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Использование цистоманометрии как объективного показателя сократительной функции мочевого пузыря у больных инфильтративным раком шейки матки
Get PDFAim of research: to carry out comparative analysis of indices of urinary system function in patients with infiltrative cervical cancer before and after surgical treatment. Materials and methods: the work is based on prospective data of clinical observation and results of treatment of 90 patients with cervical cancer treated in the department of oncogynecology of National institute of cancer. The age of patients was within 26–65 years, on the average (42,61±1,06) years. All patients were divided into three groups depending on the method of surgical treatment: I group – 45 patients with infiltrative CC, who underwent nerve-preserving operation (NPO) – surgical aid with preservation of pelvic vegetative nerve plexus – the main group. II group – 45 patients with infiltrative CC, who underwent radical hysterectomy (RHE) – control group. All patients underwent cystomanometry. All indices in the studied groups were equal. Results of research: The index of extensibility (plasticity) of bladder in patients with infiltrative cervical cancer after RHE III depends on the change of bladder volume and does not depend of insignificantly depends on the change of bladder pressure; whereas after surgical intervention with preservation of pelvic vegetative nerve plexus – it depends on the change of bladder pressure and does not depend of insignificantly depends on the change of bladder volume. The best indices of contractile function of detrusor were in patients after nerve-preserving operation. Conclusions: surgical intervention in patients with infiltrative CC with preservation of the main elements of pelvic vegetative plexus allows essentially diminish the number of postoperative urogenital disorders that is proved by indices of urodynamic study – cystomanometry in pre- and early postoperative periodsЦелью исследования являлось провести сравнительный анализ показателей функции мочевыделительной системы у больных инфильтративным раком шейки матки до и после хирургического лечения. Результаты исследования показали, что выполнение хирургического вмешательства у больных инфильтративным РШМ с сохранением основных элементов тазового вегетативного сплетения позволяет существенно снизить количество послеоперационных мочеполовых расстройств, что подтверждено применением цистоманометрии как объективного показателя сократительной функции мочевого пузыр
Вираженість та прояви психопатологічної симптоматики у пацієнтів косметологічного профілю
Get PDFThe significant prevalence of psychic pathology among patients of the medical sphere, including medical cosmetology, raises a question on organization of medical-psychological help for this profile of patients/clients.Aim of research – to detect the severity and manifestations of psychopathological symptomatology in cosmetological patients.Contingent and methods of research. In testing participated 286 жінок, who asked for cosmetological help. The interrogated were divided into 3 groups on the base of self-attitude criterion: 1 group included persons with disharmonic type and tendency to the lowered self-concept (G1, n=108), 2 group2 – with harmonic type (G2, n=96) and 3 group – with disharmonic one with tendency to the heightened self-concept (G3, n=82). The determination of severity of psychopathological symptomatology was carried out by SCL-90-R method.Results. In women, asked for cosmetological help, was the different level of psychopathological symptomatology depending on type of self-attitude. The features of psychopathological status of patients with disharmonic type of self-attitude with inclination to the low self-concept were the higher levels of psychic distress and its severity, psychopathological symptomatology was presented by the anxious-depressive, anxious-phobic, obsessive-compulsive manifestations, interpersonal sensitivity, transformation of psychic conflicts into somatic sphere, in women with disharmonic type of self-attitude with inclination to the heightened self-concept – intensive psychic distress that was manifested in psychopathological anxiety, somatization, hostility and mistrust as to surrounding people. Psychopathological status of women with harmonic type of self-attitude is characterized with the lower levels of psychopathological manifestations, reaction to the psychic stress such as monosymptoms of affective or anxious spectrum, somatization.Conclusions. Women, asked for cosmetological help, form the group that is heterogenic by psychological characteristics that must be taken into account at giving medical and psychological help. Patients with disharmonic type of self-attitude, especially with inclination to the low self-concept, form the risk group as to psychological health and need medical-psychological helpЖінки, які звертаються за косметологічною допомогою, є неоднорідною за психологічними характеристиками групою. Рівень психопатологічної симптоматики та її структура різняться залежно від типу самовідношення: гармонійного, дизгармонійного зі схильністю до заниженої чи завищеної самооцінки. Серед пацієнток з дизгармонійними типами самовідношення, в особливості низькою самооцінкою, виявлено підвищені рівні психічного дистресу та його інтенсивност
Вивчення рівнів аполіпопротеїнів А1, аполіпопротеїнів в у сироватці крові та їх співвідношення у молодих дорослих з нелікованою соматотропною недостатністю з маніфестацією в дитинстві
Get PDFThere was studied the content of apolipoproteins А1 (ApоА1) and apolipoproteins B (ApoВ) in the blood serum and their ratio in young adults ( mean age 22,47±0,30 years) with somatotropic deficiency, appeared in childhood. In most patients, who did not receive treatment with preparations of recombinant growth hormone (rGH) the undesirable changes of the lipid profile were established, especially the essential decrease of apolipoproteins A1 level and increase of apolipoproteins B level, disturbance of their ratio that favors the significant growth of cardiovascular risk.Aim. Determination of the presence of cardio-vascular risk factors in young adults with prolonged deficiency of growth hormone by the study of apolipoprotein А1, apolipoprotein В in the blood and their ratio.Methods. АpоА1 and АpоВ levels in the blood serum were determined by immunoturbidimetric method (Cobas 6000; RocheDiagnostics, Switzerland). The level of insulin-like growth factor (IGF) in the blood plasma was determined by radioimmunological method using the standard sets «IRMAIGF-1" («Immunotech» , Czech Republic). The measuring of height was carried out using stadiometer «SystemDr.KellerJ.», body mass was measured using electronic weigher Tanita BC587 (Japan). The bone age was determined by the atlas W. W. Greulich & S. P. Pyle (1993). The materials of Register of patients with somatotropic deficiency, created on the base of the department of child endocrine pathology of SI “Institute of endocrinology and metabolism, named after V. P. Komissarenko, NAMS of Ukraine” were used in the work.Statistical processing of the results was carried out using Microsoft Excel statistical programs with the help of methods of variation statistics. The results were presented as the mean values and their standard mistake (M±m). The assessment of statistical reliability was realized by Student parametric t-criterion. The difference between results was considered as a reliable one at р<0,05.Results of research. 174 patients with somatotropic deficiency, appeared in the childhood, were examined. Mean age was 22,47±0,30 years ( in women – 23,47±0,61 years; in men – 22,03±0,32 years). The height of patients was 138,0 – 174,0 cm, body mass index – from 19,2 to 33,3. Under conditions of prolonged deficiency of growth hormone only 17.8 % of patients had АpоА1 parameters within the norm and 67,2 % – the normal АpоВ parameters in the blood serum.The mean level of ApoA1 in the blood serum of young adults was reliably lower than the control parameters (0,88±0,014 g/l and 1,21±0,018 g/l respectively, p<0.001). At the same time the mean ApoB level essentially exceeded the parameters in the control group (1,171±0,022g/l and 0,995±0,028 g/l, respectively, p<0.001). ApoB / ApoA1 ratio exceeded the value 1 and was 1,366±0,028 (in the control group 0,816±0,016, p<0.001). The essential gender differences in parameters of АpоА1,АpоВ and АpоВ/АpоА1 in young adults with somatotropic deficiency, who did not receive treatment with rGH, were not found.Conclusion. There were established the significant undesirable changes of the levels of apolipoproteins А1, apolipoproteins B in the blood serum and disturbance of their ratio in young adults with somatotropic deficiency, appeared in childhood. The received data testify to the accumulation of cardiovascular risk factors in young adults under conditions of prolonged deficiency of growth hormones and the necessity of continuation/renewal of therapy with preparations of recombinant growth hormoneОбстежено 174 пацієнта (22,47±0,30 роки), які з дитинства страждали на соматотропну недостатність. Встановлено суттєве зниження рівню аполіпопротеїнів A1, підвищення рівнів аполіпопротеїнів В ,порушення їх співвідношення. Отримані данні свідчать про накопичення факторів кардіоваскулярного ризику у молодих дорослих в умовах тривалого дефіциту гормону росту та необхідності терапії препаратами рекомбінантного гормону рост
Вплив тривалості періоду визначення домашнього артеріального тиску на оцінку ефективності результатів антигіпертензивного лікування у реальній клінічній практиці
Get PDFAim. The assessment of diagnostic possibilities of protocols of home arterial pressure (AP) measuring of different duration for the control of antihypertensive therapy efficacy.Methods. The data of home AP of 236 patients as to its value, frequency of attaining the recommended level and phenotype of arterial hypertension (AH) for 3–5–7 days of measuring were compared. The coefficients of Cohen’s kappa and Leen’s correlation coordination were studied.Results. The coordination of mean AP values with the data of 7-days measuring was worsened most essentially at the reduction of measuring period to 3 days. The determination of home AP, according to the data of 5-days measuring comparing with 5-days one has no essential impact on the assessment of antihypertensive therapy efficacy as to the attainment of recommended level and establishing of AH phenotypes but worsens it at 3-days one.Conclusion. The reduction of the period of home AP measuring from 7 to 3 and 5 days can influence the values of CAT and HAT at the beginning of treatment and in the case of 3 days period it can influence the diagnostic possibilities as to the efficacy control of antihypertensive therapyЗіставлення протоколів визначення домашнього АТ різної тривалості довело, що скорочення періоду вимірювання з 7-и до 3-х і 5-и днів може вплинути на визначення величини САТ і ДАТ на початку лікування, а в разі триденного періоду – на діагностичні можливості щодо контролю ефективності антигіпертензивної терапії та встановлення фенотипів АГ при тривалому спостереженн
Аналіз чинників, що асоційовані з контролем офісного і домашнього артеріального тиску в пацієнтів, котрі отримують алгоритмізовану антигіпертензивну терапію
Get PDFAim. To define factors, associated with attaining control of the office and home AP and with the number of necessary medicaments in patients with non-complicated AH after 6 month of algorithmic antihypertensive therapyMaterials and methods. 501 patients with AH received therapy according to the algorithm that provided successive prescription of fixed combination of perindopril, ampodipine and if necessary, indapamide-retard, spironolactone, moxonidine or doxazosin for attaining the target office AP. The office and home AP was assessed by certificated oscillometric devices. For determination of factors, independently associated with attaining the target level of office and recommended level of home AP after 6 months of therapy the multiple linear regressive analysis was usedResults. After 6 months the office SAP and DAP decreased from 165,7±13,9 to 131,0±9,5 and from 96,9±9,7 to 79,3±7,1mm of m.c., home – from 148,8±15,7 to 129,4±8,3 and from 87,8±10,0 to 77,9±7,2 mm of m.c. After 6 months the target office AP was attained by 80,1 %, recommended home – by 65,8 % of patients. After 7 days indapamide-retard was added to the therapy in 24 % of patients. At the end of research 165 (37,2 %) patients were treated by three or more preparations. The high inclination to treatment was detected in 49, moderate – in 43,6, low – in 7,4 % of patientsConclusions. The attainment of target office AP in patients with hypertension in 6 month of treatment was independently associated with female sex, age, initial level of office SAP, absence of the need in 3 preparations after 7 days of treatment, high compliance. The need of prescription of three and more preparations for AP control after 6 month was associated with low compliance, probable resistant AH before inclusion in the research, home SAP after 7 days and uncontrolled AH after 1 month of treatmentЗ досягненням цільового офісного АТ в пацієнтів з АГ через 6 місяців лікування асоціювались жіноча стать, рівень вихідного офісного САТ, відсутність потреби у 3-х препаратах через 7 днів лікування, високий комплаенс. З досягненням рекомендованого домашнього АТ через 6 місяців лікування асоціювались вік, жіноча стать, рівень вихідного офісного САТ, високий комплаен
Интегральная оценка функционального состояния футболистов в разные периоды подготовки
Get PDFThe search for simple and minimally invasive methods of diagnostics of the functional status of professional soccer players was always the object of the interest of sport medicine and physiology.The aim of research was the increase of medical control of the professional soccer players by elaboration and introduction of methodology of integral assessment of the soccer players’ functional status using the program-hardware complex Fazagraf®.Methods of research. The research included 34 professional players in the age 18-34 years. The research was carried out during the football season in different training periods and included instrumental methodology of assessment of the functional status using apparatus fazagraf and also the methodology of assessment of the functional status, offered by us. Results of research. With the help of the offered methodology it was established, that at the end of basic period the low marks of FS (1,2 and 3) were not fixed. All soccer players were in the good and very good FS. At the end of competitive period of training it was revealed, that in 11 soccer players (32%) were observed the low indices of integral assessment that is FS disorders. Conclusion: in the basic period of training takes place the increase of adaptive potential and decrease of the risk of development of disorders in sportsmen’s health. In competitive period of training were observed the disorders of functional status under the effect of big physical loads and other factors that needs more attention to the medical control in this training period Целью работы являлось улучшение врачебного контроля за профессиональными футболистами путем разработки и внедрения методики интегральной оценки функционального состояния футболистов при помощи аппарата Фазаграф®. Проведен анализ функционального состояния футболистов на протяжении футбольного сезона. Выявлено, что в базовом периоде подготовки происходит повышение адаптационного потенциала, в соревновательном периоде подготовки часто наблюдались нарушения функционального состояни
Ультразвуковая диагностика травматической формы ятрогенного верхнечелюстного синусита стоматогенного происхождения
Get PDFoai:ojs.journals.uran.ua:article/70122The need for elaboration of non-invasive methods of diagnostics of inflammatory diseases of maxillary sinuses still be topical that is explained by the existence of numerous patients, for example, children and pregnant, with contraindications to the traditional x-ray examination or computed tomography, by the necessity to carry out in several cases the scanning of maxillary sinuses in the dynamics of treatment. Sinusitis in children is the dominant pathology in both stationary and outpatient practice.Aim of research. To raise the effectiveness of diagnostics of the different forms of iatrogenic maxillary sinusitis. Material and methods. The two-dimensional ultrasound examination of the maxillary sinuses 21 (100,0 %) of patient (the mean age 43,8±14,0 years old) with the traumatic form of iatrogenic sinusitis of stomatogenic origin was carried out using the ultrasound diagnostic apparatus АCUSON X 500, ATSmod.539 (SIEMENS, USA) in В-mode by the method of V.V. Shilenkova [11] using the linear sensor with the length of working surface 37 mm and frequency mode 7,5–10 MHz.Results of research. At the primary injury of healthy maxillary sinuses by the iatrogenic traumatic factor of stomatogenic origin at the stage of remission of sinusitis the sonographic picture of unchangeable sinus is typical (isoechogenicity of membrane – 57,1 % and acoustical shadow – 52,4 %). At the secondary injury that is the combination of iatrogenesis with the chronic sinusitis the sonographic signs of the chronic inflammation are observed (hyperechogenicity of membrane – 23,8 % hyperechoic content of sinus (polyps) – in 38,1 %).In the acute phase of disease the signs of catarrhal sinusitis prevail (homogenous echostructure of membrane – in 52,4 %, uniformity of its thickening - in 33,3 %) and serous character of exudates in sinus (the arced form of the outline of the sinus back wall – 38,0 %)Сонографически первичный травматический ятрогенный верхнечелюстной синусит, характеризуется изоэхогенностью мембраны (57,1 %), акустической тенью (52,4 %). Вторичном – гиперэхогенной мембраной пазухи (23,8 %), гиперэхогенным содержимым синуса (38,1 %). Острая фаза заболевания - однородной эхоструктурой мембраны (52,4 %), равномерностью ее утолщения (33,3 %) и дугообразной формой контура задней стенки синуса (38,0 %
Ефективність стабілізованого фториду олова у комплексній профілактиці карієсу зубів у молоді
Get PDFIn the work were presented the results of the clinical efficiency of preparations with stabilized stannous fluoride in the complex prophylaxis of caries in young people that stipulates the use of phytopreparations “Calcid” and UncariaTomentosa extract for improvement of caries resistance of the teeth hard tissues.Aim of the work. The improvement of the efficiency of the primary prophylaxis of the dental caries in young people by prescription of the vitaminic-mineral complex and stabilized stannous fluoride for intensifying the processes of teeth enamel remineralization.Materials and methods of research: epidemiological, clinical and statistical methods of research.Results of research: In the result of combining in the prophylactic complex the methods of endo- and exogenous prophylaxis allowed significantly raise the degree of caries resistance of the teeth hard tissues that is indicated by the essential difference between the indices of the growth of the caries intensity in the group of comparison, main and control groups and also the high values of reduction attained during the year of the use of the complex of prophylactic arrangements in young people. We must specially note the efficiency of stabilized stannous fluoride in the complex prophylaxis of dental caries that is 32 % in comparison with preparations that include sodium fluoride.The research demonstrates that the state of the oral cavity hygiene in all groups of examined young people with the high intensity of caries can be assessed as unsatisfactory one. From the aforesaid data we can see, that the combination of the preparations for the oral cavity care including stannous fluoride with prophylactic vitaminic-mineral complex has the reliable prophylactic impact, favor the decrease of the caries intensity and improves the indices of the state of the oral cavity hygiene in 1,6 times.The rise of the degree of caries resistance of enamel in one year in patients of the control group (4,88±0,15) was less evident under the effect of exogenous methods of prophylaxis and reliably insignificant comparing with the initial data (4,56±0,14). The special attention must be paid to the reliable difference of the enamel resistance test between the main and control groups 4,27±0,10 and 4,88±0,15 respectively (р<0,05).Conclusions: The essential difference between the indices of growth of caries intensity in the main group (17) and the high values of reduction (68 %) with the group of comparison (32 %), and also the positive changes of structural-functional enamel resistance (from 5,32±0,13 to 4,27±0,10) attained after the year of using the offered complex of prophylactic arrangements in combinations with the preparations for the oral cavity care including stabilized stannous fluoride in young people, proved its high clinical efficiencyУ роботі представлені результати визначення клінічної ефективності засобів із стабілізованим фторидом олова у комплексній профілактиці карієсу зубів у осіб молодого віку, що передбачає застосування фітопрепаратів «Кальцид» та екстракту Uncaria Tomentosa для підвищення ступеня карієсрезистентності твердих тканин зубів. Профілактична дія підтверджена зниженням інтенсивності карієсу та покращенням показника стану гігієни порожнини рот
Організаційні та психологічні аспекти оптимізації наднормового стаціонарного ліжкового фонду медичних закладів: досвід кіровоградської області
Get PDFIn the article was demonstrated the unique methodology of determination of effectiveness of functioning of the central district and city hospitals (CDH and CH) of Kirovograd region based on analysis of the indications to hospitalization of patients that was carried out directly by their managerial staff as an independent internal audit. Object of research – central district and city hospitals of Kirovograd region.Materials and methods – the bed fund and number of population of 21 central district hospital of Kirovograd region and 12 hospitals of regional and city subordination were analyzed.Results – the offered model of determination of “excessiveness”, ineffectiveness of the bed fund and consequently the budget costs use can give a possibility to optimize near 600 beds of 871 excessive ones at the expense of the correctly determined psychological grounding of research without using the imperative methods, by the certain phasing that provides the logics of actions, calculations and as the result – an independent making decisions by the managers of medical institutionsУ статті продемонстровано оригінальну методику визначення ефективності функціонування центральних районних і міських лікарень (далі - ЦРЛ і МЛ) Кіровоградської області на основі проведеного аналізу наявності показань до госпіталізації хворих у стаціонари, який проводився безпосередньо їх керівним складом як самостійний внутрішній ауди
Вплив неалкогольного стеатогепатиту на структурно-функціональний стан серця у хворих на артеріальну гіпертензію, ускладнену хронічною серцевою недостатністю
Get PDFAt the present time nonalcoholic fatty liver disease is often regarded as one of the components of metabolic syndrome (MS), which may contribute to the development and progression of cardiovascular disease. The aim of the study was to investigate the influence of nonalcoholic steatohepatitis (NASH) on the structural and functional conditions of the heart in patients with arterial hypertension (AH) complicated by chronic heart failure (CHF).Methods. In 126 examinating patients with diagnosed and adjusted by medication AH complicated by CHF III-IV functional class NYHA indicators of the liver functional state and blood lipids were determined. Structural and functional conditions of the heart were assessed by echocardiography. Statistical analysis of the results was performed using "Statistica 10 Enterprise x64" ("Stat Soft", USA).Results. The presence of NASH was accompanied by violation of the liver functional state with moderate cytolytic and cholestatic syndromes and dyslipidemia in patients with AH complicated by CHF. A direct correlations between an atherogenic coefficient and activities of alaninaminotrasferase and hammahlutamiltranspeptydase in blood were revealed. It was found an adverse influence of NASH on the indicators of intra-cardiac hemodynamics and remodeling of the left ventricle (LV) to increase the thickness of the LV posterior wall, interventricular septum (IVS), myocardial mass and reduce the LV ejection fraction.Conclusions. The presence of NASH in patients with AH complicated by CHF adversely affect on structural and functional conditions of the heart and intra-cardiac hemodynamics and contributes to the progression of heart failure.При обстеженні 126 хворих із діагностованою та медикаментозно коригованою артеріальною гіпертензією, ускладненою хронічною серцевою недостатністю ІІІ-ІV функціонального класу за NYHA встановлено несприятливий вплив неалкогольного стеатогепатиту (НАСГ) на показники внутрішньо-серцевої гемодинаміки та ремоделювання лівого шлуночка (ЛШ) щодо збільшення товщини задньої стінки ЛШ, міжшлуночкової перетинки (МШП), маси міокарду ЛШ і зниження фракції викид