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ANALYSIS OF COMPLICATED CERVICAL ECTOPY CLINICAL COURSE AND RECURRENCE
Get PDFPhysiological cervical ectopy (CE) is commonly found in young women, during pregnancy or intake of oral contraceptives. The complicated (pathological) CE, particularly in conditions of vaginal microbiota disturbances and human papillomavirus (HPV) infection, requires intervention, including optimal treatment and effective relapse prevention approaches.
Aim. The aim of the research was to investigate the complicated CE clinical course and recurrence features on the basis of a retrospective analysis of archival medical records in order to optimize the tactics of the complicated CE management and the relapse prevention measures.
Materials and methods. In the observational cross-sectional retrospective study using the continuous sampling method were included 740 case reports of women, who underwent inpatient treatment of gynecological pathology in Lviv Municipal Clinical First Aid Hospital in 2006–2017. The inclusion criterion was the presence of firstly diagnosed or recurrent CE. Exclusion criteria: absence of CE colposcopic or morphological confirmation, presence of physiological CE (on conditions of cytological, bacterioscopical, bacteriological and colposcopical abnormalities absence). Subsequently, three groups were formed: control group (n=150) – healthy women, who applied for a regular gynecological examination; group 1 (n=483) – women with firstly diagnosed CE; group 2 (n=257) – women with recurrent CE. Differences in mean values were considered significant with a probability level of at least 95 % (p<0.05).
Results. Patients with recurrent CE had more pregnancies (p<0.05) than the ones with firstly diagnosed CE and women of control group. The proportion of women with high parity in group 1 and group 2 was three times higher (p<0.05), than in group 3. The proportion of artificial abortions in patients of groups 1 and 2 was more than two times higher (p<0.05), than in women in the control group, group 2 patients had more miscarriages and missed miscarriages(p<0.05) in comparison to the control group. Menarche in patients with recurrent CE set in later in comparison to women of control group (p<0.05). In group 2, the proportion of women with polymenorrhea was three times higher (p<0.05), than in group 1 and control group respectively. The compromised gynecological history was more often (p<0.05) detected in group 1 and group 2, than in the control group. In patients with recurrent CE a third of gynecologic diseases in the history (32.30±2.92 %) and 23.60±1.93 % - in patients with the firstly diagnosed CE were pelvic inflammatory diseases, significantly (p<0.05) higher in comparison to the control group (3.33±1.47 %). Almost half of patients in group 1 (48.25±2.27 %) and group 2 (47.84±3.13 %) had the history of frequent infectious diseases, this indicator was significantly (p<0.05) higher in comparison to the control group (24.67±3.52 %). In patients with recurrent CE chronic diseases of different etiology were diagnosed more often (p<0.05) - their share made up 8.24±1.72 %, while in patients with firstly diagnosed CE - 4.33±0.92 %, in women of the control group - 1.33±0.94 %.The firstly diagnosed CE was more frequent (in comparison to recurrent CE) (p<0.001) characterized by asymptomatic course, whereas about half of patients with recurrent CE (46.69±3.11 %) presented with different complaints. Cytological indicators of cervicitis were found more often in patients with firstly diagnosed and recurrent CE, than in women of control group, as well as vaginal candidosis (p<0.05). Patients with recurrent CE more often (p<0.05) underwent diathermoconization (24.12±2.67 %) and cryodestruction of the cervix (8.17±1.71 %) in comparison to patients of group 1. The most often performed treatment method in patients of both groups was diathermoconization. Treatment methods aimed to restore the hormonal balance, to normalize the state of vaginal microbiota were rarely found in both group 1 and 2, drugs that affect the reparation and regeneration of the epithelium have not been used in any case.
Conclusions. Recurrent symptomatic complicated CE should be interpreted as a complex problem that requires a multi-polar approach aimed at hormonal homeostasis, local immunity, and vaginal biocenosis normalizing. These measures should precede invasive treatment and further create optimal conditions for regeneration of the cervix
DIAGNOSTIC METHODS OF CANINE TRANSMISSIBLE VENEREAL SARCOMA
Get PDFModern diagnostic of oncological diseases, along with classical clinical and morphological methods, provides for the mandatory use of instrumental immunological, immunocytochemical and molecular genetic research methods. The main tasks of such a complex of diagnostic measures are aimed at monitoring oncological diseases at all stages of the diagnostic and treatment process, namely: the detection of a tumor at early stages of its development and the study of changes in metabolic processes in the body under the influence of neoplasms, morphological confirmation of the diagnosis, identification of histostructure and histogenesis of the tumor, determination the degree of its malignancy, detection of metastatic lesion (regional and distant lymph nodes and other organs) or assessment of the risk of its occurrence. It is well know that the early stages of oncological diseases are difficult to diagnose. At the same time, early detection of the disease can save or significantly extend the life of the patient. In such cases, the determination in the blood of specific substances, which are produced by tumors of the respective organs, the so-called oncomarkers, has been successfully used by world medical practice for more than 40 years to establish the affected organ. In combination with instrumental methods (ultrasound, endoscopy, X-ray), diagnostic efficiency is sharply increasing. Successful treatment of malignant tumors is possible under the conditions of their early detection and thorough histological diagnosis. Almost 50 % of the total number of oncologically diseased dogs has tumorous processes in the tissues of their genital organs, aggressiveness and metastasis, which often leads to lethal consequences, even after radical interventions. The aim of our research was to study the histological, cytological and immunohistochemical characteristics of transmissible venereal sarcoma. It has be en established that histologically, the tumor belongs to the low-differentiated round-cellular sarcoma of the alveolar type. Typical is tumor infiltration by lymphocytes, plasma cells, macrophages. Tumor cells are characterized by the presence of a mesenchymal marker vimentine. A positive local reaction on myogenin, cytokeratin and negative on CD31, CD34, S-100 protein and desmin was observed
EFFICACY EVALUATION OF THE PHYTOTHERAPEUTIC DRUG CANEPHRON N IN THE COMPLEX TREATMENT OF PATIENTS WITH UROLITHIASIS USING EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY
Get PDFThe study objective was to analyse the effect of the herbal drug Canephron N, namely, its ability to potentiate the efficacy of extracorporeal shock wave lithotripsy (ESWL) in the treatment of patients with urolithiasis (UL) and prevent recurrence of stone formation.
Aim. To сheck the hypothesis that treatment with Canephron N can potentiate lithotripsy and reduce the risk of re-stone formation.
Methodology. Patients at the age of 18 to 65 years had calcium oxalate urolithiasis with the size of the stone from 0.8 to 1.3 cm in the kidneys and from 0.5 to 0.9 cm. in ureters who underwent ESWL procedure. They were randomized into 2 equal groups of 30 people. The treatment group received general recommendations on the management of the patient with UL following ESWL and the herbal drug Canephron N for 6 months. The control group received only general recommendations. Moreover, according to condition, both groups received painkillers and spasmolytics if pain occurred during elimination of fragments. The following parameters were evaluated: the period of elimination of fragments after stone disintegration by ESWL method; the percentage of complete elimination of fragments; the presence of pain syndrome and leukocyturia in the postoperative period; the rate of recurrence of stone formation during one year after the procedure.
Results. More complete and rapid elimination of fragments was observed in the treatment group. Thus, up to day 14 elimination of stone fragments was observed in 96.6 % of patients in the treatment group versus 76.6 % in the control group. Fewer cases of pain syndrome during elimination of stone fragments (23 % in the treatment group and 43 % in the control group) and rare cases of leukocyturia within 14 days (10 % versus 23 %, respectively) were observed in the treatment group. Recurrent stone formation within the year was not observed in patients of the treatment group, in the control group – in 23 % of patients. However, because of the small size of the groups, one may talk about a tendency but not about statistically significant patterns.
Conclusion. Canephron N is an effective and safe drug in the treatment of patients with urolithiasis who underwent extracorporeal shock wave lithotripsy. Its use contributes to more rapid and safe elimination of fragments of destructed calculi and reduces risk of recurrent stone formation
CHANGES IN THE CELL SQUAD OF ILIAC LYMPH NODES OF WHITE RATS IN CASE OF LONGTERM INFLUENCE OF NALBUFIN
Get PDFThe article presents data on the change in the cellular composition of the lymph nodes of the white rats, males of reproductive age, who received intramuscular opioid analgesics - nalbuphine every day for six weeks. The weekly dose of nalbuphine was gradually increased, creating a model of physical opioid dependence according to the patent of Ukraine No. 76564 U. All experimental animals were divided into 8 groups.
Morphometric method was used to determine the relative number of cells of the lymphoid series - small, medium and large lymphocytes, blasts and plasmocytes in the cloak zone and the embryonic center of the secondary lymphoid nodes and brain strands of the lymph nodes. Morphometric studies were performed using a system of visual analysis of histological preparations.
It was established that nalbuphine in the lymph nodes causes reactive and destructive changes: the number of large lymphocytes increases in all structural components of the lymph node with a maximum after 4 weeks, respectively, the relative number of small lymphocytes decreases in the nucleus centers and brain tracts, the relative number of plasmocytes in the brain strains increases sharply . In all structural components of the lymph nodes hemocapillaries and venules are dilated and full-blooded, around vascular edema and partial damage to the walls of the microvessels.
One week after the discontinuation of nalbuphine, the relative number of lymphoid cells in the structural components of the lymph nodes does not return to the indicators of intact animals, no reversible changes are noted
THE ROLE OF MAGNETIC RESONANCE IMAGING IN THE DIAGNOSIS OF DEFORMING ARTHROSIS OF PROFESSIONAL ETIOLOGY IN MINERS
Get PDFThe paper analyzes the effectiveness of magnetic resonance imaging with cartilage diagram in diagnosing signs of professional deforming arthrosis of knee joints in miners working in conditions of significant physical loading.
Aim of the research – to determine of diagnostic efficiency of indicators of magnetic resonance imaging of the knee joint and cartilage diagram in miners of the main occupations suffering from deforming arthrosis.
Methods. The research is conducted in 30 miners of basic occupations: 20 mining workers of breakage face (MWBF) and 10 machinists of shearer mining machines (МSMM) have been treated in the inpatient department of occupational pathology of the Lviv Regional Clinical Hospital in 2015-2017 due to deforming arthrosis. Damages of the main anatomical elements of the knee joint with arthrosis were analyzed, visualized initially with the help of MRI, and then - cartilage diagram.
Results. According to the MRI data, in miners of the main occupations with arthrosis of the knee joint the posterior cross-shaped ligament are most commonly affected (in 75.0±9.7 % MWBF and 70.0±14.5 % МSMM), damage to the medial collateral ligament are diagnosed less frequently (in 5.0±4.9 % in the MWBF and in 10.0±9.5 % in the МSMM). On average 3.8±0.4 modified elements of the knee joint are visualized in patients, whereas 4.8±0.1 affected areas are visualized on the cartilage diagram (р<0.05). In 86.7±6.2 % patients, in the analysis of cartilage diagram, changes in all five analyzed areas are diagnosed, indicating a higher efficiency of the diagnosis of changes in the structures of the joint with DA of the professional etiology of the method of cartilage diagram compared with MRI. According to the cartilage diagram the most significant changes are noted in the hypertrophy of the femur: among all miners 62.5±0.3 ms (medial) and 62.6±0.4 ms (lateral), in the MWBF group the average time of Т2-delay is the largest in the area of the medial hypertrophy of the femur is 60.9±2.3 ms, in the МSMM group – in the area of the lateral hypertrophy of the femur: 66.7±3.3 ms, which can be linked to the peculiarities of the forced working position of miners of these professions and the kinetics of joint structures.
These results can be used to diagnose the initial lesions of joint structures with DA of professional genesis, as well as the creation of prognostic models for determining the the degree of risk of development of knee joint damage, which will allow to improve the system of personified approach to diagnostic and preventive measures in working persons in conditions of considerable physical activity and forced working position
FEATURES OF CONNECTIVE TISSUE METABOLISM AND MICROELEMENTS IN BLOOD SERUM OF PREGNANT WOMEN WITH CERVICAL INSUFFICIENCY
Get PDFThe preterm deliveries are the leading cause of the perinatal morbidity and represent important mortality indicators. Functional cervical insufficiency, which is a phenotypic manifestation of undifferentiated connective tissue dysplasia, plays the main role in the development of pregnancy complications in primigravidas (women pregnant for the first time) and primiparas (women giving birth for the first time).
Aim of the research: to study the indicators of connective tissue metabolism and basic microelements in order to determine the role of undifferentiated connective tissue dysplasia in the pathogenesis of functional cervical insufficiency during pregnancy.
Methods. The 101 pregnant women (the main group) at the 22–32 week gestation period which were diagnosed with “Functional cervical insufficiency” were examined, as well as 34 pregnant women with the physiological obstructive function of the cervix (the control group). Utilizing immunoenzyme analysis we measured in blood serum the concentration of Total P1NP the amino-terminal propeptide of procollagen type I a marker of synthesis, and β-CrossLaps resorptions marker of the connective tissue. Utilizing the automatic analyzer of electrolytes and a set of reagents for their determination we estimated the content of microelements Na+, K+, Mg2+, Ca2+ and total Ca and P.
Results. The functional cervical insufficiency in pregnant women was indicated by cervical shortening up to 22.88±1.02 mm, and the majority of women (76.2 %) had phenotypical manifestations of undifferentiated connective tissue dysplasia. We found a significant increase in the concentration of marker of synthesis Total P1NP, whereas the concentration of resorption marker β-CrossLaps remains normal, and strong reverse correlation (r=–0.7362) between the index of cervix length and concentration of marker of connective tissue synthesis Total P1NP. We detected a significant increase in the concentration of total and ionized calcium, total phosphorus, deficiency of ionized magnesium, potassium and sodium that lead to changes in the structure of connective tissue and reduction of cervical obstructive function
RESEARCH OF CERTAIN PATHOGENIC CHARACTERISTICS OF CLINICAL ISOLATES OF STAPHYLOCOCCI OF SKIN BIOME
Get PDFA serious problem in patients with atopic dermatitis (AD) is the frequent attachment of a secondary skin infection. Among the microbes colonizing the skin of patients suffering from AD, S. aureus takes the lead. According to different authors, from the skin of 80–95 % of patients are sown Staphylococcus aureus. The survival of bacteria in a biotope is promoted by the persistent properties of microorganisms.
Aim of the research: to determine the adhesive properties and antilysozyme activity of clinical strains of staphylococci isolated from the skin of patients with allergic dermatosis.
The study included 50 patients with atopic dermatitis and 20 practically healthy individuals, from which 140 laboratory strains of staphylococci were isolated: 101 strains from patients with AD and 39 control strains. Bacteriological studies to isolate microorganisms and determine a number of pathogenic characteristics were carried out using the methods of classical bacteriology.
The severity of antilysozyme activity (ALA) and adhesive properties of strains isolated from affected areas of the skin was significantly higher than in cultures isolated from intact skin areas, both qualitatively and quantitatively. The obtained data made it possible to assume a certain complicating role of these factors on the course of AD
DIAGNOSTIC VALUE PARAMETERS OF ACUTE PHASE REACTANCES OF INFECTIOUS-INFLAMMATORY PROCESS IN DIAGNOSTICS OF EARLY NEONATAL SEPSIS
Get PDFAn advanced progress of clinical neonatology in recent years has enabled to achieve considerable success in newborn management with due respect to both medical treatment and general care, especially in the group of neonates with low body weight at birth. At the same time, neonatal sepsis in the early period still predetermine sickness and mortality of newborns.
Material and methods. Clinical-paraclinical indices with detection of diagnostic value of C-reactive protein and interleukins-6 and 8 were evaluated in 100 neonates with available susceptibility factors to early neonatal infection from mother’s side and clinical signs of organ dysfunction in neonates with precautions of generalized infectious-inflammatory process at the end of their first day of life.
Results. The data obtained substantiate that low concentrations of IL-6 and IL-8 prevail, and therefore the mentioned mediators hardly can be used to verify early neonatal infection. In the majority of children C-reactive protein elevated the concentration of 10.0 mg/L which is traditionally considered to be a discriminant as to the verification of an infectious process in newborns.
Conclusions. None of the clinical signs associated with infectious-inflammatory process in newborns in the first two days of their life enabled to verify reliably availability of systemic bacterial infection
ASSESSMENT OF RISK FACTORS OF SEPTIC COMPLICATIONS OF THE PUERPERIUM
Get PDFPostpartum purulent-septic complications (PPSC) and their problems are most urgent for modern obstetrics due to their significant frequency. Maternal sepsis is one of the leading causes of maternal mortality around the world, accounting for about one-tenth of the global number of maternal deaths. Understanding the risk factors for the development of septic complications of puerperium is important for preventive strategies.
Aim. To study the possibility of forming high-risk groups on the basis of analysis of anamnestic data and the course of puerperium in women with PPSC as part of the preventive measures for the development of such complications.
Materials and methods. The first stage of the study involves a retrospective analysis for the allocation of risk factors for the development of PPSC in women, who underwent inpatient treatment for this pathology - main group (n=108); сontrol group (n=35) – parous with uncomplicated flow of the postpartum period. Prospective research enrolled 65 pregnant women with extragenital pathology and/or complicated pregnancy (group 1); 30 pregnant women without severe concomitant somatic pathology with physiological course of pregnancy (group 2). The following were taken into account: age, obstetrical and gynecological history, extragenital pathology, laboratory diagnostic data. Differences in mean values were considered significant with a probability level of at least 95 % (p<0.05).
Results. To the risk factors for the development of PPSC, we classified as follows: gynecological diseases in history: menstrual dysfunction, chronic inflammatory diseases of the genital organs, bacterial vaginosis; complications of pregnancy and labor: preeclampsia, preterm labor, premature rupture of membranes, long anhydrous span, chorioamnionitis, weakness of labor, genital tract ruptures, placental attachment pathology, operative vaginal birth, bleeding; concomitant extragenital pathology: diabetes, obesity, diseases of the urinary system, diseases of the cardiovascular system, respiratory diseases, varicose disease, anemia.
Conclusions. The connection between the presence of concomitant somatic pathology, the complicated course of pregnancy and labor and the subsequent development of septic complications in the postpartum period have been established. Prediction of the risk of their occurrence at the stage of pregraviditic preparation, with various complications of pregnancy and childbirth, especially in women with extragenital pathology, differential prevention will reduce the frequency of PPSC
STUDY OF ACUTE TOXICITY OF A NEW VETERINARY DRUG FOR INTTRAMMARY INTRODUCTION
Get PDFPreclinical studies of veterinary medicinal products are important and compulsory studies in the development of new dosage forms. The aim of preclinical research is to determine the toxic effect and therapeutic efficacy of the test substance-the future dosage form, its effect on the body's basic systems, as well as the identification of possible side effects.
This work is part of the research on the development of the composition and technology of the veterinary drug - a solution for intramammary application, conventionally called "Argocide", intended for the treatment of mastitis in cattle.
A study of the acute toxicity of the intramammary veterinary drug was carried out in experiments on white rats of both sexes, according to the requirements for potential medicines. The establishment of the value of the average lethal dose (LD50) of the veterinary drug "Argocide" with intramuscular single administration to white mature rats is impossible due to the absence of animal death even when the drug is administered at doses exceeding 5.0 ml/kg. This experiment allows the veterinary preparation "Argocide" to be classified as practically non-toxic compounds (V class).
The analysis of the results of the conducted studies indicates the relative harmlessness of the potential drug for veterinary medicine and allows us to foresee that the "Argocide" preparation can be classified as low-risk substances, which justifies the expediency of its further study and introduction into practice