ScienceRise: Medical Science
Not a member yet
556 research outputs found
Sort by
Вміст α-, -інтерферону та неоптерину в сироватці крові у жінок з парвовірусною інфекцією в різні періоди вагітності
Get PDFThe aim of the study was to determine α-, g-interferon (IFN) and neopterin levels in blood serum of pregnant women with a parvovirus infection.Methods and materials: There were examined 129 pregnant women, infected with a parvovirus В19, and 16 women with physiological pregnancy in I, II and III trimesters. Each group of pregnant women (I, II, III) was divided in two subgroups, depending on the presence or absence of clinical complications. The quantitative evaluation of α-, g-IFN and neopterin content in blood serum was realized by the method of immune-enzyme analysis. Results of research: Blood serum of infected pregnant women contained increased α-and g-IFN levels, most expressed at studying IFN-γ levels that reliably exceeded control indices in I-III groups in 3,4-2,9-2,1 times respectively. At the presence of clinical complications in different periods of pregnancy women demonstrated the reliably decreased α-IFN level and reliably increased g-IFN level compared with pregnant women without clinical complications. High levels of neopterin were revealed in blood serum of infected women that testifies to the activation of a monocytic link of the cellular immunity at the impact of g-IFN. At comparing the subgroups of pregnant women it was established, that changes of the neopterin level in blood serum relative to control values had the unidirectional character, but women with clinical complications of pregnancy demonstrated the more essential exceed of control values in different trimesters– in 2,9; 2,9 and 3,1 times.Conclusions. The increase of IFN-g and neopterin up to high values reflects the activation of a cellular immunity link and can play an important role in the pathogenesis of pregnancy complicationsМетою дослідження було визначення вмісту α-, g-інтерферону (ІФН) та неоптерину в сироватці крові вагітних жінок з парвовірусною інфекцією у різні терміни гестації і в залежності від наявності клінічних ускладнень вагітності. У жінок за наявністю клінічних ускладнень в різні періоди вагітності виявлявся достовірно понижений рівень α-ІФН і достовірно підвищений рівень γ-ІФН в порівнянні до вагітних без ускладнень. Високі рівні неоптерину в сироватці крові інфікованих вагітних в різні триместри свідчить про активацію клітинного імунітету під впливом дії γ-ІФН, найбільші відхилення виявлені у жінок з клінічними ускладненнями вагітност
Клініко-психопатологічний аналіз сучасних депресивних розладів поеднаних з суїцидальною поведенкою у жинок
No full textAim of research. Study of clinical and psychopathological features of depressive disorders associated with suicidal behavior in women in modern conditionsMaterials and methods of research. A comprehensive survey of 150 women aged 25-65 years was conducted who were diagnosed with depressive disorders: disorders of adaptation, in the form of depressive reaction (42.8%); moderate and severe depressive episode (35.1%), recurrent depressive disorder (22.1%)The main group consisted of 77 patients with signs of suicidal behavior, control - 73 patients without signs of suicidal behavior.Methods of research: clinical-anamnestic, psychodiagnostic, clinical-psychopathologicalResults. Distinguished anxiety (45.4% of the patients in the main and 32.1% of the control group), obesity (35.2% and 36.3% respectively), asthenia-apathetic (7.1% of the patients in the main and 18.2% of the control group) and melancholic (12.3% and 13.4% respectively) variants of depressive disorders.It is proved that women with depressive disorders combined with suicidal behaviour are adhered to high suicide risk, high anhedonia, severe anxiety and depression on the Hamilton scale, a large depressive episode on the Montgomery - Iceberg scale. For women with depressive disorders without signs of suicidal behaviour there was an average level of suicidal risk, high level of anhedonia, severe anxiety and depression on the Hamilton scale, a large depressive episode on the Montgomery - Iceberg scaleConclusions. 1. Women with depressive disorders with suicidal behaviour characterized by anxiety, tedious, asthenia-apathy and melancholy variants of depressive disorders. Patients with disturbing and timid variants of depression are characterized by a high level of suicidal risk.2. Women with depressive disorders associated with suicidal behaviour there is a high level of suicidal risk, high anhedonia, severe anxiety and depression on the Hamilton scale, a large depressive episode on the Montgomery - Iceberg scale.3. Prognostically significant in the formation of suicidal behaviour are disturbing and timid variants of depressive disorders, high rates of clinical anxiety and depression scales, high suicidal, obese suicidal anamnesisУ ході роботи проаналізовано клініко-психопатологічну симптоматику депресивних розладів поєднаних з суїцидальною поведінкою у жінок молодого віку. Виділено тривожний, туждивий, астено-апатичний і меланхолійний варіанти депресивних розладів.Доведено, що для жінок хворих на депресивні розлади поєднані з суїцидальною поведінкою притаманні: високий рівень суїцидального ризику, низький рівень самоусвідомлення смерті, високий рівень ангедонії, важка тривога і депресія за шкалою Гамільтона, великий депресивний епізод за шкалою Монтгомері – Айсберг
Розробка системи психотерапії непсихотичних психічних розладів і дискомплаєнтності у хворих на цукровий діабет 2-го типу
Get PDFAim. Development of the system for psychotherapy of non-psychotic mental disorders and non-compliance in patients with the 2nd type diabetes mellitus to improve the treatment of the 2nd type diabetes mellitus in patients having non-psychotic comorbid mental disorders.Materials and methods. 543 patients with the 2nd type diabetes mellitus were examined on the clinical bases of the Therapy, clinical pharmacology and endocrinology department of the State Institution “Zaporizhzhia medical academy of post-graduate education Ministry of health of Ukraine”. The patients were divided in 2 groups depending on the obtained treatment criteria: 270 patients with the 2nd type diabetes mellitus, having treatment with psychotherapy and psycho preventive steps by the developed approaches, formed the studied group. The other 273 patients formed the control group and were treated by the standard clinical protocols.Methods of research: clinical and anamnestic, clinical and psychopathological, psychodiagnostical, and statistical.Results and discussion. In result of research, the system of psychotherapy for the correction of psychopathological and pathopersonal disorders, as well as compliance achievement, in patients having the 2nd type diabetes mellitus was developed. The psychotherapy system consists of three main directions: the first is improvement of compliance to diabetes mellitus therapy and the formation of harmonic lifestyle with diabetes; the second is normalization of patients’ psycho-emotional condition; the third is correction of destructive behavior and personality qualities. The following therapeutic methods were used: psychological education, relaxation, CBT, hypnotic suggestion, body-oriented, rational emotive, and existential.Conclusion. High efficiency of the developed system for neurotic manifestations leveling and improvement of compliance to the 2nd type diabetes mellitus has been provedРозроблено систему психотерапії, яка спрямована на лікування непсихотичних психічних розладів у хворих на цукровий діабет 2-го типу – неротичних проявів та патоперсонологічних порушень, – а також на підвищення рівня прихильності хворих до терапії цукрового діабету 2-го типу.Доведено високу клінічну ефективність розробленої системи психотерапії як у контексті нівелювання непсихотичних психічних порушень, так і підвищенні комплаєнсу до терапії цукрового діабету 2-го тип
Аналіз причин недостатньої прихильності до лікування та методи їх корекції у хворих на резистентну та псевдорезистентну артеріальну гіпертензію в практиці сімейного лікаря
Get PDFAim. The analysis of the main reasons for the lack of adherence to treatment in patients with resistant and pseudoresistant arterial hypertension and the possibilities of their elimination by different poor adherence correction methods against the background of antihypertensive therapy optimization in family doctor practice.Methods. Questionnaires and surveys, physical examination, office blood pressure measurement, ECG. Retrospective examination of 120 patients with resistant essential hypertension lasting more than 3 years was carried out. First and foremost, in all patients, a new method for differential diagnostics of resistant and pseudoresistant arterial hypertension by office blood pressure measurement and ECG 3 hours before and after previously assigned three antihypertensive drugs administration was used. According to the differential diagnostics results, the patients were divided into 4 groups: 30 patients with pseudoresistant arterial hypertension and 30 patients with resistant hypertension, having common methods for poor adherence to treatment correction, and 30 patients with pseudoresistant arterial hypertension and 30 patients with resistant hypertension, having additional methods for poor adherence to treatment correction.Results. In most both pseudoresistant and resistant hypertension patients, adherence to treatment violations were found.Conclusion. On the basis of comparative study of different methods for the lack of adherence to treatment correction in patients with resistant and pseudoresistant hypertension, the efficiency of the additional correction methods was scientifically proved, namely: implementation into the patients’ practice of blood pressure home monitoring with keeping a self-control diary and telephone consultation (visits) method, in elimination of subjective reasons, mostly related to irregular intake of remedies in most patientsУ статті розглянуті основні причини недостатньої прихильності до лікування хворих на резистентну та псевдорезистентну артеріальну гіпертензію. З метою проведення аналізу можливості їх усунення, застосовували різні методи корекції недостатньої прихильності до лікування на фоні оптимізації антигіпертензивної терапії. Отримані результати демонструють ефективність додаткових методів корекції в усуненні суб'єктивних причин у більшості пацієнті
Прогнозирование развития ранних послеоперационных осложнений контактной ультразвуковой литотрипсии
Get PDFNowadays, endoscopic treatment of kidney and upper ureter stones is the method of choice in a large group of patients. The success of ureteroscopic treatment of stones is a result of the development of efficient flexible ureteroscopes, new capture devices and laser lithotripters.Aim. The analysis of the reasons and the character of early postoperative complications after ureteroscopy and contact lithotripsy using semi-rigid ureteroscope and ultrasonic lithotripter.Methods. Ureteroscopy with contact lithotripsy and (or) lithoextraction against concrements of various ureter departments was made in 1268 patients. The patients were monitored after discharge in dynamics from 8 weeks to 1.5 years, and on the testimony - until the elimination of complications. All complications were divided in accordance with their severity degree by Satava classification.Results. 179 patients with early postoperation complications were found. In 62 (34.6%) hyperthermia, in 56 (31.3%) - persistent hematuria, and in 61 (34.1%) – renal colic were detected.Conclusion. In 60% of patients with 1 cm stones and 50% of patients with stones up to 1.5 cm early postoperative complications were found when the stone density was more than 1500 HU. When the stone size was 1.5 cm or more, the complications were found regardless of its density. When the stone size was less then 1 cm, early postoperative complications in the main were found at concrement’s localization in upper ureter (59.5 % of the patients). In patients with the stone density more than 1500 HU the highest number of complications was detected at the stones’ localization in upper and lower ureter – 14 (37.8%) and 16 (43.2%) cases, respectivelyВ статье проанализированы причины и характер ранних послеоперационных осложнений у пациентов с уретеролитиазом при выполнении уретероскопии и контактной литотрипсии с использованием семиригидного уретероскопа и ультразвукового литотриптора. Основными причинами осложнений ультразвуковой контактной уретеролитотрипсии является локализация камней в верхних отделах мочеточника, размеры их свыше 1 см и плотность больше 1500 H
Порівняльна характеристика рівня показників матриксної металопротеїнази-9 та високочутливого с -реактивного білку при коморбідному перебігу гіпертонічної хвороби та хронічного обструктивного захворювання легень
Get PDFThe pathogenetic connection between the hypertonic disease and the chronic obstructive pulmonary disease (COPL) is little studied. The aim of research is to study the level of matrix metalloproteinase-9 and high sensitive C-protein indicators at the hypertonic disease and the chronic obstructive pulmonary disease. Methods. There were examined 40 patients: 30 with the diagnosis of hypertonic disease of II stage, combined with the chronic obstructive pulmonary disease, and 10 patients with the chronic obstructive pulmonary disease. Matrix metalloproteinase-9 and high sensitive C-protein levels in blood plasma and also parameters of elastic properties of the pulmonary artery were determined in all patients.Results. At the data analysis it was established that indicators of matrix metalloproteinase-9 and high sensitive C-protein were higher at the comorbidity of the hypertonic disease and the chronic obstructive pulmonary disease comparing with the group of isolated chronic obstructive pulmonary diseases. The analysis of elastic properties of the pulmonary artery demonstrated the essential increase of its hardness at comorbid states comparing with chronic obstructive pulmonary diseases. Conclusions. In patients with the hypertonic disease and the chronic obstructive pulmonary disease matrix metalloproteinase-9 and high sensitive C-protein levels increase comparing with isolated chronic obstructive pulmonary diseases that may testify to the role of these markers in the injury of target organs of the cardiovascular system. The monitoring of the dynamic of chronic obstructive pulmonary disease development and system inflammation is possible at the expanse of the determination of matrix metalloproteinase-9 and high sensitive C-protein levelsУ дослідженні представлені данні стосовно рівня матриксної металопротеїнази - 9 та високочутливого С- реактивного білку при комор- бідному стані гіпертонічної хвороби та хронічного обструктивного захворювання легень, їх взаємозв’язок з пружно-еластичними властивостями легеневої артерії. Визначено підвищення рівню матриксної металопротеїнази - 9 та високочутливого С- реактивного білку при коморбідному стані у порівнянні з ізольованою патологією хронічного обструктивного захворювання легень, та доведено кореляційний зв’язок цих маркерів з функцією зовнішнього диханн
Судово-психіатрична оцінка віктимної поведінки потерпілих внаслідок сексуального насильства
Get PDFAіm – to analyze the scіentіfіc-practіcal approaches to the forensіc psychіatrіc assessment of vіctіms of sexual vіolence; to establіsh the іnterconnectіon between vіctіm’s personal features and motіvatіon of an іllegal actіon and possіble prophylactіc arrangements.Materіals and methods of the study. The study іs grounded on the analysіs of the total sample of examіned persons, who realіzed crіmіnal vіolatіons on the sexual background and were at the forensіc-psychіatrіc expertіse іn the Kyіv munіcіpal center of forensіc psychіatrіc expertіse іn 2001 - 2015 р. (durіng 15 years). For 2017 there were examіned 279 persons. Vіctіms were also examіned wіthіn the forensіc psychіatrіc expertіse for thіs perіod of tіme to study the problem of a possіble vіctіm behavіor of suffered persons, theіr characterologіcal features that help at studyіng the motіvatіon of an іllegal actіon and possіble preventіve arrangements. 69 vіctіms were examіned for 2017.There were used іnformatіon-analytіcal, socіo-demographіc, clіnіcal-psychopathologіcal, experіmental-psychologіcal, expert methods, method of sіtuatіon analysіs, statіstіcal methods.Results of research. 1. For vіctіms of crіmіnal-vіolent actіons іs typіcal the presence of the certaіn complex of socіo-demographіc and moral-psychologіcal sіgns, whіch appearance determіnes theіr typіcal behavіor and more probabіlіty to become a vіctіm of vіolent actіons.2. The personalіty and behavіor of vіctіms of sexual crіmes essentіally іnfluence the motіvatіon of a crіmіnal behavіor and sіtuatіon that іt іs realіzed іn.3.The knowledge of personal features of vіctіms, theіr role іn the crіme development and characterіstіc of relatіons between a crіmіnal and vіctіm from the posіtіon of vіctіm’s features and іts behavіor essentіally wіdens possіbіlіtіes of preventіve programs, dіrected on the vіctіmologіcal preventіon of sexual vіolatіons.Conclusіons.1. Vіctіmologіcal factors play an essentіal role іn the crіmіnal behavіor genesіs, especіally іn sexual vіolence sіtuatіons.2.Only the complex and comprehensіve study of a personalіty of a crіmіnal and hіs vіctіm, theіr іnterrelatіons, objectіve role, played by each of them іn an іllegal act, allows to make a conclusіon about the responsіbіlіty of a guіlty person and also to establіsh cіrcumstances that favored іts executіon.3. Vіctіmologіcal prophylaxіs іs an іmportant element of the ratіonal system of the vіctіmologіcal dіrectіon of preventіve actіons of crіmіnalіty by elіmіnatіon of vіctіmogenous factors of a crіmіnal behavіor together wіth іts other element – actіvіty, dіrected on elіmіnatіon of negatіve consequences of a crіmіnal behavіorПроведено аналіз науково-практичних підходів до судово-психіатричної оцінки потерпілих внаслідок сексуального насильства. Наведено визначення понять «сексуальне насильство». Виділено основні форми «віктимної поведінки», дана його класифікація. Наведено особливості віктимної поведінки в залежності від освіти, сімейного стану, віку і особливостей особистості потерпіли
Розробка методології арт-терапії в системі терапії хворих на шизофренію
Get PDFAim: The development and probation of the methodology of art-therapy in the system of therapy and rehabilitation of patients with schizophrenia.Materials and methods: During the research out the complex clinical-psychopathological and psychodiagnostic examination of 125 patients of both sexes, 20–45 years old (mean age 35,0±2,0 years ) with the established diagnosis schizophrenia in the period of stabilization was carried. The main group (patients took part in art-therapy) included 95 persons (54 women and 41 men). The control one included 30 хворих (16 women and 14 men), who received the standard regulated therapy at a hospital.Research results. During the research the two-stage system of art-therapy in the complex therapy of patients with schizophrenia was offered and its effectiveness was proved. There was established the expressed positive dynamics of the level of social functioning of patients and positive dynamics of positive, negative and general psychopathological syndromes by РANSS scale.Art-therapy favors the fast social reintegration of patients with schizophrenia, improvement of their life quality.Conclusion. The art-therapeutic intervention of patients with schizophrenia must be directed on: patients’ busy being at the expanse of their involvement in meaningful activity; development and support of their creative skills; sensor stimulation; reaction to feelings and experience of positive emotions, connected with the creative activity and its results; support and development of communicative skills, independence and self-organization; psychological integration of patients. Art-therapy for patients with schizophrenia, based on elaborated principles, is characterized by the higher effectiveness comparing with traditionally used methodsУ ході дослідження запропонована двоетапна система арт-терапії в комплексній терапії хворих на шизофренію та доведено їх ефективність. Встановлена виражена позитивна динаміка рівня соціального функціонування хворих та позитивна динаміка позитивних, негативних і загальних психопатологічних синдромів за шкалою РANSS.Арт-терапія сприяє швидкій соціальної реінтеграції хворих на шизофренію, покращення якості їх життяУ ході дослідження запропонована двоетапна система арт-терапії в комплексній терапії хворих на шизофренію та доведено їх ефективність. Встановлена виражена позитивна динаміка рівня соціального функціонування хворих та позитивна динаміка позитивних, негативних і загальних психопатологічних синдромів за шкалою РANSS.Арт-терапія сприяє швидкій соціальної реінтеграції хворих на шизофренію, покращення якості їх житт
Особливості соціального функціонування пацієнтів з постшизофренічною депресією
Get PDFAim of research – to determine disorders of the social functioning, typical for patients with PSD. Methods of research: The psychodiagnostic examination of patients included: HADS/HARS scale for the study of psychoemotional features of patients with post-schizophrenic depression; Bassa-Darki questionnaire. For studying socio-psychological features were used: the questionnaire of volitional self-control –VSC (Zverkov A.G., Eideman E.V.), questionnaire of the suicide risk (modified by T.N. Razuvaeva). The cognitive sphere was estimated using the methods “10 words” by A.R. Luria (1995), “Proof test” by B. Burdon (1995) and pictograms method. The study of the patients’ life quality was carried out using the method Mezzich, Coher, Ruipezer, Liu & Yoon, 1999. The statistical processing of obtained data and diagrams construction were realized using Excel programs and statistical package «Statistica 7.0. for Windows», and also using Student t-criterion, U-criterion of Mann-Whitney, Fisher j-criterion, Pearson c2-criterion. At the assessment of synchronicity, combination of changes of two variables or for the assessment of the similarity of two scale profiles, grade coefficients of correlations were calculated by Spearman and linear ones - by Pearson. In all cases of comparisons the probability of «р» divergences was determined. They were considered as statistically significant at p<0,05Results. Within the research were studied data about the social functioning of patients with PSD. Mean points by scales of the volitional self-control questionnaire were low (G1 – 6,5 points, G2 – 6,8 points). Life quality indices were totally within the mean values diapason. Near a half of men and women with PSD had the bed or very bad level of adaptation (G1 – 67,65 %; G2 – 46,58 %), at that women were reliably less adapted comparing with men (р≤0,05). According to the assessment of studied persons, the level of the experienced social support was low, at that least indices related to the factor “social support from “important others” (G1 – 0,9 points; G2 – 0,6 points).In men and women with PSD was determined the high risk of realization of autoagressive tendencies. In men with PSD the risk of the suicidal behavior was most often connected with factors as “social pessimism” (5,9 points), “inability” (5,6 points), “temporal perspective” (5,5 points), “affection” (5,2 points). The suicidal behavior risk in women was less comparing with men that was testified by lower values on most scales of the questionnaire and also the higher index (comparing with G1) of the anti-suicidal factor (р≤0,05). The suicidal risk in women with PSD was mainly connected with factors as “demonstrativeness” (5,3 points) and “affection” (5,0 points).Conclusions. As a result to the realized research was revealed the decrease of the social functioning in patients with PSD, manifested in the lack of volitional self-control, bad level of adaptation, low level of the social support use. The decrease of the general life quality was registered in men and women with PSD. The important parameter, revealed within the research, is the high risk of autoagresive tendencies realization; they were reliably higher in men comparing with women (р≤0,05).The determined dysadaptive psychosocial characteristics are at the same time risk factors of disease relapses that must be taken into account at elaborating the system of the complex medical-psychological support for this category of patientsВ статті викладено результати вивчення особливостей порушень соціального функціонування пацієнтів з постшизофренічною депресією. Серед соціально-демографічних характеристик вивчено вікову та статеву належність, вік дебютування та загальний термін захворювання, рівень освіти, сімейний стан та рівень матеріального достатку. Також визначали рівень соціального функціонування, якість життя, ступінь адаптації, наявність аутоагресивних тенденцій у пацієнтів з постшизофренічною депресіє
Індивідуально-психологічні предиктори формування станів дезадаптації лікарів-інтернів
Get PDFAim of research. The study of individual-psychological predictors of dysadaptation states formation of doctors-interns for elaborating the system of their diagnostics, correction and psychoprophylaxis.Materials and methods of research. For attaining the set aim, the complex examination of 213 doctors-interns of both genders of 22–25 years old (mean age 23±2 years) from the Kharkiv national medical university was realized in 2012–2016 with observing principles of bioethics and medical deontology.Methods of research: clinical-anamnestic, psychodiagnostic, statistical. Results: It was established, that 65,7 % of examined doctors-interns (55,7 % of men and 68,6 % of women) demonstrated dysadaptation states. The main role in dysadaptation states formation in doctors-interns is played by the following groups of factors: biological – chronic somatic pathology, organic pathology, bad habits, and psychosocial – discontent with labor conditions, deficit of positive emotions, imperfectness of mechanism of psychological defense, conflicts in the medical environment.It was established, that manifestations of dysadaptive states in doctors-interns are the feeling of internal strain with the impossibility to relax, anxious and depressive manifestations, decrease of the intellectual activity productivity.Three levels of dysadaptation of a family doctor to the professional activity were separated.Conclusions: The formation of disorders of doctors-interns’ adaptation to the professional activity is conditioned by many factors, biological, social and psychological ones, presented in the indissoluble complex in it. This fact determines the specificity of pathogenesis and syndrome genesis of dysadaptive states.The high, middle and low level of family doctors’ dysadaptation to the professional activity were describedВ дослідженні проведено вивчення індивідуально-психологічних предикторів формування станів дезадаптації лікарів-інтернів. Встановлено, що у формуванні порушень адаптації лікарів інтернів до професійної діяльності, лежить багатофакторна обумовленість, у якій біологічні, соціальні і психологічні фактори представлені в нерозривному комплексі, що визначає специфіку клінічних проявів дезадаптивних стані