone – spasticity. This syndrome can be objectified by electroneuromyographic (ENMG) examination which enables qualitative and quantitative assessments of the nervousmuscular system state.Objective: to determine clinical and electroneuromyographic peculiarities of the spastic syndrome of ICP children depending on the intensity of motor disorders.Materials and methods. 122 ICP children were examined (an average age 8,8 ± 3,7 years) and distributed into groups by the results of Gross Motor Function Classification Expanded & Revised (GMFCS E&R). All the patients underwent careful neurological examination and ENMG examination. To assess suprasegmental and segmental levels of nervous system lesions, the parameters of H-reflex and F-wave were analyzed.Results. Spastic forms of ICP were diagnosed in the majority of the examined children. Orthopedic pathology was found more often among ICP children with marked motor disorders, including equinovalgus position and planovalgus foot deformity. According to ENMG parameters ICP patients presented conduction disorders manifested by increased amplitude of М response, especially in testing the tibial nerve, increased Нmах/Мmах ratio and the amplitudes of Н-reflex and F-wave.Conclusions. According to the results of the conducted study, ENMG parameters changed on the side of deterioration depending on the degree of motor activity disorders by Gross Motor Function Classification.
时事性。中枢神经系统器质性病变(CNS)是由影响大脑的各种病理因素引起的一组神经精神疾病。小儿脑瘫(ICP)是儿童早期最常见的神经系统疾病。80%的ICP患儿患有痉挛形式,其主要症状是肌肉张力异常增加-痉挛。这种综合征可以通过神经肌电图(ENMG)检查客观化,可以对神经肌肉系统状态进行定性和定量评估。目的:探讨颅内压患儿痉挛综合征在运动障碍程度上的临床和神经肌电图特征。材料和方法。122例ICP患儿(平均年龄8岁,8±3.7岁),根据大肌肉运动功能扩展与修订分类(GMFCS E&R)结果进行分组。所有患者均行神经学检查和ENMG检查。通过对h反射和f波参数的分析,评价神经系统损伤的节段上和节段水平。痉挛形式的ICP被诊断在大多数检查的儿童。骨科病理更常见于有明显运动障碍的ICP患儿,包括马蹄外翻位和平外翻足畸形。根据ENMG参数,ICP患者表现为传导障碍,表现为М反应幅度增加,特别是在胫骨神经测试中,Нmах/Мmах比增加,Н-reflex和f波振幅增加。根据所进行的研究结果,根据大运动功能分类,ENMG参数在恶化侧的变化取决于运动活动障碍的程度。
{"title":"Clinical and electroneuromyographic peculiarities of spastic syndrome in children with organic lesions of the nervous system","authors":"I. A. Zorii, N. Vasylieva, I. Krychun, O. M. Nicka, I.B. Kharmanska","doi":"10.24061/2413-0737.xxvi.2.102.2022.11","DOIUrl":"https://doi.org/10.24061/2413-0737.xxvi.2.102.2022.11","url":null,"abstract":"Topicality. Organic lesions of the central nervous system (CNS) are a group of neuropsychiatric disorders caused by various pathological factors affecting the brain. Infantile cerebral palsy (ICP) is the most common neurological disease diagnosed in children at an early age. 80 % of children with ICP suffer from spastic forms, the main symptom of which is an abnormal increase in muscle tone – spasticity. This syndrome can be objectified by electroneuromyographic (ENMG) examination which enables qualitative and quantitative assessments of the nervousmuscular system state.Objective: to determine clinical and electroneuromyographic peculiarities of the spastic syndrome of ICP children depending on the intensity of motor disorders.Materials and methods. 122 ICP children were examined (an average age 8,8 ± 3,7 years) and distributed into groups by the results of Gross Motor Function Classification Expanded & Revised (GMFCS E&R). All the patients underwent careful neurological examination and ENMG examination. To assess suprasegmental and segmental levels of nervous system lesions, the parameters of H-reflex and F-wave were analyzed.Results. Spastic forms of ICP were diagnosed in the majority of the examined children. Orthopedic pathology was found more often among ICP children with marked motor disorders, including equinovalgus position and planovalgus foot deformity. According to ENMG parameters ICP patients presented conduction disorders manifested by increased amplitude of М response, especially in testing the tibial nerve, increased Нmах/Мmах ratio and the amplitudes of Н-reflex and F-wave.Conclusions. According to the results of the conducted study, ENMG parameters changed on the side of deterioration depending on the degree of motor activity disorders by Gross Motor Function Classification.","PeriodicalId":9270,"journal":{"name":"Bukovinian Medical Herald","volume":"41 6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79436578","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}
引用次数: 0
Mitochondrial cerebral dysfunction in rats with scopolamine-induced neurodegeneration under enalapril effect 依那普利作用下东莨菪碱致神经变性大鼠线粒体脑功能障碍的研究
Pub Date : 2022-12-20 DOI: 10.24061/2413-0737.xxvi.2.102.2022.10
O. Kmet, N. Filipets, T. Kmet, N.Y. Andriychuk, D. Tymkul
Objective. Neurodestructive diseases are characterized by complex pathobiochemical cascades in the neuron, which cause disturbances in energy metabolism and the formation of mitochondrial dysfunction. The renin-angiotensin system plays an important role in the physiological functioning of mitochondria, the excessive activity of which increases the risk of neurodegenerative diseases of the brain. Although angiotensin-converting enzyme inhibitors are now considered as means of prevention and treatment of ischemic lesions of the central nervous system, their corrective properties in the development of central neurodegeneration continue to be refined. The objective of our study was investigation of enalapril effect, as an angiotensin-converting enzyme inhibitor, in case of mitochondrial dysfunction of the cerebral cortex and hippocampus of rats under conditions of scopolamine-induced neurodegeneration reproducing development of Alzheimer’s disease in the experiment.Material and methods. Scopolamine hydrochloride (Sigma, USA) was injected in rats through the peritoneum at a dose of 1 mg/kg for 27 days to simulate Alzheimer’s disease. Starting from the 28th day of the experiment, enalapril was introduced through the peritoneum at a dose of 1 mg/kg, once a day for 14 days. Results. Under conditions of scopolamine-induced Alzheimer’s disease in the mitochondrial fraction of the cerebral cortex and hippocampus of rats free radical oxidation of lipids and proteins ncreases, and activity of Krebs cycle enzymes decreases – α-ketoglutarate dehydrogenase and succinate dehydrogenase; light dispersion decreases and a relative rate of mitochondrial swelling increases. After enalapril administration for 14 days to rats with scopolamine-induced Alzheimer’s disease the content of products reacting with 2-thiobarbituric acid and protein oxidation modification decreases in the mitochondrial fraction of the cerebral cortex and hippocampus; in both examined structures, the activity of catalase, αketoglutarate dehydrogenase, succinate dehydrogenase increases, and superoxide dismutase – only in the cerebral cortex; a gradual decrease of light dispersion and relative rate of mitochondrial swelling occurs.Conclusion. Improvement of the antioxidant system state and energy supply of mitochondria, decreased intensity of mitochondrial swelling in the cerebral cortex and hippocampus of rats with scopolamine-induced Alzheimer’s disease are indicative of the protective properties of enalapril.
目标。神经破坏性疾病的特点是神经元内复杂的病理生化级联反应,引起能量代谢紊乱和线粒体功能障碍的形成。肾素-血管紧张素系统在线粒体的生理功能中起着重要作用,线粒体的过度活动增加了大脑神经退行性疾病的风险。虽然血管紧张素转换酶抑制剂现在被认为是预防和治疗中枢神经系统缺血性病变的手段,但它们在中枢神经退行性疾病发展中的纠正作用仍在继续完善。我们的研究目的是研究依那普利作为一种血管紧张素转换酶抑制剂,在东莨菪碱诱导的阿尔茨海默病再现性神经退行性变条件下,对大鼠大脑皮层和海马线粒体功能障碍的影响。材料和方法。盐酸东莨菪碱(Sigma, USA)以1 mg/kg剂量经腹膜注射大鼠27天,模拟阿尔茨海默病。从试验第28天开始,依那普利以1 mg/kg的剂量经腹膜给药,每天1次,连用14 d。结果。东莨菪碱诱导的阿尔茨海默病条件下,大鼠大脑皮层和海马线粒体部位脂质和蛋白质自由基氧化增加,Krebs循环酶活性降低- α-酮戊二酸脱氢酶和琥珀酸脱氢酶;光色散减少,线粒体肿胀的相对速率增加。依那普利给药14 d后,东莨菪碱诱导的阿尔茨海默病大鼠大脑皮层和海马线粒体部分与2-硫代巴比妥酸反应的产物和蛋白质氧化修饰的含量下降;在这两种结构中,过氧化氢酶、α酮戊二酸脱氢酶、琥珀酸脱氢酶和超氧化物歧化酶的活性增加-仅在大脑皮层;光色散逐渐减少,线粒体肿胀率逐渐升高。改善东莨菪碱诱导的阿尔茨海默病大鼠的抗氧化系统状态和线粒体能量供应,降低大脑皮层和海马线粒体肿胀强度,提示依那普利具有保护作用。
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Bukovinian Medical Herald
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