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Determination of the informational content of symptoms in the dynamic processes of assessing the patient’s condition in e-health
Get PDFThe study is devoted to substantiating the tactics of choosing the signs of the patient's condition for diagnostic decision-making on corrective medical intervention in mobile medicine.
The aim of the research: to study a creation of a methodology for determining the integral informativeness of the patient's symptoms during remote monitoring of his condition.
Materials and methods: this article is based on search results in PubMed, Scopus, MEDLINE, EMBASE, PsycINFO, Global Health, Web of Science, Cochrane Library, UK NHS HTA articles published between January 1991 and January 2021 and containing the search terms “information technology”, “Mobile medicine”, “digital pathology” and “deep learning”, as well as the results of the authors' own research. The authors independently extracted data on concealment of distribution, consistency of distribution, blindness, completeness of follow-up, and interventions.
Results: concluded that to determine the Informativeness of symptoms in mobile monitoring of patients, it is possible to use risk indicators of predicted conditions as a universal method. Given that the Informativeness of the patient's condition changes constantly, for online diagnosis of conditions during remote monitoring of the patient it is recommended to use the function of informative symptoms from time to time and use a set of approaches to assess the Informativeness of patient symptoms. It is proposed to use the strategy of diagnosis and treatment using probabilistic algorithms based on the values of the risk of complications of the pathological process, as well as the formulas of Kulbach and Shannon to determine individual trends in the pathological patient process.
Conclusion: there was proposed to use risk indicators of predicted conditions as a universal method for determining the informational content of symptoms in mobile monitoring of patients
Study of hepatoprotective effect of bearberry leaves extract under insulin resistance in rats
Get PDFThe aim of our study was to evaluate the antidiabetic and hepatoprotective efficacy of dry extract from bearberry leaves enriched with arginine in dexamethasone induced IR.
Materials and methods. IR was induced in rats by low dose intraperitoneally injections of dexamethasone. Dexamethasone-induced IR in rats was treated by bearberry leaves extract enriched with arginine. Thus, animals were randomized into several groups including intact animals and animals, which administered reference compounds and medications.
The activities of alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamine transferase (GGT) were determined in blood serum and liver homogenate, in addition, in blood serum we measured lactate dehydrogenase (LDH) activity and lactate level and glycogen content liver tissue. Also, for the purpose of our experiment, in liver tissue were determined: thiobarbituric acid reactive substances (TBARS), diene conjugates (DC), and reduced glutathione (GSH) content; and superoxide dismutase (SOD), glutathione peroxidase (Gpx), and catalase (CAT) activities. All indices were determined using generally accepted unified methods or commercially available kits.
Results. Long-term dexamethasone administration led to an increase in AST, ALT and GGT overall activity in the liver homogenate and serum; this could be the result of increased permeability of hepatocyte plasma membranes, as well as their enhanced synthesis in the liver. Studied extract ameliorate these indices of liver injury. Evaluation of indices that reflected oxidative stress and the antioxidant system status in liver confirmed oxidative stress development in IR rats` liver. Administration of arginine enriched bearberry leaves extract decrease TBARS and DC content in liver tissue, at the same time, improve SOD, Gpx, and CAT activities and increase GSH content.
Conclusions. Bearberry leaves dry extract enriched with arginine inhibit oxidative stress development, improve membrane integrity, and normalize some indices of carbohydrate metabolism, particularly glycogen content in liver and lactate level in blood
The method of random balance for studying the influence of excipients quantities on technological parameters of tablets based on Origanum vulgare L. dry extract
Get PDFThe aim. The aim of the research was to study the influence of excipients amount on the technological parameters of the compression mixture and tablets based on dry extract of Origanum vulgare L. herb using the method of random balance.
Materials and methods. Objects of the study – Origanum vulgare L. herb dry extract, 8 excipients that have been studied at two quantitative levels. The tablets were prepared by direct compression method. The formulations were designed according to the method of random balance. The technological parameters of the compression mixture and tablets based on Origanum vulgare L. herb dry extract have been studied as a function of quantitative factors: silicon, magnesium carbonate basic, dioxide magnesium aluminometasilicate (Neusilin S1®), isomalt (GalenIQ™720), F-melt® Type C (co-spray dried excipients), sucralose, berry flavor and citric acid.
Results and discussion. The increase in the amount of Neusilin S1®, GalenIQ™720 and F-melt®, and the decrease in the amount of magnesium carbonate basic and silicon dioxide improved the flowability expressed by the Hausner ratio. Results of bulk density and tapped density of the compression mixture depended on the quantities of GalenIQ™720 and F-melt®. All formulations of the prepared tablets had the rapid disintegration and ranging from 6 to 15 minutes. Resistance for crushing and friability tablets’ were improved with a decrease in the amount of silicon dioxide and increase in the amount of Neusilin S1®, F-melt® and sucralose. Higher resistance to moisture of tablets based on Origanum vulgare L. dry extract was obtained by using Neusilin S1®, F-melt® and sucralose on the upper levels.
Conclusions. The tablets based on Origanum vulgare L. herb dry extract were successfully manufactured by direct compression method. The random balance method enabled us to identify the most significant quantitative factors to optimize their composition in the tablets based on the dry extract of Origanum vulgare L. herb
ASSESSMENT OF THE FREQUENCY AND RATIONALITY OF PRESCRIBED MEDICINES IN PATIENTS WITH LIVER CIRRHOSIS
Get PDFThe aim. Assessment of the dynamics of prescribing drugs to patients with liver cirrhosis (LC, K 74), in terms of real clinical practice by methods of clinical and economic analysis.
Materials and methods. 355 medical cards of inpatients with cirrhosis of the liver, which were divided into 4 groups depending on the period of stay of patients in the hospital. Methods: compatible retrospective ABC-frequency analysis, which ranked drugs consumed by patients in real clinical practice, according to the frequency of appointment using ABC-segmentation according to the Pareto principle (A – 80 % of drugs appointments: B – 15 %: C – 5 %); VEN-analysis, which divides the consumed drugs on a formal basis depending on the presence / absence of a particular drug in the regulations: vital (Vital or V), necessary (Essential or E) and secondary (Non-essential or N).
Results. Cirrhosis of the liver in recent years has been on the 10th - 11th place among the causes of death in the world. The analysis of prescribed drugs to patients with LC in real clinical practice in Ivano-Frankivsk region of Ukraine revealed that over the years doctors prescribed fewer drugs on average per patient (11.4 drugs → 8.8 drugs), which can be considered a positive fact. Among the prescribed drugs, drugs of group A – “Drugs that affect the digestive system and metabolism” prevailed, the share of which increased and was the highest in 2019 – 2020 (2007–2009 – 44.6 %; 2012–2013 – 46.6 %; 2015–2016 – 48.1 %; 2019–2020 – 48.55 %); the share of dietary supplements also increased from 1.65 % to 6.52 %.
Conclusions. Combined ABC-frequency and VEN-analyzes showed that the leaders in the years of hospital stay were the following drugs: Sodium chloride, Ademetionine, Pantoprazole, Spironolactone, Thioctic acid, Ornithine, Asparaginate K-Mg, Torasemide, Furosemide. However, the vital class V included only 9–11 % of drugs from the whole set of prescribed drugs, which requires systemic correction in accordance with European recommendations
ADVERSE EFFECT OF INSOMNIA ON BLOOD LIPIDS IN PATIENTS WITH HYPERTENSION
Get PDFInsomnia is a risk factor for the development of arterial hypertension, obesity, type 2 diabetes mellitus, cardiac rhythm disorders, and myocardial infarction. At the same time, insomnia is one of the most frequent non-cardiac complaints in patients with cardiovascular diseases.
The aim of the work was to study the presence of possible relationships between insomnia and the level of blood lipids.
Materials and methods. A cross-sectional study involving 118 patients was conducted. Criteria for inclusion in the study were age over 45 years, the presence of essential hypertension. All patients included the study underwent sampling of 7 ml of venous blood in the morning under fasting conditions. The content of total cholesterol (TCS), triglycerides (TG), high-density lipoprotein cholesterol (HDL CS) was determined by enzymatic method on a biochemical analyser Humalyzer 2000. The patient was interviewed by a pre-trained study doctor.
Results. In the article a relationship between total cholesterol, low-density lipoprotein cholesterol and the presence of insomnia has been established and proved by statistical model. The overall statistical model accuracy is 89.6 % and statistical significance p < 0.005. Accuracy of insomnia prediction is 85.7 % by level of total cholesterol (TCS) and patient interview data. Only one model with best accuracy exists and it was estimated at the article.
Conclusions. Relationship between total cholesterol, low-density lipoprotein cholesterol and the presence of insomnia has been established and proved by statistical model. Accuracy of insomnia prediction is 85.7 % by level of total cholesterol (TCS) and patient interview data
Assessing the homogeneity of Actimask® acetaminophen and N-acetyl glucosamine mixture to predict further steps in the development of orodispersible tablets
Get PDFOne of the main problems in the production of tablets, which has significant negative consequences, is the segregation of the tablet mixture leading to inhomogeneity of dosage units, material losses in the manufacturing process and improperness of the specified pharmaceutical technical characteristics of the mixture.
The aim of the research. This work aims at the pharmaceutical technical study of the substances N-acetyl-D-glucosamine and Actimask® Acetaminophen and determination the uniformity of the powder mixture of active pharmaceutical ingredients (APIs) to predict the optimal technology for obtaining a pharmaceutical formulation with the acceptable properties.
Materials and methods. N-acetyl-D-glucosamine (Zhejiang Candorly Pharmaceutical, China) and Actimask® Acetaminophen (SpiPharma, USA) were used.
Scanning probe microscope Solver P47N-PRO ("NT-MDT", Russia), optical microscope, flowability tester VP-12A, laser diffraction particle size analyzer SALD-2201 ("Shimadzu", Japan), liquid chromatograph Agilent 1260 Infinity II with Diode Array Detector (Agilent Technologies, USA), spectrophotometers Shimadzu UV-1800 ("Shimadzu", Japan) were used.
The study of API pharmaceutical technical properties (microscopic characteristics, moisture absorption capacity, flowability, bulk volume and tapped volume, particle size distribution by sieve analysis and laser diffraction), as well as vibration simulation and following chromatographic study were carried out in this work.
Results and discussion. The shape of the particles N-acetyl-D-glucosamine and Actimask® Acetaminophen, which was determined by microscopic analysis, demonstrated the possibility of N-acetyl-D-glucosamine particles to stick to Actimask® Acetaminophen ones. The experimental study allowed to reveal the hygroscopicity of both APIs; poor flowability, unsatisfactory Hausner ratio, and Carr index for N-acetyl-D-glucosamine; excellent flowability, Hausner ratio, and Carr index for Actimask®. Vibration caused segregation of the powder mixture. It was found that all layers do not meet the requirements and an excessive content of Actimask® is registered, which indicates the stratification of the powder mixture.
Conclusions. The physical properties of the substances were determined and found to have significant differences in their particle size distribution. Segregation of the mixture after vibration was confirmed by laser diffraction and assay analysis. In order to solve the segregation problem, the granulation of N-acetyl-D-glucosamine may be proposed
PREDICTION OF PROGRESSION OF ATHEROSCLEROSIS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS AND CHRONIC PANCREATITIS
Get PDFThe aim of the research was to study the relationship between the level of vaspin and the thickness of the intima-media of the carotid artery (CIMT), parameters of carbohydrate and lipid metabolism, functional state of the pancreas, markers of inflammation, and to create a mathematical model for the progression of atherosclerosis in patients with type 2 diabetes mellitus (DM-2) and chronic pancreatitis (CP).
Materials and methods: Serum vaspin level in 114 people with DM-2 or CP and a combination of these diseases were obtained. The parameters of lipid and carbohydrate metabolism, inflammation and functional status of pancreas were studied. CIMT was measured by means of B-mode ultrasonography. The obtained data were processed by the methods of non-parametric statistics to study the dependence of the parameters on the group, questions of the statistical significance of differences between two unrelated groups, the tightness of the relationship between the analyzed parameters.
Results: A statistically significant (p<0.05) increase in serum vaspin levels in patients with DM-2 compared with other studied groups was obtained. A reliable correlation between vaspin, carbohydrate metabolism and CIMT was obtained, and it appeared to be dependent on the presence of comorbid pathology. The value of vaspin / tumor necrosis factor-α (TNF-α), starting from which CIMT increase is considered present, was calculated.
Conclusions: Undertaken study confirmed the positive connection of vaspin with insulin resistance markers, but also demonstrated that serum vaspin levels is positively associated with CIMT. A mathematical model for predicting the progression of atherosclerosis in patients with the studied pathology was developed. It was demonstrated that the Vaspin/TNF-α ratio can be used as a marker of early atherosclerotic lesion of vascular wall, indicating the role of vaspin in atherogenesi
MONITORING OF THE ASSOCIATED COURSE OF LEPTOSPIROSIS AND BABESIOSIS IN DOGS OF THE SUMY REGION OF UKRAINE
Get PDFLeptospirosis and babesiosis in dogs may be associated. These diseases often have similar symptoms and mask each other, or are asymptomatic, which complicates the diagnosis, significantly worsens the prognosis and reduces the survival of sick animals. Monitoring of the associated course of leptospirosis and babesiosis in dogs makes it possible to study the frequency of this parasitocenosis in dogs and the peculiarities of its course, which is the basis for improving the diagnosis and treatment of sick animals.
The aim of the research. Monitor the associated course of leptospirosis and babesiosis in dogs.
Methods. The research was conducted in the private veterinary clinic “Vetservice” in Sumy and in the serology department of the Sumy Regional State Laboratory of the Civil Service of Ukraine for Food Safety and Consumer Protection. Blood samples were taken from dogs came for treatment to the “Vetservice” clinic. The diagnosis of babesiosis was established directly in the clinic by the results of erythrocyte microscopy in thin smears of peripheral blood of sick dogs stained by Giemsa. The diagnosis of leptospirosis was established in the serology department of the Sumy Regional State Laboratory based on the results of a study of the serum of sick dogs in the microagglutination reaction. The subjects of the study were clinically ill and suspected dogs with the associated course of leptospirosis and babesiosis, as well as blood samples from these animals. Babesium trophozoites were detected in erythrocytes under an immersion microscope, a magnification of ocular 10 x 90, and the presence of antibodies to leptospira was detected by the presence of agglutination of leptospira in microagglutination reaction.
Results. In the study of the incidence of dogs associated with leptospirosis and babesiosis during 2014–2019, according to the clinic “Vetservice” found that the number of reported cases of associated leptospirosis and babesiosis annually varies from 9 to 28 cases. This parasitocenosis is registered all year round with peaks in spring and autumn, moderately in summer and rarely in winter. Purebred animals get sick several times more often than non pedigree ones. During the period from 2016 to 2019, the number of diseases in females and males was approximately the same. During the period from 2014 to 2015, males were more often ill.
Conclusions. The prevalence of the associated course of leptospirosis and babesiosis in dogs of the Sumy region of Ukraine was determined with the determination of seasonal, breed and sexual dynamics of this parasitocenosi
EVALUATION OF HORMONAL AND METABOLIC PARAMETERS, ALONG WITH CARDIOVASCULAR RISK FACTORS IN WOMEN WITH NON-ALCOHOLIC FATTY LIVER DISEASE COMBINED WITH SUBCLINICAL HYPOTHYROIDISM DEPENDING ON AGE
Get PDFPatients with NAFLD (non-alcoholic fatty liver disease) and subclinical hypothyroidism are at risk of cardiovascular complications that cause cardiometabolic changes, thus enabling to broaden our understanding of the cardiovascular events risk in a comorbid patient.
The aim: The study of hormonal and metabolic indicators and cardiovascular risk factors in women from NAFLD combined with SH (subclinical hypothyroidism) depending on the age.
Materials and methods: 128 patients with NAFLD were studied, which were divided into 2 groups: І group – patients with NAFLD and level of thyroid-stimulating hormone (TSH) – 4 to 10 mIU/mL (n=45), ІІ group - patients with NAFLD and level of TSH >10 mIU/mL (n=49). The control group consisted of 34 NAFLD patients without SH. Depending on the level of TSH and age, degree of cardiovascular risk, indicators of carbohydrate and lipid metabolism, as well as the indicators that reflect ED were evaluated.
Results: Comparison of metabolic parameters in two groups showed a significant difference (p<0.01 between indicators depending on the TSH level, where patients were below 50 years of age: HbA1c, LDL cholesterol, HDL cholesterol, gamma-glutamyltranspeptidase (GGTP). The levels of CDEC (circulating desquamated endothelial cells), VEGF (vascular endothelial growth factor), CRP (C-reactive protein) and TNF-α (tumor necrosis factor-α) were dependent not only on TSH, but also on age. Significant differences (p=0.001) were obtained in patients aged ≤ 50 years: CDEC; VEGF, CRP; TNF-α.
Conclusions: Patients from NAFLD combined with SH have hormonal-metabolic disorders, and their degree depends on the TSH level. Early cardiometabolic changes in women are formed already at the age under 50 years, which indicates the formation of early atherosclerotic vascular change
Substantiation of the composition of a semi-solid dosage form with a probiotic component for use in dermatology
Get PDFOne of the important issues in the pharmaceutical development of a semisolid preparation for dermal use is the scientific and experimental justification for choosing the base-carrier of active substances.
The aim of this study was to experimentally substantiate the choice of rational combination of excipients in the development of a semisolid dosage form with a probiotic component for use in dermatology.
Materials and methods. Hydrophilic gelling agents were used as excipients in the study: Sepiplus 400, Aristoflex AVC, Carbopol 934, hydroxyethylcellulose HEC, sodium alginate. Physical and chemical, pharmaco-technological and microbiological methods were used to select the optimal basis. Colloidal stability was determined using a laboratory centrifuge at a speed of 6000 rpm for 5 min, an electronic thermometer and a water bath laboratory. Thermostability was determined in the thermostat at (40±2) °C for 24 hours. Investigation of the rheological properties of the samples was performed using a Rheolab QC (Anton Paar, Austria) rheoviscometer using a system of coaxial cylinders C-CC27/SS. The kinetics of water absorption of the samples were studied by dialysis through a semipermeable Cuprophan membrane, Type 150 pm at a temperature of (34±2) °C. The number of viable lactobacilli cells was determined by surface seeding on Petri dishes with dense MRS medium.
Research results. The results of the study of the number of viable lactobacilli cells showed that the lowest number of viable cells was in sample based on HEC. Tests for thermostability and colloidal stability showed that for sample No. 5 based on sodium alginate, stratification was observed in the experiment, which indicates its instability. These samples were excluded. Samples on Sepiplus 400 and Aristoflex AVC on a set of rheological features have advantages both consumer and technological; and sample on t Aristoflex AVC has the best indicators of osmotic activity and the viability of cells in the dynamics for this study.
Conclusions. As a result of physical and chemical (organoleptic, colloidal and thermostability), pharmaco-technological (osmotic and structural and mechanical properties) and microbiological studies (number of viable lactobacilli cells) studies it was found that further work should be carried out with a sample based on gelling agent Aristoflex AVC, which has the most optimal performance in this development for a semisolid dosage form with a probiotic component for use in dermatolog