EUREKA: Health Sciences
Not a member yet
407 research outputs found
Sort by
MICROBIOLOGICAL STUDY OF A PERSPECTIVE HEPATOPROTECTIVE AGENT BASED ON DRY EXTRACT FROM PRUNUS DOMESTICA FRUITS
Get PDFOne of the main directions of improving the concept of treatment of diseases of the gastrointestinal tract and liver, which is accompanied by dysfunction of the hepatobiliary system and intestines, was the search and development of herbal remedies with hepatoprotective effect with a laxative effect and concomitant prebiotic activity.
Aim of the research: to study the antimicrobial and prebiotic properties of the studied phytosubstance obtained from the fruits of Prunus domestica.
Materials and methods. The study of the antimicrobial activity of the test sample of plum fruit extract with fibers was performed in vitro by the method of multiple serial dilutions. The reference strains of the following microorganisms were used as the microbiological model: S.aureus-ATCC-25923, E.сoli-ATCC-25922, P. aéruginosa-ATCC-27853, B. subtilis-ATCC-6633, C.albicans-ATCC-885653.
The determination of the prebiotic properties of the studied sample was carried out by the method of cultivation of bacteria Bifidobacterium bifidum No. 1 and L. rhamnosus R0011 ND on nutrient media, which included the composition of plum fruit with fibers.
Results. Studies on the antimicrobial activity of plum fruit extract with fibers showed that the studied phytosubstance does not reveal antagonistic properties both with respect to gram-positive and gram-negative bacteria, as well as in the case of Candida fungi. The results of studies on the study of the prebiotic properties of the studied extract confirmed the improvement of the main physiological parameters of the culture of bifidobacteria strain Bifidobacterium bifidum No. 1 and the strain lactobacillus L. rhamnosus R0011 ND when the fruit plums with fibers were added to the culture medium.
Conclusions. The conducted studies allowed to establish the prebiotic properties of the studied extract of plum fruits with fibers, which proves the promise of its use in complex therapy schemes for gastrointestinal pathology
EVALUATION OF PAIN SYNDROME AND EFFICIENCY OF PAIN MANAGEMENT IN LUMBAR SPINE SURGERY
Get PDFMultimodal analgesia for lumbar spine surgery is still a controversial problem, because of possible fusion problems, significant neuropathic component of pain, and influence of anesthesia type. Aim of the study was to assess the efficacy of pain management after lumbar spine surgery considering characteristics of pain, type of anesthesia and analgesic regimen.
Material and methods. 254 ASA I-II patients with degenerative lumbar spine disease were enrolled into prospective study. Patients were operated either under spinal anesthesia (SA) or total intravenous anesthesia (TIVA). In postoperative period patients got either standard pain management (SPM – paracetamol±morphine) or multimodal analgesia (MMA – paracetamol+parecoxib+pregabalin±morphine).
Results. We revealed neuropathic pain in 53.9 % of patients, who were elected for lumbar spine surgery. VAS pain score in patients with neuropathic pain was higher, than in patients with nociceptive pain. Total intravenous anesthesia was associated with greater opioid consumption during the first postoperative day. Multimodal analgesia based on paracetamol, parecoxib and pregabalin allowed to decrease requirements for opioids, postoperative nausea and dizziness. Pregabalin used for evening premedication had equipotential anxiolytic effect as phenazepam without postoperative cognitive disturbances.
Conclusions. Multimodal analgesia is opioid-sparing technique that allows to decrease complications. Spinal anesthesia is associated to a decreased opioid consumption in the 1st postoperative day
METHODOLOGY FOR ASSESSING THE LOGISTICS POTENTIAL OF THE FOREIGN ECONOMIC ACTIVITY OF A PHARMACEUTICAL COMPANY
Get PDFThe aim of the article is to determine the essence of the logistics potential of a foreign trade activity of a pharmaceutical enterprise and justify the methods for determining it.
The materials used in the study include statistical data of the investigated pharmaceutical enterprises, namely JSC FF “Darnitsa”, PJSC NPC “Borschagovsky Chemical and Pharmaceutical Plant”, PJSC “Pharmak”, LLC “FC Zdorovia” and JSC “Lekhim-Kharkiv”. The study used methods of analysis and synthesis, generalization, content analysis, questionnaires and methods for assessing potential. The questionnaire was used to select indicators that should be part of the logistics potential of a foreign trade activity of a pharmaceutical enterprise.
The experts were 100 leading specialists of pharmaceutical companies. They are all involved in foreign economic activity. Experts are gender–divided into women (73 %), men (27 %); by age: up to 25 years – 8 %, 25–35 years – 14 %, 35–45 years – 27 %, 45–55 years – 36 %, over 55 years – 15 %; by experience: up to 5 years – 11 %, 5–10 years – 15 %, 10–20 years – 32 %, 20–30 years – 36 %, over 30 years – 6 %. The experts' conclusions are valid, the coefficient of concordance is 0.86, and the Pearson test exceeds the table value.
The essence of the definition of "potential of logistics of pharmaceutical enterprise’s foreign trade activity" is investigated. The types of logistics potential of foreign economic activity and indicators that are appropriate to use for determining the level of development of the logistic potential in foreign economic activity are offered.
The potential of logistics of foreign trade activities of pharmaceutical enterprises consists of the potentials of logistics in the field of export and import. The system of indicators for measuring the logistics potential of a foreign trade activity of a pharmaceutical enterprise contains indicators selected through content analysis and questionnaires.
The method of estimation of logistics potential in foreign economic activity of pharmaceutical enterprise is offered
FREQUENCY ANALYSIS OF MEDICINAL PRESCRIPTS AT PHARMACOTHERAPY OF BRONCHIAL ASTHMA IN CHILDREN
Get PDFToday, bronchial asthma is the most widespread childhood chronic respiratory disease in the world. To make managerial decisions in the health care system of Ukraine and to identify priority areas for the response to this disease, it is necessary to carry out a quantitative analysis of the appointment letters and the proportion of patients who received specific drugs for determining the main areas of therapy.
Aim. Carrying out of frequency analysis of medical prescriptions at pharmacotherapy of bronchial asthma in children.
Materials and methods. 574 medical cards of an indoor patient with the main diagnosis of "Bronchial asthma", received at the Kyiv City Children's Clinical Hospital №2. A retrospective frequency analysis of the prescribing of drugs for archival data of appointment letters was conducted.
Results. The conducted analysis of patients by age and sex allowed to establish the correspondence of the obtained results with the results of previous scientific studies on gender differences in the prevalence of bronchial asthma in children. In 45.3 % of the children, the length of stay was 2-10 days, and in 37.3 % – 11–20 days, indicating a sufficiently long period of inpatient treatment. According to the letters of appointment in the medical records of the inpatient patient, the physicians carried out 1983 appointments, of which 1867 were medicated (94.2 %), and 116 were non-medicated methods (5.8 %). The medical appointments of doctors included 1763 medicines. Of these, 94.4 % are medicines belonging to 11 groups according to ATC classification, 1.5 % – solutions for washing, irrigation, treatment, 0.3 % - dietary supplements, 0.1 % – homeopathic preparations, 3.7 % – other. The data that was obtained when calculating the intensity of the target varies in the range of 0.0006 to 0.07. The highest rates had only 2 drugs – Ventolin nebuli and Pulmicort, which were available in 22.3 % and 23.0 % of the patient's medical cards respectively, that is, every fifth patient. It was found that the ratio of drugs of domestic and foreign manufacture is 34.2 % (20 pharmaceutical companies) and 65.8 % (25 producing countries), respectively.
Conclusions. The received data of the conducted analysis of prescriptions of medicinal products allow establishing a significant nomenclature of medical appointments for children with bronchial asthma. The promising direction for domestic pharmaceutical companies in the production of drugs for the treatment of the examined nosology was revealed. At the same time, the frequency analysis of the nomenclature of drugs can be used in the selection of drugs for reimbursement programs and medical insurance after further pharmacoeconomic studies
MEDICAL GENETIC COUNSELING OF WOMEN WITH CONGENITAL HEART DISEASES OF FETUS
Get PDFAim of the work. Determine the effectiveness of prenatal diagnosis of congenital heart defects in the fetus and the informativeness of different markers used in the medical-genetic counseling of pregnant women..
Materials and methods. The analysis of the results of medical genetic counseling of pregnant women with fetal heart diseases was carried out. The effectiveness of using different methods of prenatal diagnosis in 67 pregnant women is estimated. The data of somatic, genealogical and reproductive anamnesis, biochemical markers of chromosomal pathology of the 1st and 2nd trimester of pregnancy, and the spectrum of the detected fetal heart disease were studied.
Results of the research. It was found that 46 (68.7 %) women had somatic diseases: pathology of the cardiovascular system (11.9 %); endocrine system - at 8 (11,9 %); respiratory disease – 3 (4.5 %) and urinary system – 2 (3.0 %). 13 (19.4 %) out of 67 women had acute respiratory viral infections in the first trimester of pregnancy. In 4 (6 %) cases - bad habits. The first time pregnant were 31 (46.3 %) women, 21 (31.3 %) – the second time, 10 (14.9 %) in the third, and 5 (7.5 %) in the fourth or more times. In history, 58 (86.6 %) women did not have reproductive function disorders, 8 (11.9 %) had unauthorized miscarriages and frozen pregnancy. The burden of gynecological anamnesis was observed in 12 (17.9 %) women, and hereditary - in 6 (9.0 %) women. In the structure of congenital defects of the heart, false anatomical anomalies were found more often: hypoplasia of the left heart organs – 14 (20.9 %), tetralogy of Fallot - 9 (13.3 %). Biochemical markers of chromosomal pathology in the first trimester in 11 (16.4 %) women recorded indicators that are characteristic of the risk of chromosomal pathology, and in the second trimester – in 9 (13.4 %). Two pregnant women used a NIPT (non-invasive prenatal test) test that did not detect chromosomal abnormalities in the fetus. In 8 cases, invasive prenatal diagnosis of the fetus was recommended, which was carried out by three women, and five refused.
Conclusions. The peculiarities of somatic (in 46–68.7 % of women), reproductive (in 8-11.9 % of women) gynecological anamnesis (in 12–17.9 % of women), which can be the risk factors of congenital fetal heart disease, are revealed. In the structure of congenital defects of the heart of the fetus more often revealed hypoplasia of the left heart organs – 14 (20.9 %), tetralogy of Fallot – 9 (13.3 %). In 11 (16.4 %) women recorded indicators of biochemical markers, characteristic for the risk of chromosomal pathology, in the first trimester, and – in 9 (13.4 %) pregnant women – in the second trimester. Comparative data on prenatal diagnosis of congenital heart defects in the fetus of chromosomal, monogenic and multifactorial etiology are given. On the basis of the obtained results an algorithm of medical-genetic counseling of this contingent of patients was offered
ORIGINAL EFFECTIVE, SAFE TECHNIQUE OF OBTAINING PLATELET RICH PLASMA BY CENTRIFUGATION OF THE BLOOD PLASMA IN MODIFIED SYRINGE CONTAINERS
Get PDFThe aim: to develop, substantiate an effective and safe technology for producing PRP (platelet rich plasma). To quantify the substrate based on the recommended centrifugation protocols.
Materials and methods: the effectiveness of the original harvesting protocol was evaluated by quantifying the number of platelets. The proposed technique is formed basing on the basic principles of double centrifugation of whole blood in test tubes with anticoagulant, separation with the release of a plasma layer with a high content of platelets.
The centrifuging mode for quantifying the effectiveness of the substrate was selected according to recommendations based on a study confirming maximum efficiency (160g×10min + 250g×15min).
For quantitative evaluation, blood was collected from 10 healthy volunteers (7 men, 3 women) with an average age of 26.0±2.6, and centrifuged in standard mode. Quantitative evaluation of platelets of whole blood and the obtained PRP substrate was carried out with a semi-automatic analyzer.
Results: the proposed technique is based on the use as a container for centrifuging a syringe with a LuerLock design, which is hermetically sealed with a congruent plug, adapted by the external size of the centrifuge rotor bowl. Phase selection after centrifugation was performed by aspiration of the syringe contents after centrifugation is performed through a three-way valve. The substrate was obtained by repeated centrifugation of the contents, which allows obtaining a variable volume and platelet concentration in PRP. The amount of platelets (PLT) of whole blood is 227.0±57.0 thousand per ml. PLT PRP 945.0±279.0 thousand per ml.
Conclusions: the proposed method of separation of whole blood with the release of the platelet rich plasma demonstrates high efficiency, which corresponds to the level of increasing the number of platelets in reducing the volume at the level of the best ready-made solutions.
The equipment is economical and does not require highly specialized equipment and consumables. The proposed technique provides a wide choice to the performer in the received volume of the substrate
METHOD OF STIMULATION OF PHARMACY WORKERS INVOLVED IN THE GOVERNMENT PROGRAM “AVAILABLE MEDICINES”
Get PDFThe aim is to study the current state of the organization of work in pharmacies under the government program “Available medicines” and to create proposals for the improvement of material incentives to increase the motivation of workers of such pharmacies.
Materials and methods. The research used the general methods of scientific knowledge: analysis and synthesis, analogy and comparison; method of questioning to determine the actual state and opinions of specialists on the organization of work in the conditions of pharmacy participation in the program "Available medicines".
Results and discussion. In the course of the study, the problem of lack of incentives and motivation for the work of pharmacy workers under the Government program "Available medicines" has been highlighted. According to the results of the survey of specialists of three different forms of pharmacy’ ownership, participating in the program of reimbursement of the cost of drugs, it was found that the volume and intensity of work of workers has significantly increased, and wages have remained at the same level. The number of operations performed by employees in such pharmacies has considerably increased, which is related to the registration and maintenance of recipes under the program "Available medicines". The questionnaire survey has showed that the best option for optimizing the organization of remuneration in the prevailing conditions would be to pay extra for work (overpays). It was found that the number of recipes taken by one pharmacist per day varies considerably in different pharmacies, and there are also differences in the duration of the work of pharmacies under the reimbursement program during the month. To increase the motivation of pharmacists to work in the prevailing conditions, the method of calculating the additional payment for work in the conditions of the program "Available medicines" for each chemist's worker is offered individually in accordance with the post based on a formula that takes into account the intensity of labor using the intensity coefficient and the percentage of the additional payment.
Conclusions. The conducted researches have shown that the increased intensity of labor, which takes place in pharmacies working under the program "Available medicines", is the basis for the calculation of additional payments. The application of the system of material stimulation of the work of pharmacists based on the proposed methodology will allow compensating additional labor of specialists, taking into account the intensity of their work
CHANGES IN THE HEMOSTATIC SYSTEM AGAINST THE BACKGROUND OF VARIOUS TREATMENT REGIMENS IN PATIENTS WITH ATHEROSCLEROSIS OF LOWER EXTREMITIES
Get PDFAbout 2–3 % of the population and about 35–50 % of people over 65 years suffer from obliterating atherosclerosis of the main arteries of the lower extremities. There are many known factors that potentiate atherosclerosis. Some of them are referred to as leading, such as hyperlipoproteinemia or hypertension, others to concomitant contributing to the defeat of the arteries. According to J.S.A. Fuchs include hypertension, hypercholesterolemia and smoking as major risk factors for atherosclerosis. They are less affected by obesity, diabetes, hypertriglyceridemia, sedentary lifestyle, stress
Objective of the study. The purpose of this study is to evaluate the functional status of the vascular – platelet, coagulation and fibrinolysis of the hemostasis system and their disorders using low – frequency piezoelectric thromboelastography (LPTEG) in patients with obliterating atherosclerosis of the lower extremities on the background of treatment.
Materials and methods. The initial state of the hemostasis system was evaluated in 90 patients undergoing treatment for obliterating atherosclerosis of the lower extremities in the Odessa Regional Clinical Hospital and MD Odreks. All patients underwent surgery in the amount of femoral-popliteal autologous bypass grafting. Patients in the control (1st) group (45 patients) received analgesia during surgery and in the postoperative period based on epidural administration of bupivacaine, and their treatment regimen included enoxaparin 0.4 ml (40,000 anti-XA ME) 2 times a day subcutaneously into the anterolateral surface of the abdominal wall from the first postoperative day and pentoxifylline IV 200 mg twice a day for 7 days. Patients of the studied (2nd) group (45 patients) received analgesia during surgery and in the postoperative period on the basis of epidural administration of bupivacaine, also rivaroxaban 15 mg 2 times a day oraly on the first postoperative day was included in their treatment regimen.
The dynamics of the state of the hemostatic system in both groups of patients with OA was evaluated using LPTEG in the first day before surgery and on the 3rd, 5th and 7th postoperative days.
Results and conclusions. Before surgery and the start of treatment in patients with OA, against the background of activation of the vascular - platelet link of hemostasis, significant structural and chronometric hypercoagulation with increased thrombin generation and activation of blood fibrinolytic activity are noted. Against the background of treatment in the 1st group, platelet aggregation tends to normalize and there are significant differences compared with the indicators before treatment in the 1st group, the vascular-platelet and fibrinolytic systems did not reach normal values before 7 days, but showed a significant downward trend the degree of manifestation of their violations. Against the background of treatment of the 2nd group, significant changes were observed towards normalization in all components of the hemostatic system according to the LPTEG technique. The state of the coagulation unit of the hemostasis system in patients with OA on the 7th day of therapy does not significantly differ from the norm, it is possible to note significant shifts towards hypocoagulation within the normal range. The fibrinolytic system on the 7th day of treatment does not statistically differ from normal indicators, it has significant positive dynamics compared to 1 day. The second group revealed a statistically significant normalization of all indicators characterizing the blood coagulation potential of the blood and the aggregation ability of platelets, as well as the indicator that is responsible for changes in the fibrinolytic blood system
CONCENTRATIONS OF CYSTEINYL LEUKOTRIENES IN VARIOUS BIOLOGICAL FLUIDS OF CHILDREN WITH BRONCHIAL ASTHMA, ATOPIC DERMATITIS AND FOOD PROTEIN INDUCED ENTEROCOLITIS
Get PDFClinical manifestation of food allergy is characterized by polymorphic cutaneous, respiratory and gastrointestinal syndromes. Leukotrienes occupy a key place in the pathogenesis of a wide range of inflammatory diseases, including bronchial asthma, allergic rhinitis, atopic dermatitis, hives, allergic conjunctivitis, atherosclerotic cardio-vascular lesions system, inflammatory bowel disease, multiple sclerosis, cancer, etc. Better understanding of general pathophysiological mechanisms of allergic realization put the focus on the studying of cysteinyl leukotrienes biological effects in infants with atopic dermatitis and food-protein induced enterocolitis important.
Aim. To optimize the diagnosis of allergic lesions of the gastrointestinal tract in children.
Methods. The study was conducted in the allergy center and children clinic of the «Institute Pediatrics, Obstetrics and Gynecology named after academician O. Lukyanova of NAMS of Ukraine». Children were included from September 2017 to June 2018.
We examined 60 patients aged from 3 months to 3 years old, including 22 patients with atopic dermatitis, 18 children with food-protein induced enterocolitis, 8 patients with bronchial asthma in the stage of aggravation and 12 practically healthy children (control group).
Medical examination have been perfomed, general IG E and specific serum IG E were defined by ImmunoCAP (Phadia, 100), as well as concentrations of cysteinyl leukotrienes (LTB4, LTC4, LTE4) in biological liquids (serum, saliva, urine) using immunoenzyme method using the production sets of the "Enzolifescience" (USA) company on the analyzer-photometer Multiskan Plus "Labsystems". The results of the received data were processed statistically. The probability of differences was estimated with Student’s t-test and Tau Kendall rank correlation test. The difference was considered significant at p <0.05.
Results. A significant increase in the concentrations of cysteinyl leukotrienes (C4, D4, E4) in the blood, urine and saliva was found in infants with allergic skin diseases, gastro-intestinal and respiratory tract surveyed during manifestation the disease compared with the control group.
Comparison of concentrations of leukotrienes in urine and saliva of children with atopic dermatitis (AD), food-protein induced enterocolitis (FPIE) and asthma did not find credible. However, in the serum of patients with asthma, the concentration of cysteinyl leukotrienes was significantly higher (703.9±68.7) pg / ml than in children with enterocolitis induced by dietary proteins (509.3±57.4) pg / ml and significantly did not differ from patients with atopic dermatitis (695.2±46.3) pg / ml.
According to the results of Kendall Tau correlation test, no significant Spearman rank correlation was found between the cysteinyl leukotrienes concentration in blood and urine – r=0.14 (p>0.05), blood and saliva r=0.07 (p>0.05), urine and saliva r=–0.52 (p>0.05).
Conclusions. Increase in cysteinyl leukotrienes concentrations in serum, urine and saliva of children of early age with allergic skin diseases, respiratory and gastrointestinal tract was found. The absence of significant Spearman rank correlation between concentrations of leukotrienes in blood and urine, blood and saliva, saliva and urine shows that it is possible to select any biological fluid, saliva or urine, as a non-invasive way to determine the leukotriene concentrations for monitoring activity of allergic inflammation
MINIMALLY INVASIVE UROLOGICAL INTERVENTIONS IN OUTPATIENT CLINIC ON THE EXAMPLE OF PROSTATE BIOPSY
Get PDFOne of the main directions of improving medical care was the introduction of inpatient forms of medical care for patients who do not require round-the-clock supervision.
Aim of the research: to prove the effectiveness and economic feasibility of minimally invasive procedures in outpatient conditions.
Materials and methods. The study included 3524 patients in the period from 2010 to 2017, who underwent transrectal prostate biopsy on the basis of the Department of urology of polyclinic No. 195 of the Western district of Moscow. For comparison, the patients were taken, who underwent a biopsy of the prostate gland at the base hospital No. 31, No. 51, No. 17.
Results. The average number of biopsies performed in hospital No. 31, No. 51 and No. 17 for the year amounted to 344 biopsies, and the average detectability of prostate cancer was 142 (41.3 %). The average number of biopsies per year in the urology department of the branch number 2 GP No. 195 amounted to 440.5, and the average detectability of prostate cancer – 152.8 (34.7 %). Thus, with comparable inpatient detection of prostate cancer in one large outpatient urology center, an average of 28 % more biopsies are performed (440.5 versus 344) than in 3 hospitals over a comparable period of time.
Conclusions. Inpatient technologies can reduce the burden on hospitals. The development of hospital-replacing forms is determined by the need of the population and for efficient use of financial and technical resources of health care