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Оцінка якості життя та змін мікробіоти кишечника у хворих на ревматоїдний артрит
Get PDFAim. The aim of the work was to study life quality indices depending of degrees of large intestine microflora in patients with rheumatoid arthritis.Methods. The study was carried out on 43 patients with rheumatoid arthritis and 21 practically healthy persons. To determine the role of intestinal microflora in the rheumatoid genesis in patients with RA, excrements microbiological study was carried out. The comparative assessment of life quality parameters was carried out using SF-36 questionnaire. Result. In all patients with RA were extracted bifidobacteria, lactobacteria, bacteroides and colon bacillus, at that eubacteria, peptococcus and enterococci were eliminated from their large intestine cavity. On this background the contamination of the large intestine cavity by pathogenic and conventionally pathogenic enterobacteria and also Clostridium bacteria, staphylococci and Candida yeast-like fungi took place. The analysis of SF-36 questionnaire scales demonstrated that all parameters of patients with RA were lower than in the control group and depended on large intestine cavity microflora changes by certain indices.Conclusions. In patients with rheumatoid arthritis is observed the change of specific and population level of large intestine cavity microbiota. At dysbiotic disorders in these patients was observed the decrease of life quality indices, especially, ones of the physical health component. The lowest life quality indices were observed in patients with ІІІ degree of microbiological disordersМетою дослідження було вивчити показники якості життя в залежності від ступеню змін мікрофлори товстої кишки у хворих на ревматоїдний артрит. У пацієнтів спостерігається зміна видового та популяційного рівня мікробіоценозу товстої кишки. При виникненні дисбіотичних порушень відмічалось зниження показників якості життя, особливо фізичного компоненту здоров’я. Найбільш низькі показники спостерігались у пацієнтів із ІІІ ступенем мікробіологічних порушен
Тригерне значення персистуючих внутрішньоклітинних збудників при тривалих лихоманках з подальшим розвитком соматичної патології у дітей
Get PDFDespite the intense study of intracellular infections, the data as to their clinical-diagnostic and prognostic value still contradictory, especially in children of young age. Especially, prolonged fevers (fevers of an obscure generation) may be the manifestation of a series of infectious and somatic diseases with the further formation of a chronic somatic pathology. The interest to this problem is connected, from the one side, with the necessity to prognosticate, early detect and primarily prevent a somatic pathology, forming groups of the high risk. From the other side, the possibility of transformation of an acute pathology in children in a chronic somatic pathology in adults is well-known.The aim of the research was to improve the diagnostics of the infectious pathology, caused by intracellular pathogens in children, especially at prolonged fevers (fevers of an obscure generation), by improving the diagnostics quality, based on the deepened study of clinical-pathogenetic features of these pathological states.Methods. There was realized the clinical and laboratory examination of 100 children with prolonged fevers (fevers of an obscure generation), admitted without a set diagnosis. The etiological interpretation was realized by the methods of serological markers (ELISA) and molecular-genetic ones (polymerase chain reaction). The interpretation of levels of blood interleukins was realized by IEA, using ProCon IL-1β, 4, 6, TNF-α, interferon-γ reagents.As a result of etiological pathogens verification, there were revealed beta-hemolytic streptococcus, virus of simple herpes of 1, 2 types, cytomegalovirus Epstein-Barr, chlamydiosis, mycoplasma, adenoviruses as both mono- and mixed infections. According to the research results, 90% of children demonstrated the high severity and changed status of cytokines and local protective factors. More serious disorders of the immune system are revealed at mixed viral and atypical infections and somatic diseases. Different disorders of the autoimmune mechanism of development, namely system diseases of the connective tissue can appear in children with different variants of intracellular infections.Conclusions. Clinical-anamnestic, laboratory conclusions and immunologic research using the system analysis allow to prognosticate results in the catamnesis of children with intracellular infections of different somatic pathologies, and the multi-vector and correlation analysis allow to elaborate new diagnostic criteriaОсоблива увага приділена персистуючій інфекції, викликаній внутрішньоклітинними збудниками, яка може бути чинником тривалих лихоманок, а також фоном, на якому формуються соматична патологія.Клініко-анамнестичні, лабораторні дані й імунологічне дослідження дозволяють прогнозувати наслідки в катамнезі дітей із внутрішньоклітинними інфекціями різної соматичної патології та надають можливості для розробки нових діагностичних критерії
Роль самовідношення у пацієнтів лікаря-косметолога
Get PDFThe aim of the work was the revelation of self-esteem in cosmetological patients.Contingent and methods of research. The research was carried out on the base of medical center “CA-Clinic” during 2014 – 2016. The testing included 286 women, who addressed for cosmetological help.Results. The self-attitude of women with low self-esteem, who addressed to the cosmetologist, was disharmonious and was characterized with the high level of self-non-acceptance, lowered self-respect and self-understanding, alienation of subjectively negative features, exaggeration of imperfections, acute self-criticism. In women with high self-esteem the disorder of harmony was manifested by the high level of self-acceptance, exaggeration of positive features and absence of criticism to the negative ones, lowered self-reflection.Conclusions. Cosmetological patients, who have the lowered or high self-esteem form the separate category of clients and need the use of medical-cosmetological arrangements, directed on disharmonic self-attitudeСамовідношення жінок із зниженою самооцінкою, які зверталися до лікаря-косметолога, було дисгармонічним та характеризувалося високим рівнем неприйняття себе, зниженою самоповагою і саморозумінням, відчуженням суб’єктивно негативних рис, перебільшенням недоліків, гострою самокритикою. У жінок із завищеною самооцінкою порушення гармонійності самовідношення проявлялося високим рівнем самоприйняття, перебільшенням позитивних якостей та некритичністю до негативних, зниженою саморефлексіє
Рідкісні трисомії: частота, спектр, летальність на ембріональному та фетальному етапах внутрішньоутробного розвитку
Get PDFAim. The study of primary population frequency, mortality and share of rare autosomal trisomies at different stages of fetal development for the further determination of the expected proportion of false negative results at chromosome abnormalities (CA) selective diagnostics using during reproductive losses and prenatal diagnostics.Materials and methods. Karyotyping of 1808 samples of missed abortion concept products, 1572 induced abortions, 1329 chorionic villus biopsy samples, 2240 placenta biopsy samples, and 6120 samples of amniotic fluid (13069 total) was carried out.Results. The share of Т21,18,13 at pre-embryonic stage was only 6.33 %, while the share of “rare” trisomies was 93.67 %. In the first trimester the mean share of rare trisomies (Т1-12,14-17,19,20,22 ) was 41.13%; among prenatally diagnosed 11-14 weeks fetuses was 3.01 %, 15-22 weeks fetuses – 1.68 %, and after 23 weeks – 2.22 %. It means that the mean share of rare trisomies at prenatal diagnostics can be 2.3 % among newborns.Conclusion. The share of false negative results at autosomal trisomies detection using commercial selective test systems covering Т13,Т18,Т21,Т9 and Т22 in missed abortion group can be 41 %, and at prenatal diagnostics within 11-23 weeks – 2.3 %В роботі представлені дані власних досліджень по вивченню рідкісних регулярних аутосомних трисомій на різних етапах внутрішньоутробного розвитку та серед новонароджених. Загалом проаналізовано каріотипи 16328 зразків. В першому триместрі частка рідкісних трисомій в середньому складає 41,13 %; серед пренатально діагностованих плодів 11–14 тижнів – 3,01 %, 15–22 тиж. – 1,68, після 23 тижнів – 2,22
Порівняльна оцінка кінетики радіофармпрепарату (99mTc-MDP) у пацієнтів на деформуючий остеоартроз та ревматоїдний артрит кульшових суглобів методом остеосцинтиграфії
Get PDFThe aim of this work is determination of kinetics of radiopharmaceutical (99mTc-MDP) in the nidi of fixation of injured joint structures in patients with deforming osteoarthritis and rheumatoid arthritis of hip joints.Material and methods of research. Тhe three-phase osteoscintigraphy (3p-OSG) with technetium-methylene diphosphonate ( 99mTc-MDP) was carried out according to the standard protocol to 92 patients with deforming osteoarthritis and rheumatoid arthritis of hip joints, among which– 54 women and 38 men, 37 - 75 years old.Results. Kinetics of 99mTc-MDP in the nidi of injured hip joints fixation at rheumatoid arthritis is characterized with statistically reliable prevalence of integral perfusion, retention, specific accumulation of indicator at the stages of 3-P OSG comparing with fixation nidi at deforming osteoarthritis that correlates with the differences of destructive-reparative processes in them. Conclusions. The increase of intensity of radiopharmaceutical (RP) fixation in pathological nidus at rheumatoid arthritis (RA) as to deforming osteoarthritis (DO) indicated the intensification of arterial blood supply of such nidi as a result of active inflammation, influence of infection agent or increased osteoplastic activity. The integral perfusion in rheumatoid arthritis nidi was essentially more at the expanse of the increase of vascular permeability as a result of infection agents affect, activation of the factors of resorption and synthesis of the mineral components of angiogenesis. RP retention increased in the nidi at rheumatoid arthritis that testified to the high extractive ability of such nidiМета роботи – порівняльна оцінка кінетики радіофармпрепарату (99mTc-MDP) у хворих на деформуючий остеоартроз та ревматоїдний артрит кульшових суглобів. Кінетика 99mTc-MDP в осередках фіксації уражених кульшових суглобів, при ревматоїдному артриті, характеризується вірогідним переважанням інтегральної перфузії, ретенції та питомого накопичення індикатору на етапах трьофазової остеосцинтиграфії, порівняно з вогнищами фіксації при деформуючому остеоартроз
Вплив екзогенного L-аргініну на стан кардіогемодинаміки та варіабельність серцевого ритму у хворих на ішемічну хворобу серця після перенесеної негоспітальної пневмонії
Get PDFAim of the work: to study the influence of exogenous L-arginine on structural-functional indices of heart, intensity degree of myocardium coronary changes and heart rhythm variability in patients with coronary heart disease after community-acquired pneumonia. Methods of research: the open prospective study included 60 patients with CHD, exertional angina, 2-3 f.c., who underwent community-acquired pneumonia of 3 clinical group (men – 34, women – 26, age median 72,50 (66,00; 75,00) years old). All patients underwent clinical examination, included clinical-laboratory methods of examination, two-dimensional echocardioscopy and impulse-wave dopplerography, daily monitoring of ECG by Holter at admission to hospital and in 3 months. After singing the informed consent, the patients were randomized in 2 groups. Main group included 30 persons, who received L-arginine in addition to basic CHD therapy, 30 patients of control group received only basic therapy.Results of research: patients of main group at secondary examination in three month demonstrated a tendency to decrease of final-diastolic volume of LV, reliable increase of fraction of left ventricle emission by 4,44% (р<0,05), and decrease of mean pressure in pulmonary artery was more significant (8,33% vs 2,94%; р<0,05). The inclusion of L-arginine in the scheme of CHD treatment favored the reliable (р<0,05) decrease of tachycardia duration by 49,77%, number of ventricular extrasystoles by 63,2%, duration of ST segment depression by 56,52%, increase of general heart rhythm variability (rMSSD – by 70,00%, ТР – by 97,42%) and decrease of LF/HF index by 11,67% at the expanse of activity of parasympathetic component comparing with patients, who received only basic therapy.Conclusions: the addition of L-arginin to the basic therapy in patients with IHD has the positive influence of cardiohemodinamics, favors the decrease of intensity degree of coronary changes and normalization of sympatho-parasympathetic balance of vegetative nervous systemМетою роботи було дослідити вплив L-аргініну на структурно-функціональні показники серця та варіабельність серцевого ритму у пацієнтів з ішемічною хворобою серця, що перенесли негоспітальну пневмонію. Включення L-аргініну до базисної терапії сприяє покращенню систолічної функції, зменшенню об’ємних показників лівого шлуночка, середнього тиску в легеневій артерії, тривалості ішемії міокарда та нормалізації симпато-парасимпатичного баланс
Диагностическое значение уровня галектина-3 у больных гипертрофической кардиомиопатией
Get PDFThe aim of the present research was to study galectin-3 level in patients with hypertrophic cardiomyopathy depending on the disease clinical course, the presence of complications and comorbidity for determination of possibilities of its use as hypertrophic cardiomyopathy biomarker.Methods. Galectin-3 level was studied in 90 patients with hypertrophic cardiomyopathy with the analysis depending on the disease clinical course, the presence of complications and comorbidity, as well as in 20 patients with cardiac hypertrophy caused by hypertension as the control group.Results. Galectin-3 level in patients with hypertrophic cardiomyopathy is rather variable and reliably depends on the patients’ age, heart failure severity, and the presence of concomitant third degree hypertension. Besides, there is a tendency to increase galectin-3 level in the presence of atrial fibrillation and after previous myocardial infarction. The correlation between galectin-3 level and hypertrophic cardiomyopathy clinical course peculiarities, the presence of complications and comorbidity points to the limited ability to isolated use of this biomarker for hypertrophic cardiomyopathy diagnostics, but it can be useful for determination of the disease severity and its prognosis.Conclusion. Galectin-3 level variability indicates the given biomarker’s low diagnostic importance in patients with hypertrophic cardiomyopathy, but its dependence on the disease severity indexes shows galectin-3 predictive value in the mentioned group of patientsThe aim of the present research was to study galectin-3 level in patients with hypertrophic cardiomyopathy depending on the disease clinical course, the presence of complications and comorbidity for determination of possibilities of its use as hypertrophic cardiomyopathy biomarker.Methods. Galectin-3 level was studied in 90 patients with hypertrophic cardiomyopathy with the analysis depending on the disease clinical course, the presence of complications and comorbidity, as well as in 20 patients with cardiac hypertrophy caused by hypertension as the control group.Results. Galectin-3 level in patients with hypertrophic cardiomyopathy is rather variable and reliably depends on the patients’ age, heart failure severity, and the presence of concomitant third degree hypertension. Besides, there is a tendency to increase galectin-3 level in the presence of atrial fibrillation and after previous myocardial infarction. The correlation between galectin-3 level and hypertrophic cardiomyopathy clinical course peculiarities, the presence of complications and comorbidity points to the limited ability to isolated use of this biomarker for hypertrophic cardiomyopathy diagnostics, but it can be useful for determination of the disease severity and its prognosis.Conclusion. Galectin-3 level variability indicates the given biomarker’s low diagnostic importance in patients with hypertrophic cardiomyopathy, but its dependence on the disease severity indexes shows galectin-3 predictive value in the mentioned group of patientsЦелью исследования было изучение уровня галектина-3 у больных с гипертрофической кардимиопатией в зависимости от особенностей клинического течения заболевания, наличия осложнений и сопутствующей патологии для определения возможности его использования в качестве биомаркера ГКМП. Результаты исследования свидетельствуют о значительной вариабельности данного биомаркера, на уровень которого оказывают влияние возраст больного, наличие осложнений и сопутствующей патологи
Эффективность противогрибковой сублингвальной аллергенспецифической терапии у больных до 50 лет и старше с легкой и средней тяжести бронхиальной астмой
Get PDFIn Ukraine, the relative contraindication for allergen-specific immunotherapy (ASIT) in patients with bronchial asthma (BA) is age 50 years and older, which is substantiated by its efficiency reduce with age. The use of antifungal sublingual ASIT and its efficiency in older patients remain poorly investigated.Aim – research of antifungal sublingual allergen-specific immunotherapy (with mixed-allergens of household mold) in patients with mild and moderate bronchial asthma depending on the age (up to 50 years and older).Methods. A prospective, open, controlled, parallel, single-center study with clinical-functional and allergological examination in 45 patients with asthma in the remission stage with positive skin tests to fungal mixed-allergens was carried out. The patients were divided into 2 groups depending on the age: 27 patients from 20 to 50 years inclusive (mean age 39.6 ± 1.1 years) were included in the 1st group (the control group); 18 patients from 51 to 71 years old (mean age 57.1 ± 1.4 years) comprised the 2nd group (primary). The treatment was performed using sublingual method with fungal mixed-allergens (household mold mixture) (Aspergillus fumigatus, Aspergillus niger, Penicillium sp., Mucor sp., Rhizopus sp.) during the year.Results. The patients with mild persistent and moderate asthma over 50 years old initially differed from the younger patients by slightly worse functional respiratory rates (FEV1), and a lower percentage of patients with mild and uncontrolled asthma. The sublingual ASIT was effective regardless of age, including the patients over 50 years old. The results were confirmed by a positive dynamics of respiratory function indicators, decrease in skin sensitivity to fungal mixed-allergens, asthma transformation into controlled form in 83-89% of the patients. In the patients older than 50 years, the respiratory function dynamics was less pronounced. None of the patients had severe adverse effects. Mild adverse reactions occurred regardless of age in 96-98% of the patients with asthma, most often in the form of cough, runny nose, sneezing, sore throat, and skin itching.Conclusion. The sublingual ASIT with antifungal mixed-allergens in the interior premises in adult patients with mild persistent and moderate bronchial asthma is effective regardless of age, including the patients aged over 50, which was confirmed by improved respiration function, decreased skin sensitivity to fungal allergens, and improved life quality after 12 months therapy. Mild adverse effects happened regardless of age in 96-98% of the patients with asthmaЦель работы – изучение эффективности противогрибковой сублингвальной аллергенспецифической терапии (АСИТ) (с микст-аллергенами плесени бытовой) у больных легкой и средней тяжести бронхиальной астмой в зависимости от возраста (до 50 лет и старше). Результаты показали высокую эффективность АСИТ, что подтвердило улучшение показателей функции дыхания, уменьшение кожной чувствительности к фунгальным аллергенам, улучшение качества жизни независимо от возраст
Синдром гіперальгезії у тварин та методи його лікування за експериментальними даними та морфометрією
Get PDFAim. The assessment and choice of analgesia method relative to hyperalgesia development in the experiment.Methods. Antiflogogenic effect of preparations was studied on the model of caragenin edema in 147 white non-linear rats with the mass 120–150 g. As a hyperalgesia model was used a caragenin edema. It was reproduced by the subplantar administration of 0,05 ml of 1 % caragenin solution in the right back extremity of the animal.Results. The combined use of bupivacaine regional analgesia manifested the moderate antiflogogenic effect (AFA was 25,3, 20,9 and 11,6 %, respectively), whereas fentanyl administration is, on the contrary, associated with the growth of prostaglandin edema. The conducting anesthesia with bupivacaine led to the more expressed analgesic effect that was proved by the level of corticosterone in blood. In 5th group (bupivacaine) the corticosterone level was 102,8±8,1 ng/ml that is 2,5 times less than in 2 one (fetanyl) and in 3 group (ketamine) (р<0,05)Conclusion. The complex study of reactions of pain behavior, physiological rates and laboratory stress tests demonstrated that the use of bupivacaine conducting anesthesia led to the more expressed analgesic effectУ статті відображено механізми формування синдрому гіперальгезіі та механізми розвитку патологічного післяопераційного синдромокомплексу та морфологічних змін в експерименті. Розглянуто компоненти виникнення експериментального синдрому гіперальгезії . Показано роль якісного знеболення як невід’ємної частини інтенсивної терапії після оперативних втручань на моделі експериментальної гіперальгезії. Обгрунтовані методики післяопераційного знеболення такі як використання кетаміну та регіональної анальгезія в експерименті. У роботі експериментально обґрунтовані принципи лікування післяопераційного бол
Особливості вегетативної (автономної) нервової системи у дітей з гастроезофагеальною рефлюксною хворобою та різними генотипами локусу C825T гена GNB3
Get PDFAim. To establish features of activity of different links of the autonomous nervous system in children with gastroesophageal reflux disease and different genotype of C825T locus of GNB3 gene.Materials and methods. There was realized the analysis of clinical features of GERD and functioning of the autonomous nervous system in 100 schoolchildren. The molecular-genetic study of C825T locus of GNB3 gene using PCR (rs5443) was carried out in the studied group (100 children) and in 40 healthy children, who formed the control group.Results. Sympathectomy was observed in 47 children (47%), vagotonia in 43 (43%), and euhonia was observed in 10 children (10%). Most patients with sympathectomy demonstrated normo- and hypacidity. Practically all patients with vagotonia demonstrated hyperacidity of the stomach contents.Among patients with hyperacidity (pH 0,86-1,59) the one third had СС genotype of C825T locus of GNB3 gene and persons with ТТ genotype were absent, whereas in the group of children with normo- and hypoacidity (pH 1,60-3,59)in 25% of patients was revealed ТТ genotype.Patients with СС genotype of C825T locus of GNB3 gene demonstrated vagotonia essentially more often (67,44%), and ТТ genotype was most often revealed in patients with eutonia (10%), (р<0,05).Conclusions.1). The depth of esophagus lesions is not associated with the predominance of one link of the autonomous nervous system, (р>0,05).2). Hyperacidity in children with GERD is associated with vagotonia.3). СС genotype of C825T locus of GNB3 gene is associated with vagotonia and hyperacidity, (р<0,05)Захворюваність на гастроезофагеальну рефлюксну хворобу серед дітей неухильно зростає. Різноманітність клініко-морфологічних варіантів ГЕРХ зумовлює труднощі діагностики даної патології у дитячому віці. Враховуючи велику кількість етіологічних чинників, в тому числі порушення регуляції стравоходу з боку автономної нервової системи та генетичну схильність, необхідним є детальний аналіз кожного з ни