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Особливості початкового вегетативного тонусу у хворих на запаморочення
Get PDFVegetative dysfunction is most often manifested as vertigo. The presence of vestibular dysfunction on the background of vegetovascular dystonia is conditioned by the close functional connection between vestibular and vegetative nervous system.The study of interaction and mutual connection between vertigo and vegetative functioning is necessary to improve the effectiveness of diagnostic and treating-rehabilitative arrangements.Methods. 159 patients with vertigo were examined according to the scheme for revelation of the signs of vegetative disorders. All patients were divided in four groups, taking into account the cause of vertigo. The first group included 47 patients with acute ischemia of brain in vertebrobrasilar basin. The second one included 30 patients with craniovertebral pathology and vascular anomalies of the neck part. The third one – 40 patients with the injury of peripheral vestibular analyze, the fourth group – 42 patients with psychogenic vertigo.Results. The analysis of parameters of VNS functioning in examined patients testified to the intrasystemic dysregulation; decrease of reserve possibilities of VNS adaptation, manifestations of the disorders of cerebral homeostasis and disturbance of the correct functioning of non-specific cerebral systems. Conclusions. The interconnection between vertigo and central mechanisms of vegetative regulation that must be considered as the components of rehabilitative potential was revealed. These regularities can be the base for using integration approach in the choice of rehabilitative interventions at vertigo in patients with neurological pathologyВивчався стан початкового вегетативного тонусу і його роль в формуванні запаморочення у 159 неврологічних хворих. Використана схема для виявлення ознак вегетативних порушень.Виявлено внутрішньосистемну дизрегуляцію; зниження резервних можливостей адаптації ВНС, прояви розладів церебрального гомеостазу, порушення правильного функціонування неспецифічних систем мозк
Особливості психологічного реагування на захворювання у онкологічних хворих
Get PDFThe aim of research was to reveal the features of psychological response to the disease in cancer patients at the different stages of treating process and depending on sex. Materials and methods. The research was carried out on the base of Kyiv city cancer center during 2014 – 2016. 80 cancer patients were examined at diagnostic stage, at the stage of final confirmation of diagnosis and the choice of the therapy methods– G(d), 187 persons, who underwent the anti-tumor treatment for the first time– G(п), and 155 cancer patients, who needed the repeated treatment as a result of the progressing or relapse of disease – G(в). The questionnaire “The types of attitude to disease” was used as a diagnostic instrument.Results. In 62,8% of cancer patients were revealed the non-adaptive types of response to the disease, 16,6% had combined forms of response, including personal and interpersonal maladjustment, the disorder of intra-psychical adaptation prevailed over inter-psychical one. The progressing of cancer disease conditioned the complication of manifestations of response to the disease by the way of junction of non-adaptive types and creation of their mixed forms, intensification of anxious, hypochondriac, melancholic, apathetic, paranoiac, dysphoric components in the composition of psychic response. Among cancer patients the most often were anosognostic (13,0%), anxious-sensitive (11,4%), ergopathic-anxious (10,4%), sensitive (7,8%), anxious (7,6%) and hypochondriac types (6,4%). The differences in the structure and frequency of occurrences of the types of responses to the disease indicated the presence of gender features of psychical response.Conclusion. The determination and correction of non-adaptive forms of the response to disease is an important part of medical-psychological help for the cancer patientsУ 62,8% онкохворих виявлено неадаптивні типи реагування на захворювання, 16,6% мали поєднані форми реагування, що включали особистісну та міжособистісну дезадаптацію, порушення інтрапсихічної адаптації превалювало над інтерпсихічною. Прогресування захворювання обумовлювало ускладнення проявів відповіді на хворобу шляхом злиття дезадаптивних типів і утворення змішаних форм, посилення тривожного, іпохондричного, меланхолічного, апатичного, паранояльного, дисфоричного компоненті
Фактори сімейної взаємодії та їх роль у порушенні здоровʼя сімʼї у жінок з різним станом аддиктивної поведінки
Get PDFAim. To study conditions of family interrelation components (levels) and their role in development of family health violence in women with different levels of behavioral addiction (BA).Contingent and methods. 371 married couple (MC), asking for help against the family relationship violation, and in 321 of which manifestations of BA in women were found, were examined using clinical, psychiatric, and psycho diagnostic methods. 50 relatively harmonious MC were examined as a reference group.Results. BA, that was determined in women with family health violation moderate severity, became a way of emotional stress leveling, which occurred due to the lack of a sense of psychological support from the family, and reduced its severity level, inducing, however, a feeling of family anxiety and guilt for the situation. In contrast, women with normal addictive behavior have negative psycho-emotional frustration to realize themselves in their families, creating high level of marital and parent-child conflict without guilt or anxiety feelings because of the situation.The given results show, that the disintegrative combination of psychological properties, as well as cognitive helpless, avoiding addictive and dependent pseudo-compensatory types of behavior became the patthoplastic BA factor in women with family health violation, which formed as pathological way of psycho-emotional stress relief due to their family interrelations deformation. In the meanwhile, destructive and congruent type of combination of personality traits and cognitive uncritical, destructive conflict, and emotional-maladaptive behavioral types, pathognomonic for couples with violations of family relationship, in which women did not have addictive problems, stipulated the other ways of pathological response to the pathogenic family situation, being realized within the family, increasing the level of family stress of marital relationship degradation.Conclusion. The obtained data will be used as a base for development of the system of psychological correction and preventive support of family health in case of BA in womenНа основі клініко-психологічного і психодіагностичного обстеження 421 подружньої пари, серед яких у 371 подружньої пари діагностовані порушення сімейних стосунків, а у 321 з них – ще й прояви аддиктивної поведінки (АП) у дружин, і 50 гармонійних пар, визначені фактори сімейної взаємодії та їх роль у розвитку порушення здоровʼя родини у жінок з різним станом аддиктивної поведінки. Встановлено, що соціально-прийнятні види АП, притаманні обстеженим, виступає як патологічний спосіб каналізації психоемоційного напруження, що виникає у них внаслідок деформації сімейних відносин, та знижує рівень подружньої конфліктності й деформації батьківсько-дитячих відноси
Ризик токсоплазмозного енцефаліту у ВІЛ-інфікованих пацієнтів з різним серологічним профілем протитоксоплазмових антитіл
Get PDFAim of the work. To study the prevalence of serological signs of toxoplasmatic invasion among the HIV-positive population, structure and dynamics of antitoxoplasmatic antibodies and the risk of development of toxoplasmatic encephalitic.Methods of research. 926 HIV-positive persons were under three years observation: cohort of seropositives of toxoplasmosic included 531 persons and the cohort of seronegative ones – 395. Annually there were determined anti -Toxoplasma IgM, IgG and the frequency of toxoplasmosis of encephalitis in cohorts, the absolute and relative risk, the additional part of population risk were calculated.Results. The prevalence of seropositivity of toxoplasmosis in HIV-infected patients in Ivano-Frankivsk region is 57,25±1,6 %, that caused 86.84 % of additional part of population risk of toxoplasmatic encephalitis. The number of men (58,55 %) was more than the one of women (41,45 %). In seropositive cohort 4,16 % had toxoplasmatic encephalitis, that is 6 times more that in the cohort of seronegatives. The highest risk of morbidity was in the group of patients with seroreversion (21,43 %), that is 5 times more than in the whole cohort of seropositive persons (relative risk = 4,74) and 28 times more than in seronegative one (relative risk = 28.20). Seroreversion was also attended with the raised risk of toxoplasmatic encephalitis comparing with seronegative cohort (relative risk = 11,45).Conclusion: the highest risk of toxoplasmatic encephalitis was in patients with seroreversion of antibodies to toxoplasmasПід трирічним спостереженням перебували 931 ВІЛ-інфікованих осіб. Вивчено ризик захворюваності на токсоплазмозний енцефаліт в когорті серопозитивних на токсоплазмоз (531) і когорті серонегативних (395) осіб. У серопозитивних захворюваність на токсоплазмозний енцефаліт становила 4,16 %, що в 6 разів більше, ніж в когорті серонегативних. Найвища захворюваність була в групі пацієнтів із серореверсією (21,43 %
Использование устройства для мониторинга температуры тела в клинической практике
Get PDFDevice for the body temperature monitoring was elaborated for the long-term, precise temperature measurement in the given time intervals with further presenting the measurement results in digital form. The aim of research is to elaborate and practically approve in clinical conditions the device for body temperature monitoring.Methods. After analysis of existent analogous devices the technical problem was formulated and device for the body temperature monitoring was manufactured. For realization of the body temperature monitoring the elaborated device was applied in 108 (100 %) wounded persons with fire wounds of the soft tissues. All wounded were of the male sex. The age was from 23 to 58 years. Mean age was 34±4,5 years. Results of research. The temperature indices at the measurement using the mercuric thermometer and elaborated device were not differ in 91 (84,3 %) observations. In 17 (15,7 %) cases were observed the differences in received temperature results not more than by 0,2 0С. At the repeated measurements the differences were not revealed, the previous differences were connected with insufficient contact between the mercuric thermometer and surface of patient’s body. The elaborated device was used in 76 (70,3 %) observations separately, in 32 (29,7 %) observations together with other medical diagnostic devices. The complications, negative phenomena were not observed.Conclusion. At clinical approbation the elaborated method for the monitoring of body temperature of biological objects demonstrated the high reliability of the received results (error of the results 0,1 0С), that allows use device not only for practical but also for scientific aims. The possibility for operative reaction of the medical stuff to alarm as a result of the body temperature rise is convenientВ работе анализируются результаты использования устройства для мониторинга температуры тела в клинике. Дано описание конструкции устройства, приведена принципиальная схема. В ходе эксплуатации выявлены возможности и ограничения применения. Проведен анализ результатов использования устройства. Использование разработанного устройства является удобным для пациентов и медицинского персонала и позволяет достоверно осуществлять мониторинг температуры тел
Актуальные подходы к терапии вульвовагинитов с учетом антибиотикорезистентности инфекционных агентов
Get PDFAim of research: the study of qualitative composition and parameters of sensitivity/resistance to antibiotics of the different groups of biota of the low parts of genital tract in patients with nonspecific vulvovaginites.Methods of research: 242 women 18-47 years old underwent clinical-laboratory examination on the base of clinic and department of sexually transmitted infections SI “Institute of dermatology and venereology, NAMS of Ukraine”. They were divided in two groups: 1st group – 205 (84,7 %) patients with clinical and laboratory signs of vulvovaginitis; 2th group (control one) -– 37 (15,3 %) clinically healthy women. All patients, included in the research, underwent the complex of laboratory examinations according to the regulative documents of HM of Ukraine.Results of research: The composition of vaginal microbiocenosis in patients with vulgovaginites, caused by conventionally pathogenic microorganisms was characterized with the prevalence of aerobic representatives of Enterobacteriaceae and Staphylococcaceae families that formed association both between themselves and with representatives of the other taxonomic groups. The therapy of vulvovaginites, caused by aerobic conventionally pathogenic microorganisms, must be realized individually, taking into account the results of determination of sensitivity of the aerobic microflora. At impossibility of cultural study with determination of sensitivity of separated microorganisms to antibacterial remedies, the preparations of choice in the treatment of vulvovaginites, caused with conventionally pathogenic microorganisms can be quinolones, lincosamides, nitrofurans and ceftriaxone that the higher sensitivity of conventionally pathogenic microorganisms was observed toЦель исследования: изучение качественного состава и показателей чувствительности к антибиотикам разных групп биоты влагалища у пациенток с неспецифическими вульвовагинитами. Состав вагинального микробиоценоза характеризовался преобладанием представителей семейств Enterobacteriaceae и Staphylococcaceae. Лечение неспецифических вульвовагинитов должно проводиться индивидуально с учетов данных определения чувствительности выделенных возбудителей к антибиотикам различных груп
Антиоксидантная терапия как новый метод профилактики и лечения гематологической токсичности химиотерапии рака молочной железы
Get PDFThe aim of our work was to study the effectiveness of antioxidant therapy in prevention and treatment of leucopenia; to investigate the influence of deficit of prooxidant system as to the risk of hematological disorders development (agranulocytosis development; to ground the necessity of application of antioxidant therapy for prevention and treatment of hematological toxicity of chemotherapy.Materials and methods of research: retrospective study of medical documentation, biochemical analyzes, radiological examination. The control group included 110 persons, the group with studied preparation – 80 ones. All patients were women with spread breast cancer, who were treated by the standard chemotherapy schemes. The studied group received antioxidant Thiotriazoline during the treatment.Results. In patients of the studied group, who received thiotriazoline in preventive and therapeutic regimes, the frequency of occurrence of leucopenia is reliably lower than in the control group of patients. Patients with the low level of SH-groups (less than 1 mmol/g of protein) at the parallel activation of oxidative stress are the group of neutropenia risk on the background of BC chemotherapy and need the dynamic observation with individual selection of thiol donors and preparations with verified antioxidant effect. The decrease of effectiveness of antioxidant enzymes of glutathione links and displacement of thiol-disulfide balance to the decrease of content of restored indicate the reliable clinical necessity of personal application of medical preparations with glutathione-protective effect and antioxidant potential such as Thiotriasoline, which clinical approbation was realized in our workЦелями нашего исследования было изучение влияния прооксидантно-оксидантного равновесия на риск развития гематологических нарушения после проводимой цитотоксической терапии при раке молочной железы, исследовать эффективность и целесообразность применения антиоксидантной терапии с целью профилактики и коррекции лейкопении. Проведенное исследование маркеров оксидативного стресса и клинических результатов применения антиоксидантов указывает на клиническую и лабораторную эффективность исследуемого препарат
Сучасний стан умов праці в металургійному виробництві України
Get PDFAt the modern stage of metallurgical industry development the replacement of old technological equipment and introduction of new technologies is very slow. It generates the series of acute hygienic problems, and the influence of professionally harmful factors of production environment of metallurgical enterprises on workers’ health remains essential despite the sanitary-hygienic arrangements.Methods of research. The complex studies were carried out and the characteristic of working conditions and labor process at 1230 working places for 2010–2015 years at the main technological processes was given.Results of research. It was established, that the essential modernization of production, automatization and mechanization of the main technological processes took place, the specific weight of operating professions, in which the observance and management of the process is 48–79 % of the general volume of productive operations, increased. At the same time the significant volume of heavy physical work still remains 28−54 %. The labor conditions and type of labor process in 75 % of workers do not correspond to hygienic norms and are related to the 3 class or to the 4 degree of harmfulness and assessed as harmful and dangerous.Conclusions. The conditions of labor and working process in metallurgical workshops still remain harmful and dangerous moreover the rates of microclimate and dust concentration are the limiting ones. The received results open the prospects for further scientific researches, directed on the professional risk classification, depending on working conditions and introduction of preventive arrangements, directed on its decreaseПроведені комплексні дослідження на всіх етапах металургійного виробництва та встановлено, що 75 % працівників працюють в умовах, що не відповідають гігієнічним нормативам і відносяться до 3 класу 3 або 4 ступеню шкідливості і оцінюються як шкідливі і небезпечні. Проведенні дослідження доводять необхідність розробки і впровадження профілактичних заходів, для покращення умов прац
Исследование полиморфизма гена L-myc (T3109G) в прогнозировании риска токсических осложнений при лечении неходжкинских лимфом
Get PDFAim of research. To define the influence of polymorphic variants of L-myc (T3109G) gene on the risk of development of hematological and non-hematological toxicity at polychemotharapy in patients with the different forms of non-hodgkin’s lymphomas.Methods. Patients with diffuse-macrocellular and microcellular lymphomas underwent 4 courses of polychemotherapy according to the nosologic forms of disease and treatment protocol. The clinical course of disease was assessed paying attention to the toxic effects and response on the therapy. The clinical-laboratory parameters in the period of disease manifestation were analyzed in details. All patients underwent the molecular-genetic examination of polymorphic variants of L-myc (T3109G) gene. Using the statistical analysis was assessed the influence of polymorphic variants of gene on the risk of development of toxic effects and the interconnection with clinic-laboratory parameters.. Results. The studies of the influence of polymorphic variants of L-myc (T3109G) gene on the risk of development of hematological and non-hematological toxicity at PCT at the different forms of NHL proved that the summary frequency of detection of the clinical cases of hematological and non-hematological toxicity did not differ in patients with DMCL and MCL and was not associated with polymorphism of the studied gene. Polymorphism of L-myc (T3109G) gene determined the spread of the tumor process, the risk of development of II-IV stages of disease that were detected more frequently at 3109ТG and 3109GG genotypes; and the 3109GG genotype was associated with the loss of body weight and the rise of the number of erythrocytes in the period of disease manifestation before the beginning of PCT courses. The risk of development of nephrological toxicity at chemotherapy in patients with NHL was associated with 3109ТG and 3109GG genotypes on L-myc gene. The number of toxic effects and the features of their combination in examined patients were not connected with polymorphism of L-myc (T3109G) gene.Conclusions. The further studies are needed for elaboration of the therapeutic-preventive arrangements on the decrease of risk of nephrological toxicity in patients with non-hodgkin’s lymphomas at polychemotherapy coursesПроанализировали влияние полиморфизма гена L-myc (T3109G) на развитие токсичности у пациентов с неходжкинскими лимфомами. Выявлено ассоциацию генотипов 3109ТG и 3109GG с повышением риска развития нефрологической токсичности. Наличие генотипа 3109GG было ассоциировано с потерей массы тела и повышенным количеством лейкоцитов в период манифестации заболевания. Необходимы дальнейшие исследования для разработки лечебно-профилактических мероприяти
Оценка эффективности программы реабилитации у пациентов с впервые выявленным эпизодом язвенной болезни желудка и двенадцатиперстной кишки
Get PDFDuodenal (DU) and gastric ulcer (GU) experience their rise in Ukraine, demonstrating threatening increase by 38,4 % in last decade with the prevalence of 2299 per 100 000 of population. Every second patient is treated in-patiently, every third experience disability spell annually. Reduction in related risks is confirmed not only by absence of effective therapy, but rather shortcomings in patient management and patient devotion. General belated timing of rehabilitation initiation in post hospital stage appeared to be cardinal obstacle of its efficiency with low (up to 20 %) coverage, and securing clinical effect in 8 % cases only. The goal was to evaluate efficacy of rehabilitation program detailed at first episode of in-patient treatment at gastroenterological department.Methods. Data were organized by cohort design. Control cohort comprised 180 patients with first episode of hospitalization due to DU or GU in gastroenterological Vinnitsa city department during 2009–2012 years. Experimental cohort consisted of 220 equal patients who entered rehabilitation program (RP). RP was administered randomly. Randomness was statistically verified on principal confounders. Cases were traced for 4 years. We applied three modifications of semi-parametric frailty model to study effect of program on the risk of recurrent hospitalization.Results. All three modifications coincided in that program secured typically at least 39 days to recurrent hospitalization per patient with drop in risk at least at RR=0,774.Conclusion. To reduce belated timing of rehabilitation initiation, we shifted administration of rehabilitation to hospital stage. RP frame combines 10 scales, namely medication of ulcer, diet modification, overweight control, physiotherapy exercises, NSAID-induced gastropathy control management, risk factor management, blood pressure correction, diabetes management, anxiety and depression management. Program efficacy estimation relied upon time to recurrent hospitalization, which proved to be very sensitive to quality of care. Results of three survival model modifications coincided in that program secured typically at least for 39 days to recurrent hospitalization per patient with drop in risk at least at RR=0,774В последнее десятилетие уровни заболеваемости язвой желудка (ЯЖ) и 12-перстной кишки (ЯД) демонстрируют рост в Украине, с распространенностью 2299 случая на 100 000 населения. Снижение указанных рисков зависит не столько от наличия эффективной фармакотерапии, сколько от качества менеджмента пациента и комплайенса. Распространенная отсрочка начала реабилитационного процесса на постгоспитальном этапе рассматривается как основное препятствие эффективности с низким охватом (до 20 %), что приводит к устойчивому клиническому эффекту только в 8 % случае