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Оцінка якості життя у хворих із постінфарктним кардіосклерозом на фоні метаболітної терапії
Get PDFAim of research – to estimate the dynamics of life quality indices in patients with postinfarction cardiosclerosis on the background of the metabolic therapy using the questionnaire MacNew Heart Disease Health-related Quality of Life.Materials and methods: in the research took part 99 patients (71 % of men and 29 % of women) with postinfarction cardiosclerosis, stable angina of effort of ІІ-ІІІ functional class. Patients of the group of comparison (n=49) continued to take the basis therapy of the ischemic heart disease, whereas patients of the main group (n=50) additionally took glutargin. All groups were representative by age and sex. The patients’ life quality estimation was realized by the questionnaire MacNew.Results: The determination of the life quality was carried out using the questionnaire MacNew Heart Disease Health-related Quality of Life, most effective for patients with the ischemic heart disease. At the comparative analysis of initial life quality indices by the questionnaire MacNew in both groups, all patients with postinfarction cardiosclerosis demonstrated the decrease of all indices of scales and didn’t differ statistically. It was established, that on the background of glutargin treatment took place the statistically reliable increment of the physical activity (from 4,3±1,0 to 5,2±0,9 points, p<0,05) and reliable increase of the routine activity, limited by the pain influence (from 4,6±0,8 to 5,9±0,9 points, p<0,05).Conclusions: All patients with postinfarction cardiosclerosis demonstrated the essential decrease of life quality indices in physical, emotional and social spheres. Glutargin inclusion into the standard therapy of patients with the ischemic heart disease allows to improve the life quality of patients with postinfarction cardiosclerosis essentiallyДослідження присвячене питанням впливу метаболітної терапії на якість життя у хворих із постінфарктним кардіосклерозом. Показано, що включення глутаргіну в стандартну терапію ішемічної хвороби серця значно покращує показники якості життя за рахунок приросту фізичної активності на 21 % та збільшення повсякденної діяльності, котра обмежена впливом болю на 28 % (p<0,05
Визначення показників мінеральної щільності стегнової кістки за даними рентгенівської денситометрії у дітей раннього віку
Get PDFThe aim of the research was the determination of indices of mineral density of the spongy substance, mineral density of the cortical layer and also the cortical index according to the data of X-ray densitometry in infants at norm and at hip joint dysplasia. Materials and methods. Using the developed program „OsteoGraf-child”, there was carried out the analysis of x-ray photographs of hip joints of 56 children 0 days - 3 years old, suspected in trauma or HJD. Results of research. „OsteoGraf-child” program for the diagnostics of structural changes of a femur at norm and at hip joint dysplasia in infants allows to determine indices of the femur mineral density, for the spongy and compact substances separately, and to calculate the cortical index. Conclusions. Indices of the age norm of the mineral density of the spongy substance and femur cortical layer were established that allows to estimate objectively the bone tissue status in infants. At the conservative treatment of hip joint dysplasia using the long-term immobilization was detected the reliable decrease of indices of the spongy substance and cortical layer mineral density in infants of 6–12 months that needs a treatment correctionМетою дослідження було визначення показників мінеральної щільності стегнової кістки за даними рентгенівської денситометрії у дітей раннього віку в нормі і при дисплазії кульшового суглоба. За допомогою розробленої програмами „OsteoGraf-child” вперше були встановлені показники вікової норми мінеральної щільності губчатої речовини та кортикального шару стегнової кістки, а також визначено зміну цих показників при консервативному лікуванні дисплазії кульшового суглоб
Дослідження факторів фіброзу у хворих на вперше діагностований мультирезистентний туберкульоз легенів
Get PDFAim. To study the levels of tissue factors of fibrosis and markers of destruction of the pulmonary tissue in patients with firstly diagnosed multidrug-resistant pulmonary tuberculosis.Materials and methods. There were examined 48 patients with firstly diagnosed multidrug-resistant pulmonary tuberculosis, divided in groups depending on treatment results, with studied levels of general oxyproline, free and protein-bound oxyproline and also aldosterone, matrix metalloproteinase-9 and tissue inhibitor of metalloprotainase-1 at the beginning of the treatment. Pearson’s χ2 and Fisher methods, Kruskel-Wallis criteria, Spearman methods were used.Results. The group of patients, who finished their treatment successfully, demonstrated the mean values of oxyproline and MP-9, the highest levels of aldosterone and TIMP-1 compared with other groups of patients. Patients, who died before the finish of the main course of chemotherapy, had demonstrated the highest levels of bound oxyproline and MP-9, and also a bit lower levels of free oxyproline and TIMP-1 compared with the group of effectively treated ones. The least levels of all studied parameters were observed in the group of unsuccessfully treated patients.Conclusion. The processes of decay of the pulmonary tissue prevailed over the reparation ones in the groups of the non-effective treatment that is indicated by an imbalance of free and protein-bound oxyproline and MP-9/TIMP-1 ratio. The exhaustion of compensatory mechanisms may be indicated by the lower level of aldosterone in the groups of the non-effective treatment and its reverse correlation with the prevalence of tuberculosis process and intoxication signsУ хворих на вперше діагностованиймультирезистентний туберкульоз легенів дослідили рівні оксипроліну та його фракцій, альдостерону, ММП-9 та ТІМП-1 на початку лікування. У ефективно пролікованих пацієнтів, рівні оксипролінів та ММП-9 мали середні значення, та найвищі рівні альдостерону та ТІМП-1; при неефективному лікуванні – дисбаланс фракцій оксипроліну та ММП-9/ТІМП-1, та знижений рівень альдостерон
Аналіз морфологічних и функціональних змін нефроендотелію при системних аутоімунних ревматичних хворобах
No full textIntroduction. The nature of the lesion and the pathogenesis of kidney vessels damage in systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), Henoch-Schönlein purpura (HSP) and microscopic polyangiitis (MPA) remains not enough studied, although the severity of such vasculopathy determines the prognosis of systemic autoimmune rheumatic diseases.The aim and purpose of the work was to evaluate the nature of morphological changes in the endothelium of the capillaries and arterioles of the kidneys in SLE, RA, VHS and MPA, connection with clinical and laboratory factors of the diseases' course and the influence of systemic vascular endothelial dysfunction.Materials and methods. The kidney biopsy results and data of laboratory analysis of vascular endothelial function were analysed in 94 patients, among which 41 persons suffered from SLE, 17 – RA, 24 - HSP and 12 – MPA. The ratio of men and women in these groups was respectively 1:7, 1:2, 2:1 and 1:3, the average age of the patients - 38, 50, 28 and 41 years, duration of disease from its manifestation - 12, 12, 10 and 4 years, the distribution of patients I, II and III degree of activity of the pathological process - as a 1:2:3, 1:2:2, 2:1:1, 1:2:9. Kidney biopsy is performed only in patients with the presence of proteinuria (excluded patients with AA amyloidosis). Carried out echocardiography, doppler ultrasound of the vessels and biomicroscopy of the conjunctiva vessels; by immune-enzyme analysis were studied indicators of vascular endothelial growth factor, endothelin-1, thromboxane-A2, homocysteine, prostacyclin, cyclic guanosine monophosphate, E- and P-selectin. Histological sections of the kidneys were stained with hematoxylin-eosin, alcian blue and van Gieson, becoming the PAS-reaction. In addition, the immune-enzyme (with peroxidase label) and fluorescence immunoassay methods of research of kidney tissue were performed.Results. The proliferation of capillary endothelium was peculiar with a greater extent to SLE and MPA, and arteriolar endothelium - only to MPA, whereas these changes were not peculiar to RA. Deposits of immunoglobulin (Ig) A in the blood vessels were the most typical for HSP and C1q-complement component - for SLE and MPA. The lesions of the endothelium of the capillaries and arterioles of the kidneys depend on the severity of the skin syndrome, peripheral neuropathy, leukocytoclastic enantemy and hands and feet capillaritis. Vascular endothelial dysfunction as vasodilators and vasoconstrictors imbalance occurs in 35 % of RA patients with renal disease, in 39 % SLE, 52 % HSP and 100 % MPA. Morphological lesions of the renal vascular endothelium are closely related to the severity of instrumental signs of extrarenal systemic angiopathy. Plasma levels of vascular endothelial growth factor determine proliferation of glomerular endothelium in patients with MPA, and in the development of renal immune endothelial deposits (IgA, IgG, IgM, C3, C1q) in SLE participate endothelin-1 and E-selectin, in RA - P-selectin, VSH - homocysteine.Conclusions. All patients with SLE, RA, HSP and MPA peculiar changes of the capillaries and arterioles endothelium of the kidneys glomeruli, in which genesis the disorders of systemic endothelial dysfunction of vessels participate.Метою роботи стала оцінка характеру морфологічних змін ендотелію судин нирок при системному червоному вовчаку, ревматоїдному артриті, геморагічному васкуліті та мікроскопічному поліангіїті, зв'язок з клініко-лабораторними чинниками перебігу захворювань і вплив системної ендотеліальної дисфункції судин. Остання в цих групах хворих бере участь в патогенетичних побудовах нефропатії, щільно пов'язана з системними проявами ангіопаті
Застосування протипухлинної вакцинотерапії на основі дендритних клітин в ад’ювантоному лікуванні хворих на рак підшлункової залози
Get PDFPancreatic cancer (PC) is included in the seven most widespread cancers and is the most aggressive of all gastrointestinal cancers. Unfortunately, all known modalities in PC treatment do not provide the desired result. Anti-tumor vaccinotherapy (ATV) seems to be promising. It causes a specific immune response (IR) directed to the tumor-associated antigens (TAA), included into the vaccine. The original construction based on dendric cells (DC) was offered as ATV: mechano-activated lyophilized tumor cells (MALTC), which was used with adjuvant chemotherapy simultaneously.The aim of our research was to study the influence of DC- MALTC-ATV in adjuvant treatment composition on general survival of PC patients.Materials and methods. After radical surgery, the patients were randomly divided in two groups: basic group (22 patients), which received DC-vaccine in addition to adjuvant chemotherapy (Gemcitabine+Tegafur), and control group (21 patient), which received only chemotherapy. The general survival rate was calculated using Kaplan–Meier estimator, comparison of survival rates between groups was carried out by Logrank test.Results. The overall survival median is 36 and 11 months for basic and control groups, respectively. By the moment of statistical analysis on the 35th month of observation, 29 % of patients from the control group survived compared to 50 % of the basic group patients.Conclusion. Therefore, the use of DC- MALTC-ATV in complex with adjuvant chemotherapy significantly improves general survival rates in PC patients (р=0,02)Метою дослідження було вивчити вплив протипухлинної вакцинотерапії на основі дендритних клітин, навантажених механо-активованими аутологічними ліофілізованими пухлинниими клітинами (ДК-МАЛФПК-ПВТ) у складі ад’ювантного лікування на загальну виживаність хворих на рак підшлункової залози (РПЗ). Дослідження провендено на 43 хворих, що отримували гемцитабін-вмісну ад’ювантну хіміотерапії. Застосування ДК-МАЛФПК-ПВТ значно підвищує загальну виживаність хворих на РП
Вплив споживання молока та молочних продуктів на ризик виникнення та важкість перебігу акне у пацієнтів підліткового віку з Acne vulgaris, які отримують лікування у дерматологічній клініці при Лікарні Короля Фахда Університету Ель-Хубар, Саудівська Аравія
No full textIntroduction: Acne vulgaris is a common cutaneous disorder. Many studies were done exploring the relationship between acne and diet with controversial results.Aim: To assess the relation between dairy products consumption and acne risk and severity in young adult patients with acne vulgaris.Method: This is a case control study using interview questionnaire conducted at the dermatology clinics at King Fahd Hospital of the University in Alkhobar, Saudi Arabia for a period 6 months. A total of 100 participants. Their ages varied 13–25 years. Participants were interviewed with questionnaires related to specific dairy food consumption. Acne severity was assessed by a dermatologist on duty using the Global acne grading system. Results: There was no statistically significant difference (P<0.05) found between the severity of acne with all the dietary factors except for consumption of milk (P=0.033).Discussion and conclusion: This study suggests that dairy products consumption does not influence or aggravate acne development in our young adults who were Saudis except for milk. We recommend conducting a randomized controlled trial to establish a causal relationship between frequent milk consumption and acne severityУ представленому дослідженні було вивчено взаємозв’язок між споживанням молока та молочних продуктів на ризик виникнення та важкість перебігу акне у пацієнтів підліткового віку з Аcne vulgaris. З метою дослідження було здійснено анкетування щодо споживання молочних продуктів та оцінку ступеня тяжкості акне за допомогою Глобальної системи класифікації акне. Було встановлено, що немає статистично значущої різниці між важкістю перебігу акне та всіх харчових факторів, окрім споживання молока. В результаті проведеного дослідження можна припустити, що споживання молочних продуктів, окрім молока, не впливає та не викликає загострення акн
Вплив на післяопераційний період ранньої мультимодальної реабілітації при абдомінальній гістеректомії
Get PDFThe aim of research was to estimate the influence of the use of early multimodal rehabilitation concept on postoperative period after scheduled abdominal hysterectomy.Methods. 41 female patients, divided in two groups, were involved in the study. In the main group (19 patients) early multimodal rehabilitation protocol was used. Preoperative period: informing and teaching the patient; bowel preparation rejection; starvation rejection; the use of dietary carbohydrate mixes; thromboembolic complications prevention.Intraoperative period: antibiotic prophylaxis; regional (epidural analgesia); short acting anesthetics; postoperative infusion therapy limitation; rejection of nasogastric intubation; normothermia; the routine use of drains rejection.Postoperative period: effective pain relief; non opioid analgesics; nausea and vomiting prevention; early mobilization (after epidural block regression); early enteral nutrition.In the control group, hysterectomy via laparotomy was performed using combined anesthesia (Sevoflurane + epidural analgesia + Fentanyl) with artificial lung ventilation. In the control group, general anesthesia was implemented using Sevoflurane, system analgesia – using Fentanyl (5 μg/kg/hour). In the main group, anesthesia was implemented using Fentanyl (3–5 μg / kg/ hour) and epidural 0.5 % solution of Bupivacaine (6–8 ml). During postoperative period, in the main group prolonged epidural analgesia by small boluses of 0.25 % Bupivacaine solution (4 ml/hour) in combination with system administration of Dexketoprofen (100–150 mg/day) + Ketorolac (60 mg/day) + Paracetamol (2000 mg / day) was used. In the control group, postoperative analgesia included Paracetamol 3000 mg / day, Dexketoprofen 150–200 mg/day, Tramadol 50–100 mg/day.Besides, pain level (VAS) within 12 and 24 hours after operation at rest and during coughing was estimated.Results. The groups were identical by anamnestic (start of menstruation, number of pregnancies, births, abortions and pregnancy losses), anthropometric and demographic characteristics, as well as by duration of the surgeries, blood loss volume and preoperative parameters of mean arterial pressure and heart rate.Pain level when coughing in the control group was higher than the one in the main group, statistical difference was determined in 12 and 24 hours, and it was higher than30 mm, which required more analgesics. An adequate postoperative analgesia allows starting early activation of the patients in the control group. Postoperative bed-day in patients of the main group (FTS) was considerably shorter than in patients of the control group without FTS.Conclusion. The proposed complex of measures is one of the ways for the fast track gynecological surgery operations concept implementation. This approach allows early discharge, which undoubtedly has direct economic effect and increases prestige of doctor and medical institutionУ дослідженні взяли участь 41 хвора, які були розділені на дві групи. В основній групі (19 хворих) застосовували протокол ранньої мультимодальної реабілітації. У контрольній групі (22 хворі) використовували традиційний периопераційний режим. Запропонований комплекс заходів є одним із шляхів реалізації концепції fast track хірургії при гінекологічних операціях. Подібний підхід дозволяє домогтися ранньої виписки, що несе в собі, без сумніву, прямий економічний ефект і значно збільшує престиж лікаря та медичної установ
Особливості метаболічних порушень у хворих на грижі поперекового відділу хребта у поєднанні з артеріальною гіпертензією
Get PDFThe combination of arterial hypertension (AH) with the spine pathology is a natural manifestation of connected structural-functional disorders.Aim is to determine the features of metabolic disorders in the organism of patients with hernias of lumbar spine, associated with arterial hypertension (AH), on the base of clinical-biochemical and immunological markers.Materials and methods. The study was carried out in 2016 on the base of SI “Institute of spine and joints pathology, named after prof. M.I. Sitenko, NAMS of Ukraine”. There were examined 37 patients with lumbar spine hernias: 23 – without concomitant pathologies, 14 – in association with AH of 1–2 degrees of І–ІІ stage. The control group – 30 persons, 13 men and 17 women. General protein, glycoproteins, chondroitin sulfates, C-reactive protein, glucose, urea, creatinine, β-lipoproteins, calcium, ALAT, ASAT, CPK, LDG, IL-1, IL-4 and IL-6 were determined in blood serum.Results of research. The content of interleukins in the group of patients with AH was higher than in the group of patients without it. In the group of patients with AH IL-1 was increased in 10,5 times, IL-6 – in 5,3 times that testifies to heavier immunologic disorders in patients with AH. The content of glycoproteins in patients without AH was increased by 55,8 %, in patients with AH – in 2,1 times comparing with control. The content of chondroitin sulfates in patients with hernias without AH was increased in 2,8 times, in ones with AH – in 4 times. LDG was increased, CPK – decreased in both groups. β-lipoproteins in blood of patients without concomitant AH was increased by 44,6 %, in patients with AH – by 67 %.Conclusions. In patients with lumbar spine hernias, associated with AH were observed heavier inflammatory-destructive disorders in the cartilage tissue. The increased content of β-lipoproteins in blood of patients with lumbar spine hernias, associated with AH comparing with patients without it may indicate age disorders of lipids metabolism. IL-1 and IL-6 уin patients with lumbar spine hernias, associated with AH were higher comparing with patients without itУ статті на основі лабораторних маркерів визначено особливості метаболічних порушень: у хворих на грижі поперекового відділу хребта з АГ спостерігалися більш суттєві зміни хрящової тканини. Підвищення вмісту β-ліпопротеїнів, ІЛ-1 та ІЛ-6 у крові хворих з АГ може вказувати на вікові порушення метаболізму ліпідів та імунного статусу пацієнті
Прогностическая роль биомаркера-гликопротеина в диагностике патологических изменений у пациентов с артериальной гипертензией и сахарным диабетом 2 типа
Get PDFAim – To study the influence of galectin-3 level on metabolic disorders progression and structural-functional changes of myocardium and vessels in patients with the associated course of arterial hypertension (AH) and diabetes mellitus (DM) type 2.Materials and methods. Under conditions of the specialized department of arterial hypertension and kidney diseases SI “Institute of therapy, named after L.T. Malaya, AMS of Ukraine” were examined 92 patients with AH of II stage, 2 degree. They were divided in groups: 1 group – patients with AH without disorders of carbohydrate metabolism; 2 group – patients with AH and pre-diabetes; 3 group with the associated course of AH and DM type 2. The control group was maximally comparable with the studied one by age and sex.There were examined the parameters of carbohydrate metabolism, insulin resistance and galectin-3 level. The echocardiography with the heart functional state determination was carried out. For the assessment of the thickness of the general carotid intima-media complex, the duplex ultrasound scanning was realized.Results: In patients of 2 and 3 group was reveled the positive correlation between the insulin level of peripheral blood, hypertrophy of the left ventricle myocardium and the thickness of the general carotid intima-media. Hypertrophy of the left ventricle myocardium was more expressed in patients with AH and DM type 2 comparing with ones of 1 and 2 groups and the control group (р<0,05). Galectin-3 level was higher in the group with associated course of AH and DM types 2 than in 1 and 2 group and the control one (р<0,05).The positive correlation between galectin-3 level and insulin resistance parameters and structural-functional of vessels and heart remodeling was observed. Conclusions. It was established that the increase of galectin-3 level in blood serum may participate in insulin resistance progression, myocardium and vascular wall remodeling in patients with the isolated AH and with the associated course of AH and DM type 2В исследовании рассмотрено влияние уровня галектина-3 в сыворотке крови на прогрессирование глюкометаболических нарушений и кардиоваскулярного ремоделирования у пациентов с артериальной гипертензией и сахарным диабетом 2 типа. Полученные данные дают возможность рассматривать изменения уровня галектина-3 в сыворотке крови, как потенциальный биомаркер вышеперечисленных нарушени
Сучасні підходи до лікування безпліддя у жінок, хворих на ендометріоз яєчників, з використанням екстракорпорального запліднення
Get PDFAim of research: to raise the effectiveness of sterility treatment in women with ovary endometriosis using extracorporeal fertilization and vitamin D.Materials and methods of research. There were examined 90 women with ovary endometriosis, divided in three clinical groups. The first group included 30 women, who underwent the program of extracorporeal fertilization traditionally after the surgical treatment of ovary endometriosis. The second group consisted of 30 women with sterility, who underwent the program of extracorporeal fertilization before the surgical intervention as to ovary endometriosis, the third one included 30 patients with sterility, who underwent the program of extracorporeal fertilization before the surgical intervention as to endometriosis and took cholecalciferol 5000 IU/day during 12 weeks. The control group included 30 women without endometriosis, who underwent the program of extracorporeal fertilization because of tube-peritoneal sterility.Results of research. The ovarian reserve in women, who underwent the operation as to ovary endometriosis, is essentially decreased that is proved by the ultrasound determination of antral follicles condition and is explained by the uncontrolled extraction of ovarian follicles at the operation.Ovary endometriosis leads to the decrease of oocytes quality at the expanse of dysregulation of paracrine ovarian factors, characterized by the ratio IL-8/IL-12. The study of the content of 25(ОН)-vitamin D demonstrated its low level in women with ovary endometriosis and sterility comparing with the control (р<0,05). The use of cholecalciferol 5000 IU/day during the program of extracorporeal fertilization favored the increase of its effectiveness.The received data demonstrate the optimization of sterility treatment in women with ovary endometriosis using the program of extracorporeal fertilization before the surgical treatment and additional use of vitamin D. The elaborated method allows to increase the pregnancy frequency, favors the decrease of the number of days of stimulation, decrease of the total dose of preparations, necessary for ovulation stimulation that is probably conditioned by the absence of the injury of antral follicles by the surgical intervention. The use of the tactics of sterility treatment with ovary endometriosis using extracorporeal fertilization before the surgical treatment at the background of the therapy by vitamin D increases its effectiveness almost twice due to the decrease of the risk of the ovarian reserve destruction at the surgical treatment at normalization of the content of vitamin D. Conclusion. The sterility treatment in women with ovary endometriosis using extracorporeal fertilization before the surgical treatment at the background of vitamin D intake allows to increase the effectiveness of the therapy essentially at the expanse of the use of the untouched ovarian reserve and normalization of paracrine indices of folliculogenesisУ дослідженні представлені сучасні підходи до лікування безпліддя у жінок з ендометріозом яєчників шляхом використання екстракорпорального запліднення до хірургічного втручання на тлі використання терапії вітаміном D, що підвищує ефективність терапії майже в 2 рази завдяки зниженню ризику руйнування оваріального резерву під час оперативного лікування, нормалізації вмісту паракринних показників фолікулогенезу та вітаміну