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TOPICALITY OF IMPLEMENTATION OF MOBILE MEDICAL APPLICATIONS WITHIN THE FRAMEWORK OF ELECTRONIC HEALTH IN UKRAINE: THE EXPERIENCE OF LEADING COUNTRIES OF THE WORLD
Get PDFToday, in the field of healthcare of the leading countries of the world there is a technological breakthrough due to the use of modern electronic systems. Thanks to the use of medical electronic technologies, it is possible to improve the quality of medical and pharmaceutical care for all segments of the population. The eHealth system provides opportunities for direct participation of patients in their health, which involves organization of a healthy lifestyle and disease prevention.
The aim of the study was to analyze the experience of implementation of mobile medical applications and electronic medical systems within eHealth in the healthcare systems of the leading countries of the world and Ukraine.
Materials and Methods of the Ministry of Health of Ukraine, FDA, WHO, NHS, ABI Research and other open information databases and statistical agencies were used in the work. The analytical, comparative and generalization of scientific information methods were chosen for the research.
Results and Discussion. Modern reformation and further development of the healthcare system of Ukraine provides for the introduction of not only government programs of reimbursement, but also the introduction of electronic information systems, mobile applications for medical, pharmaceutical workers and patients at all stages of medical and pharmaceutical care. The integrated implementation of eHealth determines availability of the necessary healthcare management information system, which should have the following components: registers of medical institutions, services, doctors, patients, diagnosis coding system and electronic medical documentation (electronic medical records and prescriptions). Currently, 1472 medical institutions, 24506 doctors and 21068249 patients have joined eHealth in Ukraine.
Conclusions. It has been determined that information electronic technologies allow not only to reduce government spending on the healthcare, but also to achieve a reduction in the number of errors in prescriptions, visits to doctors without the necessary needs and decrease the total number of deaths. The introduction of electronic technologies, in particular mobile applications for the national healthcare system in Ukraine should be controlled by state authorities and independent international organizations on the control and development of information electronic systems
POLLEN–FOOD ALLERGY SYNDROME AMONG CHILDREN WITH SENSITIZED TO SPRING TREES
Get PDFIt is known that among 40–70 % of patients pollinosis can run in conjunction with pollen-food allergy syndrome (PFS), while development of PFS is associated with the consumption of fresh fruits, vegetables, nuts and spices. Clinical course and severity of the disease depend on the sensitization profile, which can be represented by proteins-panallergens (PR-10, profilins, nsLTPs). However, there is little information about the sensitization profiles of patients with pollinosis caused by pollen of spring trees in Ukraine.
Aim. To study the profiles of sensitization of children with spring pollinosis.
Methods. We examined 61 children (aged 4-17 years) with spring seasonal allergic rhinitis/rhinoconjunctivitis (SAR). To establish the diagnosis, all children were given questionnaires, skin prick tests (SPTs) with commercial pollen extracts, and prick to prick tests with fresh fruits, vegetables and nuts. Component resolved diagnosis (CRD) were detected using an ImmunoCAP system. (Phadia, 100).
Results. It has been found that in 43 children (70.5 %) had polinosis in combination with PFS, the main clinical manifestation of which was an oral allergic syndrome in 43 children (100 %). Among the causal food allergens that caused the manifestations of PFS were more apples, peaches, carrots and hazelnuts (consumption of which led to 11.6 % of children before the development of anaphylaxis). All of the examined children (100 %) had a positive IgE response to rBet v 1 at significant concentrations. In 9.3 % of children, panallergens were found at once from several botanical groups. Such panallergens: rBet v 2, rBet v 4, rPhl p 7, rPhl p 12, rArt v 3 are generally not defined in the control group children.
Conclusions. Birch related PFS are common in Ukrainian pollen-allergic children with nuts and fruits predominantly implicated. Sensitization profile of children with Birch-pollen syndrome is complex and associated with sensitization to panalergens. Clinicians should be worried of PFS in patients with a high degree of sensitization to birch pollen and even young children if they have birch sensitization
EVALUATION OF CENTRIFUGING REGIMES FOR THE PURPOSE OF OPTIMIZING THE PLATELET RICH PLASMA HARVESTING PROTOCOL
Get PDFAim: Based on the classical principles, to determine the optimal conditions for centrifugation, PRP harvesing (platelet-rich plasma). To conduct a quantitative assessment of the substrate obtained under different conditions of centrifugation.
Materials and methods. Based on the basic principles of obtaining platelet-rich plasma (PRP) by centrifuging in containers with an anticoagulant followed by phase separation to obtain the final substrate, the efficiency of the technique under the conditions of single and double centrifugation as well as under different conditions of acceleration and centrifugation was evaluated.
Blood for follow-up was collected from 20 healthy volunteers (11 men, 9 women) average 25.3±4.1 in syringes of LuerLock design with ACD-A anticoagulant solution, and centrifuged. Centrifugation was carried out under controlled conditions using a centrifuge with rotating bowls of the rotor. Centrifugation was performed at an acceleration of 100-400g in time intervals up to 20 minutes. Activation of the substrate was performed with calcium chloride solution.
Quantitative evaluation of platelets of whole blood and the final substrate of PRP was carried out with a semi-automatic analyzer.
Results. The obtained results demonstrate the maximum level of harvesting efficiency when performing double centrifugation in the 150g×15 min+250g×10 min mode. Subject to this centrifugation protocol, it is possible to obtain a substrate that complies with the standardized requirements for PRP.
The maximum level of an increase in the number of platelets in the substrate in comparison with whole blood is determined at the level of ×4.36 with concentration (volume reduction) x5 in comparison with the volume of whole blood.
Conclusions. This study demonstrated the advantage of double centrifuging modes over single modes.
According to the results of the study, it was possible to determine the conditions for an optimal double-centrifugation mode (acceleration and duration), which allows us to achieve the most efficient concentration of the substrate
DEVELOPMENT OF HPLC-MS METHOD OF VOGLIBOSE AND QUERCETIN QUANTITATION IN HYPOGLICEMIC ACTION TABLETS
Get PDFAim. The purpose of our study was to develop a method for simultaneous quantitation of voglibose and quercetin in a solid dosage form.
Materials and methods. The objects of the study were voglibose, quercetin, tablets containing voglibose - 0.2 mg and quercetin 100 mg. Measurements were carried out by high-performance liquid chromatography (HPLC) according to SPHU, supp. 1, 2.2.29, N, using the following equipment: a mass-selective detector Agilent 6530 Q-TOF was used as the detecting system.
Results. According to the developed method, the quantitative determination of voglibose and quercetin in the tablets of hypoglycaemic action was investigated. The following results were obtained: the content of C 10 H 21 NO 7 (voglibose) in one dosage unit of the test drug was 0.2 mg; and the content of C 15 H 10 O 7 (quercetin) -0.105 g, which suggests the validability of the proposed method for quantitation of the active substances in tablets for the prevention and treatment of type II diabetes mellitus.
Conclusions. In the course of the study, a method was developed for determination of voglibose and quercetin in a hypoglycaemic action preparation using high-performance liquid chromatography (HPLC) with a gradient mode of elution. It has been established that the chosen chromatographic conditions allow quantitative determination of the active pharmaceutical ingredients studied in a solid dosage form with a tolerance of ±5 %. Validation of the developed methodology has been conducted and its suitability for the simultaneous quantification of quercetin and voglibose in tablets has been demonstrated. The reproducibility of this method has been proved
CLINICAL CHARACTERISTICS OF MEN AND WOMEN IN YOUNG AND MIDDLE AGE WITH ARTERIAL HYPERTENSION AT DIFFERENT GALECTIN-3 PLASMA LEVELS ACCORDING TO THE RESULT OF LINEAR REGRESSION ANALYSIS
Get PDFThe aim of the research was to describe the clinical charachters of male and female patients with stage II arterial hypertension (AH) of young and middle age with different gradations of galectin-3 plasma levels according to multiple linear stepwise regression analysis.
Materials and methods: 160 patients with AH of different sex (male and female) and age (young (18–44 years), middle (45–60 years)) were examined (clinical, laboratory and instrumental). Multiple linear regression was used to determine the clinical presentation of patients with AH at different levels of the neurohormone (StatSoft's Statistica MultipleRegression v. 10.0 module). which were divided into groups that vi told for the entirely different patient characteristics. multiple linear regression was performed for each indicator separately and the results have been shaped in the form of regression equations.
Results. Patients with young and middle-aged AH have been found to be relatively high (RH) levels of galectin-3 associated with: the presence of a complex of metabolic risk factors – obesity and dyslipidemia; in combination with multiple features of structural and functional changes in the cardiovascular system, such as the presence of concentric left ventricular (LV) hypertrophy in combination with myocardial relaxation disorders (Е/e' aver>7.2) and signs of hemodynamic overload of the left atrium (LA) (LA volume index (LAVi)>34 ml/m2); the presence of valve dysfunctions in the form of mitral (1–2 degree) and aortic regurgitation (1 stage); the presence of structural remodeling of the carotid arteries (intima-media thickness (IMT)>0.91 mm). Plasma abdominal obesity was the most informative marker of RH galectin-3 in plasma, IMT>0.91 mm and LAVi>34 ml/m2.
Conclusions. The association of plasma galectin-3 levels with various clinical and instrumental indicators indicates a certain effect of the neurohormone on the course of AH in young and middle-aged male and female patients. Of indisputable interest is the determination of the features of the course of AH and the clinical profile of patients at different gradations (relatively low (RL), relatively moderate (RM) and relatively high (RH)) galectin-3 plasma level
THE METHOD OF FORECASTING OF THE INDICATORS FOR DRUG REIMBURSEMENT TO PATIENTS WITH CARDIOVASCULAR DISEASES IN UKRAINE
Get PDFThe aim of the study is to develop a method for forecasting the indicators for drug reimbursement to patients with cardiovascular diseases (CVD) in Ukraine within the framework of the government program “Available medicines”.
Materials and methods: materials of the State Statistics Service of Ukraine and medical records of patients with CVD, who were prescribed with medicines according to the government program, were used in the study.
Results: according to the method proposed for forecasting the volume of drug reimbursement to patients with CVD under the government program it has been found that Enalapril has the highest indicator – 10916.4 USD thousand in 2019 and 10736.8 USD thousand in 2020. Clopidogrel takes the second position – 12108.13 USD thousand and 11908.24 USD thousand, while Amlodipine occupies the third position – 9105.60 USD thousand and 8955.28 USD thousand.
Among the medicines not included in the government program, but prescribed rather frequently the largest forecasting amount required for reimbursement (in case of inclusion in the program) is 18910.55 USD thousand in 2019 and 18598.36 USD thousand in 2020 for Magnicor, and the least amount is 444.55 USD thousand and 437.22 USD thousand for Acetylsalicylic acid, respectively.
Conclusions. The government program to provide patients with effective and affordable medicines has a significant impact on reforming the healthcare system of Ukraine. The study conducted can be used to expand the government program in the process of formation and distribution of budget funds
DENTAL CARIES PROGNOSIS BY NEURAL NETWORK COMPUTER TECHNOLOGIES
Get PDFComputer technologies are widely implemented in clinical dental practice. The use of computer neural network programs in predicting dental caries as the most common dental disease is quite relevant.
The aim – to study the effectiveness of using the “CariesPro” computer program developed using neural network technologies in the individual prediction of dental caries in persons of all ages.
Materials and methods. We examined 73 persons aged 6–7, 12–15 and 35–44 years, in which the intensity of dental caries was determined taking into account the number of cavities, the hygiene condition of the oral cavity, the structural and functional acid resistance of the enamel of the teeth according to the enamel resistance test and its functional component. The data were added to a neural based computer software program “CariesPro” designed to predict dental caries. After 1 year, a second examination was performed and the dental caries obtained were compared with the individually predicted computer program.
Results. The highest intensity of dental caries was found in persons aged 35–44 – 6.69±0.38, in children 6–7 and 12–15 years it was 3.85±0.27 and 2.15±0.24, respectively (p <0.05). After 1 year, the corresponding intensity indices for persons of these age categories were 8.92±0.52; 6.27±0.35 and 4.23±0.2. The growth rates of caries intensity were, respectively, 2.23±0.25; 2.42±0.15 and 2.09±0.15. After comparing the re-survey data with the computer-programmed estimate, the probable number of carious cavities was found to be 61 true and 12 false predictions from the entire sample, the prediction accuracy of the constructed and trained neural network was 83.56 %.
Conclusion. The “CariesPro” computer program, developed using neural network technologies, allows to predict the number of carious lesions in a year with a probability of 83.56 %
THE INFLUENCE OF VAGINAL SUPPOSITORIES “MELANIZOL” ON THE SYSTEM OF LPO-AOS IN CONDITION OF MODEL OF A NONSPECIFIC VAGINITIS IN RATS
Get PDFIt is known that almost any pathology is accompanied by an imbalance of the lipid peroxidation (LPO) and the antioxidant system (AOS), and diseases of the female reproductive system are no exception. Thus, modern therapies of nonspecific vaginitis (NV) should include drugs with an antioxidant effect in the complex treatment, because the role of the LPO-AOS system in the mechanism for the development of NV is great. This problem can be solved by new complex drug with plant material with a wide spectrum of action.
Aim. The aim of our research was to study the effect of new vaginal suppositories “Melanizol”, containing metronidazole and tea tree oil on the system of LPO-AOS on a model of nonspecific vaginitis in rats.
Materials and methods. The study object was the new vaginal suppositories “Melanizol”. As reference drugs there were taken suppositories “Gravagin” and “Hippophaes oleum suppositories”. The study has been carried out on the model of experimental nonspecific (irritative) vaginitis caused in rats by the mixture of turpentine oil and dimethyl sulfoxide. Blood serum and vaginal tissue were used as the material for the study. Thiobarbituric acid-active products (TBA-AP) were determined as the component of a lipid peroxidation. The catalase (CAT), the superoxide dismutase (SOD) and the reduced glutathione (G-SH) were determined as the component of an antioxidant system.
Results and discussion. On the background of experimental vaginitis in serum and in vaginal tissue homogenate in rats, significant changes in indicators of the LPO-AOS were noted. Change of these indicators show a systemic response of the body to pathological changes in the vagina, which is manifested in the depletion of AOS and activation of the LPO. The vaginal suppositories “Melanizol” in the study on the model of nonspecific (irritative) vaginitis in rats showed an antioxidant effect. Suppositories “Melanizol” significantly reduce the level of TBA-AP, interfering with lipid peroxidation processes, and restore the level of G-SH, as well as the activity of SOD and catalase in the blood and in the vaginal homogenate, helping to protect the cell membranes. Suppositories “Melanizol” significantly exceed the reference suppositories “Gravagin” and are not inferior to the reference drug “Hippophaes oleum suppositories” in activity to reduce the level of TBA-AP, and to restore the level of G-SH, as well as restoration the activity of SOD and CAT. Antioxidant activity of vaginal suppositories “Melanizol” can be explained by the presence of tea tree oil and metronidazole in their composition, which is confirmed by literature data.
Conclusions. The conducted researches have shown that the new vaginal suppositories “Melanizol” demonstrated antioxidation activity. Results of this experiment allow us to recommend them for the further studies as medication for the treatment of nonspecific vaginitis
EXPERIMENTAL APPROVAL OF THE EFFICACY OF THE COMBINED COMPOSITION RECTAL CREAM NEW TEST-SAMPLES IN THE CONDITIONS OF ACUTE COMPLICATED ANAL FISSURE IN RATS
Get PDFAnal fissure (AF) is one of the most common anorectal problems. The severity of the disease, the chronicity of the pathological process and frequent complications lead to a sharp deterioration in the quality of life of patients. An important place in the treatment of anal fissure is occupied by drugs that affect its key mechanism of pathogenesis, namely, reduce the muscle tone of the internal anal sphincter and have anti-inflammatory, analgesic, and reparative properties.
Aim: conducting of screening studies of the effectiveness of new test samples of rectal cream of the combined composition (RCCC) on the model of acute complicated anal fissure in rats and determining the optimal composition of the potential drug.
Materials and methods. The research was conducted on the basis of the Central Scientific Research Laboratory of the National Pharmaceutical University (CSRL NUPH) in the spring (April) season of 2015 on the female rats.
A study of test specimens of the rectal cream of the combined composition was performed on a modified model of acute anal fissure. The effectiveness of the treatment was evaluated in terms of (0 to 2) severity of edema, hyperaemia, local bleeding, purulent necrotic processes, scapular formation, anatomical defect, and a general indicator of the severity of the pathological process (by the sum of the points for all the criteria that were analyzed). The level of proinflammatory PGE2 in serum was determined by the immune enzyme method.
Results. The RCCC sample No. 4 showed the most expressive therapeutic effect among the four samples under study, and had credible benefits to the inhibitory effect on purulent-necrotic processes, as expressed by the differences in the overall rate of the pathological process (6 days: 5.83±0.47 points against 7.00±0.37; 7.83±0.31 under the influence of RCCC No. 2, No. 3, respectively, and for 11 days 5.00±1.03 versus 6.83±1.28 points (p=0.08 ) under the influence of RCCC No. 1). The ability of RCCCs No.1 and No.4 to reduce the level of pro-inflammatory PGE2 in blood serum of rats compared with CP in 1.8 and 2.0 times, respectively, contributed to accelerating epithelization and scar formation. The advantages of RCCC No. 4 on the comparison of the ointment "Proctozan" with the reduction of the period of epithelization of the defect of the mucous membrane of the anal canal for 3 days (for 7 days – RCCC No. 4, for 10 days - ointment "Proctozan").
Conclusions. The rectal cream of the combined composition No. 4 showed the greatest efficacy, had advantages over the comparison ointment "Proctozan", and is promising for the creation on its basis a new drug for the treatment of anal fissures
MUSCLE SPASTICITY AND ITS INTERACTION WITH MYOFASCIAL SYSTEM OF CHILDREN WITH CENTRAL PARESIS
Get PDFTraditionally, the problem of muscle spasticity was considered by experts as a kind of local problem associated with the inhibition or traumatisation of the central motor neuron in a certain part of its path. According to this approach, only the first stage of the causal relationship of the two systems was reflected: the nervous and the muscular systems. In the following, intrasystem relations of the muscle and muscle complex appeared according to the type of harmonization or destructivization of the activity of this system. To resolve this problematic situation, the article examines the original theory of Thomas V. Myers about “anatomical trains” or “myofascial meridians” as an integral musculoskeletal system of the human body, which forms the basis of its anatomy and motor activity. Key ideas of tensegrity as a structure of balanced compression-tension of the musculoskeletal system are identified, and it is necessary to rush to the targets, carrying out the correction of motor disorders of the tender age children with paresis of central type by means of physical education. For deeper understanding of the activities of these mechanisms of children myofascial status harmonization, the main myofascial lines were briefly characterized: surface back line, surface frontal line, lateral line, spiral line, arm lines. On this basis, working hypothesis was formulated as for using the holistic myofascial system capabilities of the child’s body to correct both the tonic state of individual spastic muscles and to improve the general children motor status. To check the formulated hypothesis, the directions of the implementation of correctively directed physical education of tender age children with central paresis of different localization levels were indicated. An attempt was made to use the basic knowledge of the myofascial meridians functioning to increase the efficiency of diagnosing the state of musculoskeletal formations of children with spastic paresis, developing strategies and tactics for correcting their tonic state, methods and techniques for adjusting the balance of compression and tension of these structures to improve children motor activity and to improve the efficiency of their basic motor regimes mastering. There was made a fundamental conclusion that the correctional work by means of physical education should be preceded by preparatory work aimed at normalization of the whole myofascial system of a child with a spastic type of movement disorders, which can be carried out using purely medical techniques and the techniques based on the means of children physical education. Prospects of the scientific and practical development of the problem indicated in this article are highlighted separately