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VASCULAR PATHOLOGY OF AN EYE AND THE THREAT OF DEVELOPING AGE-RELATED MACULAR DEGENERATION AFTER RADIATION EXPOSURE
Get PDFOn the contrary to the previous expectations, the most common Chornobyl catastrophe victim’s pathology was the vascular pathology of an eye. The work is devoted to the assessment of changes in capillary tubes, arterioles and venules, which were irradiated as a result of Chornobyl catastrophe and those who have been exposed to radiation while working in the Chornobyl exclusion zone.
The results of eye vascular system examination is presented by 615 persons: 358 Chornobyl clean-up workers, inspected in 1993–1994, 2007–2008 and 257 participants of works at the «Shelter» object, that were inspected in 2007–2008 and in 2017.
Microcirculatory damages in conjunctiva are the most early ionizing radiation induced eye damage. Dose dependence from microcirculatory damages in conjunctiva has been proved. The conjunctiva index, which characterizes the evaluation degree of microcirculatory abnormalities value for individuals irradiated at a dose of up to 10 mSv was 5.33±0.34, at a dose of 10 to 30 mSv – 9.71±0.93. Thus, a significant (t=4.42, p<0.05) increase in the display of microcirculatory abnormalities in conjunctiva was revealed with an increase in the dose load. In the correlation analysis, there was found a direct connection, r = 0.48, between the conjunctiva index and the dose of irradiation.
The expressive tendency to correlate the negative dynamics of the macular zone with the degree of deterioration of microcirculation shows the effect of microcirculatory disorders on the development of age-related macular degeneration. At the correlation analysis, there was found a direct connection of significant decreased number of functioning capillaries with the deterioration of the macular zone of the retina (r=0.37). It is also advisable to appoint prophylactic complexes of lutein and zeoxanthine to patients in the case of microcirculatory disorders
THE LYMPH NODES IN RATS WITH EXPERIMENTAL TYPE 1 DIABETES MELLITUS (DM-1)
Get PDFThe aim is to study morphofunctional structure of NALT (nasal associated lymphoid tissue) and visceral lymph nodes of rats with experimental type 1 diabetes mellitus (DM-1) and to define the effectiveness of the treatment with herbal drug “Imupret”.
Materials and methods: The experiment involved 20 animals, divided into 4 groups: the 1st group was the control group of healthy rats, the 2nd group was the control group subject to prophylactic treatment with “Imupret, the 3rd group included rats with experimental diabetes, and the 4th group included rats with experimental diabetes subject to treatment with “Imupret. Functional changes in immune organs were evaluated by the results of morphometric analysis; morphological pattern was evaluated by histostructural changes.
Results. The research revealed that under conditions of diabetes mellitus type 1, the volume, area and density of the lymphoid tissue decreased, and only its "fine" cell was detected. The paper demonstrates the development of relative immune deficiency in immunocompetent organs in rats with diabetes mellitus type 1. The use of drug "Imupret" demonstrated its immunomodulatory function, which is especially important in terms of immunosuppression in patient with DM-1.
Conclusion. The received results are of a great clinical significance, and show the necessity of early prevention and treatment of immunity disorders under conditions of diabetes mellitus type 1
COMPARATIVE ANALYSIS OF THE EFFECTIVENESS OF CHRONOTHERAPY AND TRADITIONAL METHOD OF ALOPECIA AREATA TREATMENT
Get PDFAlopecia areata – is the one of widespread baldness forms, difficultly subjected to treatment. The method of chronotherapy that gains an essential circulation in Ukraine and throughout the world may play the important role in its solution.
Aim: to study the clinical effectiveness of chronotherapy for alopecia areata treatment.
Materials and methods. For attaining the set aim 108 persons with the diagnosis alopecia areata were examined and treated. Patients were divided in two groups. The main group included 45 persons – treated using the method of chronotherapy. The control group consisted of 67 persons, who received the traditional treatment of alopecia areata. The series of clinical, biochemical and immunological studies, directed on the assessment of the treatment effectiveness, were realized.
Results. The treatment of patients with alopecia areata by the method of chronotherapy is statistically reliably more effective than the traditional treatment of this pathology and provides the renewal of hair growth in 53,3 % of patients that is accompanied by normalization of alexin, sulfhydryl groups content, acid phosphatase activity, serine, asparagine acid, valine, threonine, alanine, cystine, leucine, isoleucine concentrations. The offered chronotherapy method has the expressed anabolic effect on patients’ organism. The menstrual cycle is normalized, pre-menstrual syndrome symptoms and aldodysmenorrhea disappear, patients’ working ability and state of health improve.
Conclusions. The obtained data deepen knowledge about the pathogenesis of alopecia areata at the biochemical and immunological levels and favor the rise of the effectiveness of diagnostics and treatment of this pathology. At the study the high chronotherapy effectiveness at treating alopecia areata was revealed and the possibility of its use for the effective treatment of a series of other pathologies was proved
FEATURES OF DENTAL IMPLANTS IN THE COMPLEX TREATMENT OF PERIODONTAL DISEASE
Get PDFAim: To Improve the treatment of patients with partial edentia and chronic generalized periodontitis by including dental implantation to the complex of therapeutic measures.
Materials and methods: There have been presented the results of 240 patients with varying severity degrees of generalized periodontitis who underwent surgery on periodontal tissues with dental implantation. The research was conducted at the OCH of Ivano-Frankivsk 2007–2017.To improve the efficiency for dental implants and periodontal surgical intervention is necessary to determine the quality of bone remodeling, identifying markers of bone tissue metabolism.
Results: It was established that in 40,81 % patients the results of research showed markers of bone remodeling indicating a high rate of bone formation (25,12±2,23 ng / ml) and a slight increase in rate of resorption marker, which results in low rates of bone resorption (8,54±1,23 nmol/L). These patients were not prescribed with osteotropic drugs. 50,83 % of patients with osteopenia were noticed to manifest the formation of bone possible raise of bone resorption (10.82±1.34n/mole), which was the indication for antiresorptive medication prescription. In 8,36 % of patients with osteoporosis was observed inhibition of bone formation processes (18,05±2,08 ng / ml) and increased resorption indices (15,34±1,87 nmol/L). Medications that stimulate osteogenesis and prevent bone resorption were prescribed.
Conclusions: When planning dental implants and periodontal surgical intervention it is necessary to identify markers of bone remodeling to assess the structural and functional state of bone tissue and prescribe osteotrophic drugs that promote positive postoperative period
PREOPERATIVE REVELATION OF INSULIN RESISTANCE AS A CRITERION OF DEBULKING NECESSITY IN PATIENTS WITH OBESITY
Get PDFThe article considers the questions of a necessity of widening the list of obligatory preoperative examinations of patients with obesity for the choice of adequate operation volume, especially for simultaneous debulking of a greater omentum. The aim of research is an estimation of possibility of using an insulin resistance index (НОМА – IR) as a necessity criterion of simultaneous debulking of a greater omentum at operative interventions in patients with obesity.
There were examined 60 persons from the surgical stationary, divided in 2 groups. 1 group included 20 patients with the normal body mass, 2 – 40 patients with different degrees of obesity. Insulin resistance was revealed on the base of glucose and insulin estimation, HOMA-IR index calculation.
It was revealed, that glucose level in all patients doesn’t reliably exceeds the upper threshold of norm, insulin rates don’t differ from the control ones, even in patients with obesity, and rise in 20 % of patients only at 3 degree of obesity. It creates an illusion about the normal state of carbohydrate metabolism in these patients, whereas insulin resistance index estimation allows to reveal a pre-clinic stage of these disorders and to make a timely decision as to a possibility and necessity of simultaneous palliative operation as an ometnectomy that doesn’t complicate a course of operation and postoperational period, but allows to decrease an expressiveness of carbohydrate metabolism disorders at obesity.
The standard preoperative estimation of glucose level in blood doesn’t allow to diagnose an insulin resistance state, that is patients of the high risk group of metabolic syndrome development (especially the ones with obesity) need the additional insulin estimation and insulin resistance index calculation in preoperational period
DETECTION OF AUTONOMIC DYSFUNCTIONS IN COMPLEX NEUROPSYCHOLOGICAL EXAMINATION OF NMU STUDENTS
Get PDFAccording to the data of the world statistics there is observed the growth of autonomic dysfunctions. It is one of the main problems of clinical neurology: 12–25 % of children and near 70 % of adults suffers from these disorders.
Aim: diagnosing of autonomic dysfunctions in the contingent of students with the help of neuropsychological investigations.
Methods and materials: There were examined 1379 students of medical university. Self-appraisal autonomic system tone testing, Kerdo index, G.Dagnini-B.Aschner reflex and ortho-clinostatic sign were carried out on the first phase. For 157 students the Heart Rate Variability was investigated on the second phase. All students were tested by the Eysenck Personality Inventory on the third phase. 70 students (31 men, 39 women) were accordingly tested by the Minnesota Multiphasic Personality Inventory.
Results of research: Increasing of sympathetic part of the autonomic nervous system showed 221 (82.1 %) from 257 persons. Kerdo index was positive at 156 (60.7 %) persons. Reactivity of the autonomic nervous system by the G.Dagnini-B.Aschner reflex showed sympathetic reaction in 133 (51.8 %) persons. Autonomic ensuring of the vital functions study by ortho-clinostatic sign also showed prevalence of the sympathetic reaction – 150 (58.4 %) students. According to the RSAI, 5 marks (optimal) were showed in case of 52 (33.1 %) students. 4 marks – 68 (43.3 %) persons. 3, 2 and 1 marks were registered in case of 26 (16.6 %) persons. Average SI was 168.47 ± 16.42. 4 marks of RSAI correlated with SI=137.29 ± 5.75, 2 marks correlated with SI=508.12 ± 32.12. According to psychological tests, all students with extraversion reliably showed non-stability of the higher nervous action (14.38±017), increased average T-marks of F-scale (77±1.949), 9-scale (71±1.553) and 8-scale (71±1.801).
Conclusions: Indicators of autonomic tone, autonomic reactivity and autonomic activity ensuring showed prevalence of sympathicotonia in contingent of students. Heart Rate Variability investigation found dystonic disorders of autonomic nervous system of supra-segmental level mainly. Eysenck Personality Inventory found the prevalence of extraversion and non-stability of the higher nervous activity what may indicate further autonomic dysfunctions. Minnesota Multiphasic Personality Inventory testing revealed psychological disproportions with prevalence of hypomanic, paranoid, schizophrenic tendency. Psychologic affects cause further somatic complaints as manifestation of autonomic dysfunctions
RESULTS OF SURGICAL MANAGMENT OF PRIMARY MITRAL REGURGITATION IN A SINGLE-CENTER STUDY
Get PDFMitral regurgitation (MR) remains the second dominant defect in the structure of valvular cardiac diseases.
It affects more than 2 million people in the USA. Basic causes are classified as degenerative (with valve prolapse) and ischemic (due to ischemic heart disease) in advanced countries or rheumatic ones (in developing countries).
Alone radical method of MR treatment is surgical correction through mitral valve repair (MVRe) or replacement (MVR) yielding definitely higher survival percentage and improvement of heart failure (HF) class comparing to pharmacotherapy.
Evolution of approaches to the management of non-ischemic MR passed through some stages starting from predominantly MVR to organ-preserving approaches like plastic repair.
In the prospective single-center study were analyzed the results of treatment of 72 patients with primary MR (PMR) who were subjected to mitral valve replacement (MVR) or plastic mitral valve repair (MVRe) performed in the Department of cardiac surgery affiliated with Lviv regional clinical hospital (Ukraine) since October, 2013 till February, 2016.
The conclusions of performed study are next:
1) Key direct cause of MR is the chordal rupture of MV cusps; etiological factor in the majority of advanced countries is degenerative changes in contrast to rheumatic changes in the developing countries.
2) Principal method of MR surgical correction in out center is MVR, though the preferable global trend is MVRe.
3) Complications and lethality percentages in this study were higher among the patients from MVR group. Improvement of HF class according to NYHA was more evident in the MVRe group.
This corresponds to results of other studies and guidelines that recommend MVRe as optional method for MR correction
THE PECULARITIES OF CORRELATION BETWEEN INSULIN RESISTANCE, CARBOHYDRATE AND LIPID METABOLISM INDICES IN PATIENTS WITH GRAVES’DISEASE
Get PDFAim. The number of patients with endocrine disorders in the world, in particular, Graves’ disease is continuously increasing. Recent studies have determined the fact of insulin resistance in thyroid disorders. On the one hand, numerous researches prove correlation of hypothyroidism with arterial hypertension, ischaemic heart disease and lipid metabolism disorder, on the other – carbohydrate metabolism disorder and hyper-sympathicotonia are closely associated with hyperthyroidism. The subject of the research was to study the correlation of insulin resistance, lipid and carbohydrate metabolism indices in patients with Graves’disease.
Material and Methods. During the study 53 (37 female and 16 male) patients with Graves’ disease with noticed IR have been examined. At the beginning, after 3– and 6-months thyreostatic therapy with insulin sensitizers (metformin or pioglitazone) the following investigations have been performed: assessing thyroid-stimulating hormone levels, free thyroxine and triiodothyronine; assessing glycated haemoglobin, glucose, C-peptide and fasting insulin as primary IR markers; calculating НОМА-IR index for analysing tissue sensitivity to insulin; calculating НОМА-β index for evaluating the functional capacity of β-cells of islets of Langerhans; measuring Caro indices to monitor hyperinsulinemia, measuring total cholesterol level, low-density lipoproteins, very-low-density lipoproteins, high-density lipoproteins , triglycerides, for analysing IR in relation to lipid metabolism.
Results. The research results found out that free thyroid hormones and thyroid-stimulating hormone are closely related to lipid metabolism. Thus, thyroid-stimulating hormone was characterized as having direct correlation with low-density lipoproteins, while the free thyroxine inversely correlated with total cholesterol, low-density lipoproteins, and high-density lipoproteins. The free triiodothyronine negatively correlated with high-density lipoproteins. The research has also determined the direct correlation between insulin and free thyroxine, as well as free triiodothyronine in patients with diffuse toxic goitre.
Conclusions. The study proves the presence of insulin resistance in patients with Graves’ disease that generates interest to further study of the changes in insulin sensitivity, relation of insulin resistance to thyroid-stimulating hormone, thyroid hormones and looking for the ways to correct these disorders
EFFICIENCY OF DIFFERENT TECHNIQUES OF CATTLE TREATMENT WITH INSECTICIDES
Get PDFThese researches were carried out on the use of insecticide for infected animals, depending on its quantity (volume), shape and disperse of the drop during spraying. We used the solution of EktosanTM (LTD “Brovapharma”, Ukraine) in dilution 1:1000, with spraying of external usage twice, against Bovicola bovis Linnaeus, 1758, (Trichodectidae, Mallophaga) spontaneous infected lactating dairy cows of 4-8 years of age and young cattle aged 4˗6 to 12 months during 2009˗2010 in the State breeding farm “Ploskivske”, Kyiv region, and in February-March, 2012 in the private farm “Volyn”, Rivne region of Ukraine. A total number of 464 hosts (cows and calves) were examined, out of which 356 animals or 76.72 % were infected by B. bovis.- Efficacy of three techniques of cattle treatment with insecticide was studied. The time-indexes (time-consuming) for treatment and prophylactic manipulations of animals were investigated and recorded.
100 % efficiency of three techniques with full-volume system sprayer (2000 cm3/animal), medium-volume sprayer (250 cm3/animal) and low-volume sprayer or fine-dispersed atomizer (100 cm3 /animal) was established.
According to the work time consuming, the least time for animals’ treatment technique spraying was spent by using a disinfection full-volume system sprayer “DUK”. Full time of this manipulation has taken 33 minutes. The most labor-intensive technique was with using a manual low-volume sprayer “Rosynka”. The work by this technique has taken 58 minutes, and was by 43.1 and 23.3 % minutes more in comparing to full-volume system and medium-volume system sprayers.
The medium-volume system spraying technique for animals was more economically expedient, in accordance for employees’ labor expenses and EktosanTM insecticide price
INTEGRAL EVALUATION OF EFFECTIVENESS OF THE RENEWAL TREATMENT OF PATIENTS WITH ISCHEMIC HEART DISEASE AFTER MYOCARDIUM SURGICAL REVASCULARIZATION
Get PDFCardiovascular diseases are the one of main causes of lethality in all developed countries. In the structure of this group of diseases ischemic heart disease (IHD) occupies the leading place. In the last decade methods of myocardium surgical revascularization that allow to remodel the myocardium essentially and to increase its functional features significantly are developed. Alongside with it, myocardium surgical revascularization doesn’t eliminate main causes of atherosclerotic diseases. Ineffective rehabilitation, including insufficient management of main factors of the cardiovascular risk may essentially decrease results of this operation.
The aim of the study was to elaborate the integral evaluation of the effectiveness of the renewal treatment of patients with IHD after myocardium surgical revascularization. For this aim we offer to use metabolic (leptin, НОМА index, atherogenicity index) and clinical-functional indices (body mass index, physical working ability and ejection fraction (EF) of the left ventricle, anxiety and depression level) before and after the renewal treatment and the result – integral index (I), calculated by the formula: , where М(1+2+n) – metabolic (leptin, НОМА index, atherogenicity index) indices, F(1+2+n) – functional and anthropometric ones (BMI, physical working ability, and EF of the left ventricle).
The use of the integral index before the renewal treatment allows to elaborate the effective rehabilitation program, and after – to study the effectiveness of elaborated complexes and to decrease risks of IHD progression.