EUREKA: Health Sciences
Not a member yet
407 research outputs found
Sort by
PROGNOSTIC VALUE OF IMMUNOHISTOCHEMICAL MARKERS IN PATIENTS WITH DIFFUSE LARGE B-CELL LYMPHOMA
Get PDFDiffuse large B-cell lymphoma (DLBCL) is a potentially curable disease, but standard treatment is not effective enough for all patients. That is why so important to identify high risk patients who need more aggressive therapy at the time of diagnosis. Nowadays prognosis for patients with DLBCL is based on International prognostic index (IPI). However, this index consists of only clinical parameters and does not include the biological characteristics of the tumour. Immunohistochemistry (IHC) markers could also play a prognostic role. There are some publications regarding predictive and prognostic role of expression of Bcl-2, Bcl-6, MUM1, CD10 and CD30, but their results are controversial. The aim of our study was to analyze prognostic role of these markers, to compare survival of patients with positive and negative expression of these markers and to build a prognostic model which include biological parameters for identifying high risk patients. There were statistically significant differences in EFS between the group of patients with negative and positive expression of CD10 (51.5 % versus 72.5 %, р=0.01) and in OS between the group of patients with negative and positive expression of Bcl-6 (61.1 % versus 79.6 %, р=0.03). Six-factors nonlinear neural network prediction model (MLP_6) was built. The sensitivity of the model is 63.2 % (95 % CІ 49.3 % – 75.6 %), specificity – 85.2 % (95 % CІ 79.1 % – 90.1 %). Prognostic factors include negative IHC expression of Bcl-6, CD10, non-GCB molecular subtype (according to algorithm Hans), gender (male), advanced Ann-Arbor stages, >2extranodal involvement. Our nonlinear neural network prediction model could improve prognostic role of IPI by adding of biological tumour characteristics (IHC expression of CD10, Bcl-6, molecular subtype by IHC algorithm)
EVALUATION OF THE THERAPEUTIC AND PREVENTIVE POTENTIAL OF THE MEDICINAL PRODUCT CANEPHRON N IN THE TREATMENT OF GESTATIONAL PYELONEPHRITIS IN PREGNANT WOMEN
Get PDFBackground: Gestational pyelonephritis (GP) is one of the most common and serious diseases of the middle and second half of pregnancy, which complicates approximately 6 % of pregnancies, and is one of the leading causes of non-obstetric pre-delivery hospitalization.Methods. The paper provides data from the open, multicentre, prospective, comparative (parallel group) study in 60 pregnant women diagnosed with gestational pyelonephritis, which were divided into two groups 30 subjects each. Patients in the treatment group received antibacterial therapy for 7 days + treatment with standard dosage of medicinal product Canephron N for 3 months. Patients in the control group received antibiotic therapy alone for 7 days.Results. The average age of pregnant women at the time of diagnosing was 23±6.23 years; it was the first pregnancy for 39 women (65 %). The most common complaints at admission to the in-patient department were as follows: lumbar pain (96.2 %), dysuria (70.2 %), rise in temperature above 38°C (64.4 %). Leukocyturia and bacteriuria were detected in 100 % of cases with prevalence of E. coli in 84.2 % (101 of 120) of cases. By 30 day in GP patients in the treatment group bacteriuria was detected in 2/30 (6.67 %) patients, and in the control group – in 5/30 (16.7 %) patients (p 1: 2 <0.05), by 60 day in the treatment group – 2/30 (6.67 %), in the control group – 8/30 (26.7 %) (p 1: 2 <0.05), respectively, by 90 day – 3/30 (10 %) and 10 (33.3 %), respectively (p 1: 2 <0.05). The disease relapsed in 1 of 30 (3.33 %) GP patients in the treatment group and 3/30 (10 %) patients in the control group (p 1: 2 <0.05) and 3/30 (10 %) patients in the treatment group with CP, and 7/30 (23.3 %) patients in the control group during the follow-up period (p 1: 2 <0.05).The use of the herbal medicinal product Canephron N in pregnant women with gestational pyelonephritis and in the acute exacerbations of chronic pyelonephritis has shown its high efficacy and undoubted therapeutic and prophylactic effect, good tolerability and decrease in the frequency of relapses of pyelonephritis
COMPARISON OF THE QUALITY OF LIFE OF PATIENTS IN THE LOCALY ADVANCED BREAST CANCER FORMS AFTER SYSTEM AND INTRALYMPHATIC POLYCHEMOTHERAPY
Get PDFIn recent years, breast cancer (BC) is the most common cancer pathology and the most common cause of disability among women in developed countries. Finding the most effective ways of interaction between the patient and the doctor creates the preconditions for the necessary analysis of the treatment process from an objective and subjective point of view. Therefore, an important indicator to be taken into account is the quality of life of a patient.
To compare the indicators of a comprehensive assessment of the quality of life of patients to the adverse locally advanced forms (LA) of breast cancer before and after systemic intravenous polychemotherapy (SPCTx) and selective endolymphatic polychemotherapy (ELPCTx) in neoadjuvant mode.
The study was conducted on the basis of a random analysis of outpatient cards from 112 patients with LA BC T4A-DN0-3M0 who received a comprehensive antitumor treatment on the basis of the Donetsk regional antitumor center and the University Clinic of the Odessa National Medical University from 2000 to 2017, which was proposed a questionnaire at various stages of preoperative treatment. The first (control) group consisted of 65 patients (58 %) with inoperable forms of LA BC, which was performed in neoadjuvant mode by SPCTx. The second (study group) included 47 patients (42 %) with inoperable forms of LA BC, which was performed as a neoadjuvant course ELPCTx.
According to the integral indicators of quality of life and quality of health between patients in the control and study groups, there was no statistically significant difference. In a detailed analysis of the indicators of symptomatic scales, the difference between the groups did not exceed the critical. Based on the results of a study conducted among patients receiving endolymphatic chemotherapy in a neoadjuvant mode, the subjective evaluations of treatment in absolute numbers have better reference values without statistical superiority.
The study of the integrative indicator of quality of life and its discrete elements is an ergonomic and economical means of heuristic assessment of the health of patients in order to further develop more rational and convenient ways of solving urgent issues of modern oncology by increasing compliance and finding a compromise between the physician and the patient
COGNITIVE DISORDERS IN PATIENTS WITH PARKINSON'S DISEASE ON THE BACKGROUND OF AUTOIMMUNE PATHOLOGY
Get PDFParkinson's disease (PD) is a progressive neurodegenerative disease characterized by the predominantly dopaminergic neuronal black matter degeneration. The multicentre study of PRIAMO (PaRkinson & non Motor symptom) showed that in 98.6 % of cases, non-motor symptoms (NMS) were observed in patients with PD. Cognitive impairment is one of the most common NMS PD. According to these studies, cognitive dysfunction develops in most patients at an early stage of the disease, with mild to moderate cognitive impairment. In the later stages of the disease, dementia occurs in 80 % of patients with PD.
Aim of the research. To study the peculiarities of cognitive impairment in patients with PD and autoimmune thyroiditis (AIT), their association with motor and non-motor disorders, and to assess the impact on the quality of life of patients.
Materials and methods of the research. 109 patients with PD aged 47 to 75 years were examined. The main group consisted of patients with IA and IB subgroups, control – IIA and IIB subgroups. General clinical and neurological examinations, evaluation of motor functions by the Unified Parkinson's disease Rating Scale (UPDRS), neuropsychological testing (MMSE, MoCA, FAB, BDI), Hamilton's Alert Scale (HARS), scale used for assessing autonomic disorders in patients with PD and Parkinson’s disease questionnaire (PDQ-39), statistical analysis using the "Statistica 6.0" program.
Results. Neuropsychological testing showed that MMSE, MoCA, and FAB obtained from patients with PD and AIT are lower compared to patients with PD. Analyzing the indicators of MMSE, FAB, and MoCA scales in dynamics, a statistically significant difference was found in subgroups of IB and IIB; in subgroups of IA and IIA – was not observed. During the analysis of the results of the neuropsychological testing, no association was found at the statistically significant level in the subgroups of IA and IB between the duration of the disease and MMSE, MoCA, and FAB scales. In the IA subgroup, in the initial review, feedback was observed on a statistically significant level of average strength between the level of anxiety and the indicator of the MMSE scale, an indicator of the MoCA scale. In the IA subgroup, there was no relationship at the statistically significant level between the indicators of neuropsychological testing (MMSE, MoCA, FAB) and motor and non-motor manifestations (depression, vegetative disorders). There was a connection at a statistically significant level between the indicators of neuropsychological testing (MMSE, MoCA, FAB) and motor and non-motor manifestations of PD in patients who received anti-parkinsonian therapy for a long period of time. The negative influence of the level of cognitive impairments on the quality of life of patients with PD and AIT was revealed, indicating the high medical and social significance of these violations.
Conclusions. Neuropsychological testing showed that MMSE, MoCA, FAB scores in patients with PD and AIT (IB subgroup) were lower compared to patients with PD (IIB subgroup). There was a connection at a statistically significant level between the indicators of neuropsychological testing (MMSE, MoCA, FAB) and motor and non-motor manifestations of PD in patients who received anti-parkinsonian therapy for a long period of time. The negative influence of the level of cognitive impairments on the quality of life of patients with PD and AIT was revealed, indicating the high medical and social significance of these violations
LEVEL OF GLYCATION END PRODUCTS AND GALACTIN-3 IN PATIENTS WITH CHRONIC HEART FAILURE AND ATRIAL FIBRILLATION IN DEPENDENCE ON THE AGE AND RENAL FUNCTIONAL
Get PDFAim. To analyze the changes of advanced glycation end products (AGE) and galectin-3, their relationship in patients with chronic heart failure (CHF) and atrial fibrillation (AF), depending on the renal functional and age.
Material and methods. 30 patients with CHF II-III FC according to the classification of the New York Heart Association (NYHA) with preserved systolic function were examined (EF >45 %, mean 58.73 [45.38, 88.00] %), mean age 66.86 [46.00, 85.00] years who were on treatment in the Regional Hospital afterI.I. Mechnikov. Men accounted for 60 % (18 people), women - 40 % (12 people). All patients were with AF: 17 (56.7 %) - with a permanent form, 13 (43.3 %) - with persistent. The serum creatinine level was determined and the GFR was calculated by CKD-EPI. The level of galectin-3 in the blood was determined by immunofermentive analis using the “Human Galectin-3 Platinum ELISA” kit (GmbH, Austria) on the Stat Fax 2100 (USA) immunofermentive plate analyzer. The fluorescent AGEs in plasma were analysed by quantitative autofluorescence (fluorimeter Hoefer DQ 2000, USA) with fixed spectrum of excitation at 460 nm with 20 % quinine solution as a standard with results expressed with conversion to glycated albumin.
Results. AGE (mean 1.579 [0.884, 2.796]) and galectin-3 (mean 8.542 [2.72, 17.73]) levels increased in 83.3 % (25 patients) and 23.3 % (7 patients) respectively. The level of galectin-3 increased with age (by 33.18 %, p<0.05), while the level of AGE did not have significant changes. Levels of AGE and galectin-3 increased with a decrease in GFR (by 18.9 %, p<0.05 and 18.44 %, p<0.05, respectively). The level of AGE and serum creatinine correlated to GFR (r=0.25, p<0.05 and r=-0.22, p<0.05, respectively), while the level of galectin-3 correlated to GFR (r=-0.16, p<0.05). Intake of irbesartan reduced the level of galectin-3 (by 21.66 %) and AGE (by 4.9 %). The level of serum creatinine was decreased (by 4.89 %) and GFR was increased (by 6.3 %) compared with the intake of ACE inhibitors (by 2.9 % and 1.02 %, respectively).
Discussion. The results showed changes in AGE with a decrease in GFR in patients with CHF and AF, which makes it possible to consider AGE, as a marker of cardiorenal syndrome and makes it promising to further study it. Galectin-3 showed itself not only as a diagnostic marker, but also as a dynamic (positive effect of using irbesartan). Irbesartan had comparable clinical efficacy with ACE inhibitors in patients with CHF and AF.
Conclusions. Among patients with CHF and AF, the level of AGE was increased 83.3 % of patients, galectin-3 - in 23.3 %. Depending on the age, priority was given to galectin-3 (an increase of 33.18 %, p<0.05). The levels of AGE and galectin-3 depends of GFR and were increased (by 18.9 % and 18.44 %, p <0.05 respectively). The use of irbesartan showed a more significant positive effect on the level of galectin-3 and AGE with GFR in the range <60≥30 ml/min/1.73 m2
DETERMINATION OF TECHNOLOGICAL PARAMETERS AND INDICATORS OF THE QUALITY OF NEW HERBAL COLLECTION
Get PDFRheumatic diseases include more than 1000 nosological forms, among which the highest incidence is osteoarthritis, rheumatoid arthritis and osteoporosis. The predominantly advanced age, the presence of comorbid diseases, the duration of the course of the disease and the need for concomitant treatment complicate the conduct of anti-inflammatory and analgesic therapy in such patients. Herbal medicines, in particular in the form of doses, due to the mildness of the action and the absence of significant side effects, can be used in the complex therapy of the acute period of rheumatic diseases, as well as for the prevention of relapse.
The aim of the presented work was to develop the composition, technology and determination of the quality indices of herbal collection, which reveals analgesic and anti-inflammatory properties and can be used for the prophylaxis and auxiliary therapy of a number of conditions in rheumatology.
Materials and methods. In the course of research, the methods used in the State Pharmacopoeia of Ukraine 2.0 (SPHU) were used.
Results. As a result of the analysis of literary data and our own experimental studies on the chemical composition and pharmacological activity of certain types of medicinal plant material, we have developed herbal collection that is recommended for the treatment and prevention of rheumatic diseases of the joints. Studies have been conducted on the development of quality collection indicators, which guarantee the effectiveness, safety, reproducibility of the imposed collection. The basic technological parameters of the raw material are determined: specific, bulk and volume mass, porosity, degree, degree of shredding. In order to prevent uneven mixing, an optimal degree of grinding of the raw material of the investigated collection, which ranges from 0.20 mm to 0.35 mm, is established, which allows obtaining a homogeneous mixture and contributes to the maximum yield of extractive and active substances. A series of experimental works aimed at studying the influence of the method of infusion (for 15, 30, 45, 60 minutes and until complete cooling) on the quality of the collected water extracts from the collection was conducted. The optimal method for setting the collection for 60 minutes is the best, since the content of extractives and flavonoids in the aqueous extract was highest and amounted to 49.57±0.52 % and 0.52±0.03 % respectively.
Conclusions. The composition of the herbal drug was developed: Harpagophyti radiх, Sophoraе alabastra, Valvae fructus Phaseoli vulgaris, Polygoni avicularis herba with the following ratio of components 50: 20: 20:10. The technological parameters of the raw material are studied: specific, volumetric and bulk mass, porosity, singularity of raw materials. The optimum degree of shredding of raw material is established, which helps to maximally remove biologically active substances and extractives. Experimental way is determined the optimal mode of collection, which can be recommended to the consumer to obtain the maximum therapeutic effect
ROLE OF THE PERICARDIOSCOPY IN THE TREATMENT OF PERICARDIAL EFFUSION
Get PDFIn recent years surgical treatment of pericardial effusion has been favoured by mini-invasive interventions. Pericardioscopy supplements it. In the literature actively discusses its expediency, efficiency and informativeness.
Aim of the study. Analyze our experience of using pericardioscopy during surgical treatment of pericardial effusion using mini-invasive interventions.
Materials and methods. From 2000 to 2017, 92 patients with pericardial effusion were operated in our clinic using mini-invasive interventions. Pericardioscopy was used in 72 (78.26 %) cases. In 32 (44.44 %) pericardioscopy was performed with subxiphoid pericardiotomy, in 40 (55.56 %) – with thoracoscopy on the right or left side.
Results and discussion. The use of pericardioscopy has allowed to significantly reduce the number of idiopathic pericarditis from 20.0 % to 5.56 % and increase the informativeness of the minimally invasive interventions by 14.44 % (χ2 = 4.11, with ν = 1, α = 5 %). There is no reliable difference in the number of relapses of the disease.
Conclusions. The use of pericardioscopy during mini-invasive interventions is safe and effective. The method of choice in most cases is subxiphoid non-pleural pericardiotomy with pericardioscopy
CORRECTION OF IODINE DEFICIENCY STATES AND DYNAMIC MODELING OF POSITIVE DYNAMICS OF INDICATORS OF THYROID FUNCTIONS BY SUPPLEMENTATION
Get PDFThe problem of iodine deficiency diseases (IDD) is recognized as relevant due to the significant prevalence of iodine deficiency among the population of many countries of the world, an increase in the incidence of diseases with a wide range of clinical manifestations and a marked tendency to increase the frequency and severity of IDD among children of all age groups
We carried out a clinical-anamnestic examination of the child's contingent (187 persons) aged 13–17 years living in an ecologically dependent biogeochemical endemic zone of iodine deficiency, the mountain region of the Zakarpattya region during the period from 2014 to 2015. To identify the pathology of the thyroid gland, a palpatory method of examination was used according to the methodology of the WHO / MRKIDZ, 2001. According to our data 80 pupils (42.8 %) had increased thyroid gland of 1 degree, they were allocated for further and detailed examination and identification of environmentally caused somatic effects. Preventive measures included taking the dietary supplement Yosen, the manufacturer of TOV “OmniFarm”, TU U 10.8-35758392-004: 2014 for 6 months. A statistical model for forecasting the dynamics of TSH with supplements with iodine and selenium has been developed. According to our data, the degree of positive changes (decrease of TSH, increase of T4) with supplements with iodine and selenium depends on the starting content of the microelement of iodine in plasma and / or urine: the lower is the initial level of iodine - the more pronounced is the effect of supplements
VARIABILITY OF THE HEART RHYTHM AS AN ADDITIONAL MARKER FOR DETERMINING VEGETATIVE FUNCTIONS IN PATIENTS WITH CHRONIC CEREBRAL ISCHEMIA
Get PDFAim. Practical cardiology is in constant search for non-invasive vascular risk markers. Heart rhythm reflects the body's response to various stimuli of the external and internal environment. Heart rate variability (HRV) has a prognostic and diagnostic value and allows timely identification of conditions that threaten life. The results of an instrumental examination of heart rhythm fluctuations in patients suffering from chronic cerebral ischemia against the background of angina pectoris of different functional classes allows to evaluate the prognosis of the disease and select the appropriate treatment.
Materials and methods. An assessment of the state of the mechanisms of regulation of physiological functions in patients suffering from chronic cerebral ischemia against the background of angina pectoris of different functional classes was obtained according to spectral and temporal analysis of heart rate variability using electrocardiographic monitoring. The spectral characteristics of the heart rate variability were studied: HF (high frequency), LF (low frequency), VLF (very low frequency).
Results. Heart rhythm regulation in patients with chronic cerebral ischemia occurred under the influence of neurohumoral mechanisms. The imbalance of functional systems was caused by changes in the autonomic nervous system, which disrupted the normal functioning of the sympathetic and parasympathetic parts. We marked decrease in the activity of the parasympathetic autonomic nervous system, which changed the indices of spectral analysis, while the high-frequency component of the spectrum was characterized by a decrease, while the low-frequency component was characterized by an increase. The progression of stable angina of tension (SAT) in patients with chronic cerebral ischemia (CCI) occurred with disruption of the autonomic nervous system (ANS) and was associated with a shift in the physiological response towards sympathetic activity. This was particularly pronounced in patients in group 2 with CCI on the background of SAT III FC, as the regulatory mechanisms were in a critical state of tension against the background of long-term chronic ischemia, they showed a high level of humoral modulation of regulatory mechanisms, which was manifested by excessive VLF and high-frequency oscillations.
Conclusions. A connection was established between the autonomic nervous system and chronic cerebral ischemia, which was expressed in the imbalance of the ANS, associated with reliable signs of the dominant sympathetic system, which was associated with the progression of stable angina of tension
EFFICIENCY AND SAFETY OF LEFLUNOMIDE TREATMENT IN PATIENTS WITH PULMONARY SARCOIDOSIS
Get PDFPatients who have contraindications to the prescription of GCs (glucocorticosteroids), or have developed serious side effects during treatment with GCs, as well as patients with resistance to GCs therapy, are prescribed immunosuppressants.
The aim of the research - to study the efficacy of leflunomide monotherapy in patients with pulmonary sarcoidosis with contraindications to prescription or serious side effects of glucocorticosteroids.
Fourteen patients with sarcoidosis of the respiratory system of stage II were examined – 12 women and 2 men aged 30 to 69 years. In 10 patients there were contraindications to the appointment of GCs (diabetes mellitus – 5, hypertension – 3, obesity – 1, exacerbation of gastric ulcer – 1), which caused the appointment of immunosuppressive therapy as a starting. In 4 cases, serious side effects of SCs were noted, requiring the drug to be abolished (osteoporosis – 3, steroid diabetes – 1). Leflunomide was administered at a dose of 20 mg per day, daily for 3 months. The evaluation of efficacy was carried out using computed tomography of the thoracic cavity organs, body plethysmography, spirometry and determination of the diffusivity of the lungs.
Monotherapy with leflunomide in patients with contraindications to prescription or serious side effects of GCs was successful in 7 out of 13 patients, in 2 patients there was a stabilization of the process, in 4 patients with leflunomide therapy progression of the disease was noted and in 1 case the treatment was discontinued due to serious side effects of preparation.
The results obtained make it possible to recommend the use of leflunomide as monotherapy in patients with pulmonary sarcoidosis with contraindications to the prescription and/or poor tolerability of GCs and methotrexate. It is necessary to continue studying the possibilities of combined use of leflunomide with other drugs of the first line