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DYNAMICS OF BONE TRAP-5B LEVEL IN PATIENTS WITH BONE METASTASES OF RENAL CELL CANCER AT COMBINED TREATMENT
Get PDFThe objective of this study was to determine the sensitivity of tartrate-resistant acid phosphatase (Bone TRAP-5b) for early detection of bone metastases (BM) and to investigate the efficacy of bisphosphonates (BF) (zolendronic acid-ZA) in prevention of bone metastases in patients with Renal Cell Carcinoma (RCC). The 60 patients with RCC with proven BM were investigated to assess the sensitivity and specificity of Bone TRAP-5b. 95 patients with RCC with high level of tartrate-resistant acid phosphatase (Bone TRAP-5b) (8,5±0,2 IU/L) after radical surgical treatment were divided into two groups: 1-st group: (n=44) received zolendronic acid (ZA) (BF +), and 2-nd group (n=51) patients didn’t receive ZA (BF-). Patients of both subgroups were similar by age, sex, stage of disease. The levels of Bone TRAP-5b, Ca++, alkaline phosphatase, LDG were accessed every 3 months, and MRI imaging, bone scan with 99mTc every 6 month in both groups. We determined the high correlation between bone TRAP-5b and the presence of bone metastases (r=0,9; p <0,05), but its level wasn’t dependent with the number of BM. The results showed the high sensitivity and specificity of Bone TRAP-5b at the critical value of 5.2 IU/L (98,3 % and 90,0 %), (χ2=64,6; p<0.01). Using BF for the prevention of bone metastases in high risk group patients with RCC provides a significant difference in the incidence of bone metastases in patients
EXPRESS PREDICTION OF EXTERNAL DISTINCTIVE FEATURES OF PERSON USING THE PROGRAM OF DERMATOGLYPHICS FOR PREDICTION
Get PDFThe aim of our study was to investigate the current state of computer identification applications, such as artificial neural networks. The material of our study were antroposcopic and anthropometric parameters obtained from 180 male and females aged 18–55 years living in the Ivano-Frankivsk region and belonging to Boiko, Lemko or Hutsul ethno-territorial group. Prints of comb pattern of the toes obtained by scanning with Futronic's FS80 USB2.0 Fingerprint Scanner using the program ftrScanApiEx.exe. followed by the transfer of data to a personal computer. For statistical processing of the obtained data we use STATISTICA 12 from the company StatSoft. Construction of neural networks was carried out using Neural Networks. As a result of our research there was carried out the prediction of anthropometric and antroposcopic parameters (ethno-territorial and gender belonging, etc.) through the use of dermatoglyphic parameters of the hands and feet in 180 people living in the Ivano-Frankivsk region. The proposed method allowed to obtain the results with a forecasts probability 73–90 %. The use of above algorithm of actions allowed a 50 % increase of quality of identification of unknown person for using dermatoglyphic method and 67 % facilitatation of the process of identification (of quantitative and qualitative calculations, determining correlations between parameters) in comparison with previously known manner. Therefore, our proposed method can be used as an express diagnostics of common phenotypic traits of the person (ethno-territorial affiliation, gender, etc.) at admission of mass victims (natural disasters, acts of terrorism, armed conflicts, man-made disasters, etc.), it doesn’t not require a long time for conducting, specially trained staff and is inexpensive.Conclusions: The possibility of predicting external-recognizing features of a person such as etno-racial belonging, sex, anthropometric and antroposcopic parameters will allow widely use dermatoglyphic method at the level with other methods in conducting forensic identification of impersonal, fragmented and putrefactive modified corpses
Р. LEU72MET MUTATION OF GHRELIN GHRL GENE IN CHILDREN WITH GASTROESOPHAGEAL REFLUX DISEASE
Get PDFGastroesophageal disease (GERD) is the one of most spread diseases that injures an esophagus. Taking into account the large number of factors that can cause GERD development already in child age, including genetic predisposition, it is necessary to analyze each of them in detail.
Aim of this work was to analyze a frequency and possible association type of р. Leu72Met mutation of GHRL gene in children with gastroesophageal reflux disease.
The analysis of clinical parameters and course of disease in the group of 100 schoolchildren with GERD was carried out. The molecular-genetic study of c.214C>A locus of GHRL gene by CPR method (rs696217) was carried out in patients with GERD and 40 healthy children from the control group.
In 82% of children with GERD was revealed a GHRL 214СС (Leu/Leu) homozygous genotype, at 58% among children from the control group. GHRL 214СА (Leu/ Met) genotype was registered three times more seldom in children of the studied group comparing with ones from the control group: 15,0% and 42,5%, respectively. It was established, that GHRL 214CС genotype presence conditions the increase of GERD development risk in 3,4 times. On the contrary, GHRL 214CА genotype manifests a reliable protective effect that is essentially decreased GERD development risk in a child at such genotype – 0,24 comparing with a conventional unit.
There was established alleles and genotypes distribution of c.214C>A (р.Leu72Met) locus of GHRL gene in children with GERD. GHRL 214CС genotype is associated with threefold increase of GERD risk development. Gender differences as to GERD development risk at different genotypes of ghrelin gene were established. At GHRL 214СС (Leu/Leu) genotype the relative GERD risk for boys increased in more than 6 times. There were not established any differences in alleles and genotypes distribution depending on erosive or surface inflammatory changes of a gastrointestinal tract mucosa
SATISFACTION OF PATIENTS WITH FIRST MEDICAL CARE: CROSS-SECTION STUDY (ON THE EXAMPLE OF CITY KYIV)
Get PDFAfter reorganization of ambulatory-polyclinic net of medical institutions in city Kyiv in 2013 and creation of centers of first medical care (FMC), the necessity in monitoring of patients’ satisfaction with received first medical care appeared.
Aim. To estimate satisfaction of patients of FMC Centers of city Kyiv with received first medical care, to compare it with patients’ satisfaction in rural area of Ukraine and in European Union countries.
Materials and methods. The cross-section study was realized in FMC centers of city Kyiv during 6 months of 2017 year. In total 397 persons, 18 years old and more, who addressed to doctors of the first link during no less than one year, were selected for the study. The used EUROPEP instrument, the questionnaire, consists of 23 questions with their possible assessment by Likert five-point scale and includes the following aspects: doctor-patient-relationship, assessment of direct medical care, information and support of a patient by a doctor, organization aspects of care, its accessibility. The internal succession of the questionnaire Cronbach's alpha was estimated, and its reliability was checked. Main indices of research results were mean EUROPEP indices (minimum 1, maximum 5).
Results. The study has established, that satisfaction of Ukrainian patients with FMC (index - 75,5 %) is statistically reliably lower than indices of European Union countries. In average, only 37,16 % of respondents estimated the level of received FMC as “perfect” and correspondingly 38,35 % of patients as “good”. There were revealed problems with an access to medical care, namely: “Time of waiting for a consultation near a cabinet” received the least mark (3,29 and 45,59 % respectively), “Possibility of registration for consultation by phone” is also low (3,47 and 59,95 % respectively). Problems in communications, the low level of trust and doctor’s authority were revealed in the decreased index “Doctor’s help in fighting against negative emotions, connected with your health status” (3,72 and 56,17 % respectively). There was studied, that in Ukraine satisfaction of patients, who live in rural area, is statistically reliably lower than Kyiv indices.
Conclusion. The study of satisfaction of patients with received FMC revealed imperfection of the existing system of first medical care. The research results may be used at elaborating new functional-organizational model of activity of first medical care, including patients’ satisfaction as an important component in the integrative dimension of the medical help quality. 
DETERMINATION OF INFLUENCE OF AUXILIARY INGREDIENTS ON ANTIOXIDANT ACTIVITY OF EXTRACT OF LEAVES OF THE QUINCE AND GRAPES SEED MEAL IN PHYTOGEL WITH THE USE OF SPECTROMETRIC METHOD WITH THE DPPH INDICATOR SYSTEM
Get PDFTo study an impact of auxiliary substances on gel containing extracts of quince leaves and grape seed meal, which is based on polymethylsiloxane.
Pharmaco - technological and physicochemical methods. In this study, a spectrophotometric method is applied to determine an antioxidant activity of the gel.
We examined an impact of auxiliary substances on the gel. According to the results of studies we chose auxiliary ingredients which improve not only gustatory quality but also technological parameters. Applying spectrometric analysis, we investigated an antioxidant activity of phytogel. The gel has a structure of rigid matrix, which is built through a process of condensation of methylsilanetriol and siloxane bonds between the silicon atoms, which makes it possible to maintain and stabilize active natural ingredients. The experiment proved that the extract of leaves of quince and grape seed meal have some antioxidant activity. But, upon the introduction of stevia extract as a coregent taste, the gel that contains quince leaf extract and grape seed meal increases the antioxidant activity. Phytogel has antioxidant activity of 84% relative to the reference sample, which suggests that the gel can resist the harmful effects of free radicals, which are constantly produced in the human organism
It was confirmed that the addition of auxiliary substances into the gel with the extracts of quince leaves and grape seed meal based on polymethylsiloxane increases bioavailability and therapeutic efficiency, in particular, the antioxidant activity, of the gel.
Stevia extract as an adjuvant in the phytogel, as gustatory corrector, increases the antioxidant activity of phyto pharmaceutical drugs
EVALUATION OF FUNCTIONAL CONDITION OF RESPIRATORY MUSCLES OF PATIENTS WITH A COMPLICATED BRONCHIAL ASTHMA PATHOLOGY AND CHRONIC OBSTRUCTIVE PULMONARY DISEASES
Get PDFThe aim of the research was to study the functional state of respiratory muscles and neuro-respiratory drive in patients with a combined pathology of bronchial asthma and chronic obstructive pulmonary disease.
The functional condition of the respiratory muscles and the tone of the respiratory centre were determined with the help of a device for occlusion spirometry. Also, the patient was observed with a spirometry, a general plethysmography of the body.
Materials and methods.
140 patients with combined broncho-obstructive pathology, 34 patients with asthma and 17 patients with COPD were examined. Spirometry, general plethysmography of the body and occlusion spirometry were provided for all patients.
Results show a decrease in muscle strength of breath in all categories of patients with broncho-obstructive diseases, especially expressed in patients with bronchial asthma and asthma-COPD intersection. The muscle strength of breath was maintained with a significant increase in COPD patients compared with those with bronchial asthma. With increasing broncho-obstruction in patients with asthma-COPD intersection, there was a progressive and reliable decrease in muscle strength for breath and expiration, as well as a tendency to increase neuron respiratory drive. In patients with asthma-COPD intersection with more expressed symptoms revealed a significant and reliable weakening of muscle strength for breath and increased neuro-respiratory drive. During the work were obtained reliable links of the parameters of respiratory muscle strength not only with the parameters of pulmonary volume and bronchial patency, but also with the degree of neutrophilic inflammation in this category of patients.
Conclusions The obtained data on failure of the functional state of the respiratory muscles and the neuro-respiratory drive can be used in the development of rehabilitation programs for the management of patients with combined broncho-obstructive pathology
MAIN AGENTS OF OPPORTUNISTIC INFECTIONS OF GENITOURINARY TRACTS AND THEIR ANTIBIOTIC RESISTANCE
Get PDFToday the one of most important medical-social problems is a growing antibiotic resistance of opportunistic infectious agents.
Aim of research: the dynamic observance of antibiotic resistance of opportunistic pathogens – infectious agents of genitourinary tracts under conditions of venereological clinic.
The study included 2205 patients with inflammatory diseases of genitourinary tract, who were on the stationary treatment at the department of venereology of SI “IDV NAMS of Ukraine”. Bacteriological studies for isolation of conventionally pathogenic microorganisms with determination of sensitivity of separated laboratory strains to antibacterial drugs of the different groups were carried out using the methods of classic bacteriology.
It was demonstrated, that the composition of microbiocenosis of genitourinary tract in patients with infections, caused by conventionally pathogenic microorganisms was characterized by the prevalence of aerobic representatives of Enterobacteriaceae and Staphylococcaceae families that formed associations both between each other and with representatives of other taxonomic groups. The analysis of antibiotic sensitivity of separated strains testifies to the necessity of permanent microbiological monitoring of opportunistic infectious agents for elaborations of the regimes of rational antibacterial therapy
INFLUENCE OF LONG-TERM CYTOTOXIC CHEMOTHERAPY ON THE CONDITION OF PERIPHERAL VENOUS CHANNEL
Get PDFThe necessity of long-term venous access in cancer patients appears at frequent and long-term courses of cytotoxic therapy. Peripheral veins of forearms are most often used for these aims. The conditions of peripheral venous channel in 32 cancer patients, who underwent the long-term treatment with antitumor preparations were analyzed in the article on own investigatory material.
The methods of dopplerography, morphological and immunohystochemical studies were used.
The qualitative and quantitative dopplerographic changes in forearm veins in different terms after chemotherapy start were revealed in most patients.
The conclusion was made about unsuitability of forearm peripheral veins for the long term administration of cytostatics and the necessity to create the alternative vascular access that would correspond to the criteria of safety, reliability and long-term exploitation
ELIMINATION OF CONGENITAL SYPHILIS IN UKRAINE: ANALYSIS AND THE EMERGING ISSUES
Get PDFThe objective of this study is to analyze the indicators of the process of elimination of mother-to-child transmission of syphilis in Ukraine thus helping to prepare for elimination of this process according to the WHO targets and criteria.
Epidemiological and clinical data of 237 women who had syphilis before or during pregnancy and babies born to them (238) from 1999 to 2007 years were presented. In addition were used statistical forms of the Public Health Center and Center for Medical Statistics of the Ministry of Health of Ukraine for the incidence of syphilis and HIV in women of reproductive age, pregnant women and children born to them, including those who were diagnosed with congenital syphilis (CS) and HIV infection.
Analysis of the causes of СS suggests that the main risk factors in Ukraine were the lack of prenatal care in 44 % and treatment in 99 % of pregnant women with syphilis. Besides out-of-date normative base regulating STI diagnostic and care create delay in diagnostics and treatment of pregnant women and their newborns.
In addition, the delay with prenatal diagnosis and treatment, late infection, quality of diagnostics, iatrogenic errors, refusal of women from current requirement for hospitalization, reinfection, and birth at home can be attributed to risk factors for CS.
Despite the main target indicator of CS elimination has been achieved, process indicators of syphilis as coverage of syphilis testing and treatment of pregnant women as well as other additional requirements have not reached yet.
On the way to the CS elimination Ukraine is facing a few challenges. There is an urgent need on further year the new strategy on STI/СS prevention with targets and targets indicators. In addition national protocols of the treatment of pregnant women should be adapted according to the European Guidelines as well as comprehensive data is required for surveillance and monitoring of CS elimination
DETECTION OF RS9939609 POLYMORPHISM OF FTO GENE AND RS324011 POLYMORPHISM OF STAT6 GENE AND SEVERITY DEGREE OF BRONCHIAL ASTHMA ASSOCIATED WITH OBESITY
Get PDFThe aim of this research was to analyze the distribution of FTO and STAT6 genes polymorphism in patients with bronchial asthma (BA), associated with obesity (Ob) depending on the main disease severity degree.
Materials and methods. The study included 117 patients 18–48 years old, divided in 3 groups. The main group (bronchial asthma, associated with obesity) included 57 patients, two groups of comparison – 30 patients with the diagnosis BA and a normal body weight, and 30 patients with obesity, but without the pathology of the bronchopulmonary system.
The general genomic DNA was extracted from blood according to the standard protocol. The genetic typing was realized by the method of allele-specific amplification with the detection of results in the real time regime using TaqMan-probes, complementary to polymorphic parts of DNA. The detection of deletions in FTO and STAT 6 genes was realized by the method of polymerase chain reaction (PCR) using specific primers.
Results. In the main group, among patients with BA and Ob, carriers of Т/Т genotype were 36,84 %, Т/А – 45,61 %, А/А – 17,55 % against 40 %, 60 % and 0 % respectively in PHP group by FTO gene. Carriers of С/С genotype in the main group were 38,6 %, С/Т – 35,09 %, Т/Т – 26,31 % against 40 %, 55 % and 5 % respectively in PHP group by STAT6 gene. In the main group the light persisting BA was diagnosed in 20,0 % of cases, middle severity – in 60,0 % and severe – in 20,0 % of patients. In the group of comparison this disease severity was observed in 17,7 %, 66,5 % and 15,8 % of observations, respectively.
Conclusions. So, among patients with BA, associated with Ob with the middle and severe course of asthma the percent of heterozygous (Т/А) and mutant carriers (А/А) rs9939609 polymorphism of FTO gene is higher than at the light course. The analogous situation is observed at the study of rs324011 polymorphism of STAT6 (C2892T) gene among this category of patients. So, the determination of FTO and STAT6 genes polymorphism in patients with BA, associated with Ob, can be considered as a marker of the more severe course of asthma