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READINESS ASSESSMENT OF PATIENTS WITH ARTERIAL HYPERTENSION TO THE APPLICATION OF TELEMEDICAL TECHNOLOGIES
Get PDFThis article presents original data on patients' awareness of arterial hypertension and their readiness to use telemedicine technologies.
The aim: to study the factors that may affect the effectiveness of diagnosis and treatment of patients with arterial hypertension (AH) through the use of telemedicine technologies.
Materials and methods: this study involves 336 outpatients and indoor patients diagnosed with arterial hypertension. Anonymously, using a questionnaire, were assessed patients' awareness of their diagnosis, access to the Internet, and the ability to remotely control of blood pressure.
Results: only about a third of all respondents systematically took the recommended antihypertensive therapy daily. Among them, the vast majority were indoor patients (82 %). We found a direct dependence between the regularity to use the antihypertensive therapy and the interest in the use of telemonitoring of blood pressure (Spearman correlation coefficient +0.59). There is a low awareness of patients about the possibilities of remote monitoring of blood pressure (only 11 %), the vast majority of patients (60 %) for the first time learned about such technologies. Among our respondents, a statistically significant dependence was found between the age of patients and interest in telemonitoring blood pressure at a significance level of p<0.01 (χ2 – 26.119, and the critical value of χ2 significance level p=0.01 is 9.21).
Conclusions: the main sources of information for patients with arterial hypertension are primary care physicians (family doctors, therapists) and the Internet. Limited access of patients to the Internet can negatively affect over introduction of telemedicine technologies for the management of arterial hypertension, despite the great interest of patients and society
THE ROLE OF QUALITY OF LIFE IN MELATONIN CONTENT AS A REGULATOR OF DEFENSE AND AGGRESSION FACTORS IN GASTROESOPHAGEAL REFLUX DISEASE PATIENTS WITH SLEEP APNEA SYNDROME
Get PDFThe aim of the study: to study the effect of the quality of life on the melatonin content, and at the same time to assess the state of the factors of aggression and protection of the esophageal mucosa in patients with GERD without comorbidities and with concomitant obstructive sleep apnea/hypopnea syndrome (OSAHS).
Methods. 45 patients were taken for the study. 23 of them had GERD concomitant COPD, 22 were with isolated GERD with a non-erosive form.
Melatonin levels were determined using the enzyme immunoassay method (ELIZA). Quality of life was assessed using the SF-36 questionnaire. Antioxidant protection of the mucous membrane (protection factor) – was assessed by the activity of superoxide dismutase (SOD). SOD activity in blood serum was determined by calorimetric method. Determination of the DC level was carried out in the blood by the spectrofluorimetric method.
Results. The study showed that in patients with GERD with concomitant COPD, there is a significant decrease in the indicators of antioxidant activity and melatonin, both with indicators from the control group and with indicators of patients with GERD without comorbidity.
At the same time, in patients with GERD without comorbidities, an increase in the level of DC was observed in comparison with the control group and patients with GERD with concomitant pathology and acidity of gastric juice.
When analyzing the indicators of QOL in patients with GERD with concomitant pathology, there is a significantly more pronounced decrease in mental health, role emotional functioning and vitality.
Conclusions. It has been established that in patients with GERD in the stage of exacerbation of the disease, there is a statistically significant decrease in QOL indicators with a high degree of reliability, manifesting itself in patients without combined pathology in the spectrum of indicators of the physical component of health, and in patients with GERD with concomitant obstructive sleep syndrome – in the spectrum of the psychological component quality of life.
It has been shown that with a decrease in QOL in patients with GERD, the level of melatonin decreases, the decrease in which more clearly increases in patients with concomitant obstructive sleep apnea.
Simultaneously with a drop in the level of melatonin in patients with GERD without associated pathology, the aggression factor increases with a high degree of certainty - that is, a decrease in the pH of gastric juice and an increase in the content of DC, while in patients with GERD with concomitant sleep apnea syndrome, the factor decreases with a high degree of certainty. Protection of the esophageal mucosa – (that is, a decrease in SOD activity), which must be taken into account when treating this category of patients
Standardization of Eucalyptus globulus leaves and Cetraria islandica slan
Get PDFThe aim. The aim of this study was to propose methods of standardization of Eucalyptus globulus leaves and Cetraria islandica slan by the main group of biologically active substances (BAS). This was done for further development of complex medicines based on Eucalyptus globulus leaves and Cetraria islandica slan.
These studies provide an opportunity for further development and standardization of extracts from these plants, and the main aim of this study is the development and standardization of a complex medicine.
Materials and methods. Thin layer chromatography was used to determine the presence of these markers. Quantitative values of these biologically active substances were determined by spectrophotometric method according to the relevant methods of the State Pharmacopoeia of Ukraine.
Results. Markers for the certification of Cetraria islandica and Eucalyptus globulus have been proposed in this study. Chlorophylls and 1,8-cineole were chosen as a marker for the study of Eucalyptus globulus, and polysaccharides were chosen as a marker for Cetraria islandica. The qualitative and quantitative content of these markers in the studied objects was studied.
Further research in this direction will be aimed at developing methods for control and standardization of water and alcohol extracts from these plants.
Conclusions. Biologically active substances in medicinal plant raw materials were studied. It is proposed to study extracts and finished products from Eucalyptus globulus leaves and Cetraria islandica slan using these methods.
The method of qualitative and quantitative determination of polysaccharides in Cetraria islandica slan is easy to apply and easily reproducible. It is important to be able to standardize Eucalyptus globulus leaves for essential oils and chlorophylls.
The biologically active substances-markers found in Eucalyptus globulus leaves and Cetraria islandica slan will be used for the development of herbal medicines, the standardization of which will be carried out for the same compounds
Study of influence of bacterial lysate on cytokine indicators in experimental periodontis in rats
Get PDFThe aim of the research: to optimize the treatment of patients with a disturbed cytokine profile by a bacterial lysate in an experimental model of periodontitis against the background of changes in the local and systemic immune response.
Materials and methods: prospective study has been conducted on experimental periodontitis in 42 rats for 90 days. The animals were treated by solution of «Respibron» and the reference drug «Imudon». The concentration of cytokines in the blood serum was determined by the enzyme immunoassay, circulating immune complexes – precipitation method is measured on a spectrophotometer, C-reactive protein – using a latex diagnosticum. All interventions and euthanasia of animals were carried out in compliance with the European principles.
Results: the obtained data from the study indicate a high degree a state of decompensation of experimental periodontitis. An immuno-inflammatory reaction preceding periodontitis is accompanied by the disturbances of the cytokine balance, local and systemic immune response. Applying of bacterial lysates led to the compensation of bacterial dysbiosis, restoration of the balance of the activity of pro- and anti-inflammatory cytokines, and a decrease the hyperactivity of immunological markers.
Conclusion: the studies carried out have shown that the use of bacterial lysate is a pathogenetically substantiated component of therapeutic tactics. The normalizing effect of the lysate on the parameters of the immune response and cytokine profile has been reliably shown. Considering the immuno-inflammatory reaction at the experimental periodontitis, accompanied by the cytokine imbalance, study the pharmacological correction by bacterial lysate should continue from the point of view of establishing the mechanisms of development, protection, and restoration of tissues.
It has been proved that by the end of the 90-day period of observation of the course of experimental periodontitis, the power of natural compensatory mechanisms acquired a state of decompensation. It has manifested by increased pro-inflammatory cytokine IL-1β in 1.7 times, and TNF-α in 3 times, decreased anti-inflammatory cytokine IL-10 in 1.6 times; increased the concentration of CIC in the blood in 2 times, C-reactive protein in 4.4 times at the local level in the gum tissue homogenate of the control pathology group of animals.
The powerful corrective effect of bacterial lysates «Respibron» and «Imudon» on the indicators of the cytokine series on the model of chronic experimental periodontitis has been reliably established. The normalizing effect is due to the compensation of bacterial dysbiosis, restoration of the balance of the activity of pro- and anti-inflammatory cytokines, and a decrease in the hyperactivity of immunological markers.
The therapeutic effect of «Respibron» (bacterial lysate of 13 strains of microorganisms) can be assessed as expressive and more powerful in comparison with «Imudon».
The obtained results make it possible to continue the study of the course of experimental periodontitis from the point of view of establishing the mechanisms of development, protection, and restoration of tissues under conditions of pharmacological correction with bacterial lysate «Respibron»
«Terrible triad» of the shoulder. Biomechanicalsemi-natural modeling andjustificationto rotator cuff restoration
Get PDFThe aim of this study: was determine the force of tension and deformation of axillary nerve in rupture rotator cuff and paresis of deltoid muscle of the shoulder joint.
Material and methods: Semi-natural modelling based on the axial scans spiral computed tomography of the intact shoulder joint was performed to determine the degree of traction load on the axillary nerve with distal displacement shoulder head and tendon rupture which paresis of the deltoid muscle.
Result: The values of deformations for axillary nerve being at the limit of tissue strength at distal displacement of humeral head of the model by 50 %, progressively increased with increasing distal displacement of humeral head to 100 % of its diameter, reaching values 1.7 times higher than the strength nervous tissue.
Conclusion: The progressive changes occurring in the axillary nerve under the action of traction loads, and as a consequence of its ischemia, over time can lead not only to demyelination, but also to the defeat of the axons themselves atrophy of its fibers. In turn, deltoid muscle atrophy increases the traction load on the affected axillary nerve, which forms a vicious circle. The only possible option to "break" the vicious circle is restore the stabilizing structures damaged during the injury, among which one of the most important is the tendons of the rotator cuff of the shoulder. Surgical restoration of the integrity rotator cuff of the shoulder reduces the traction load acting on the axillary nerve, which in turn significantly improves the conditions for reinnervation of the deltoid muscle.The aim of this study: was determine the force of tension and deformation of axillary nerve in rupture rotator cuff and paresis of deltoid muscle of the shoulder joint.
Material and methods: Semi-natural modelling based on the axial scans spiral computed tomography of the intact shoulder joint was performed to determine the degree of traction load on the axillary nerve with distal displacement shoulder head and tendon rupture which paresis of the deltoid muscle.
Result: The values of deformations for axillary nerve being at the limit of tissue strength at distal displacement of humeral head of the model by 50 %, progressively increased with increasing distal displacement of humeral head to 100 % of its diameter, reaching values 1.7 times higher than the strength nervous tissue.
Conclusion: The progressive changes occurring in the axillary nerve under the action of traction loads, and as a consequence of its ischemia, over time can lead not only to demyelination, but also to the defeat of the axons themselves atrophy of its fibers. In turn, deltoid muscle atrophy increases the traction load on the affected axillary nerve, which forms a vicious circle. The only possible option to "break" the vicious circle is restore the stabilizing structures damaged during the injury, among which one of the most important is the tendons of the rotator cuff of the shoulder. Surgical restoration of the integrity rotator cuff of the shoulder reduces the traction load acting on the axillary nerve, which in turn significantly improves the conditions for reinnervation of the deltoid muscle
Clinical and immunological efficiency of different therapy regimens in patients with infectious mononucleosis caused by Epstein-Barr virus
Get PDFThe aim of the study was to evaluate the effectiveness of ribonucleic acid in the correction of immune disorders in patients with infectious mononucleosis (IM) caused by EBV.
Materials and methods. We examined 110 patients with a mean age of 23.3±4.2 years with IM, among whom women accounted for 52.7 % (n=58). The material for the study was the serum of patients obtained during the disease course. The set of tests of patients with IM included clinical and biochemical methods, enzyme-linked immunosorbent assay, polymerase chain reaction method, immunogram. Statistical processing of the obtained data was performed with “Statsoft Statistica v. 10.0 for Windows” using the methods of variation and correlation statistics.
Results. The obtained results analysis revealed changes in the system of cellular and humoral parts of the immune system and the diversity of the immune response in patients with IM. The progressive nature of changes in immune parameters indicated the formation of secondary cellular immune imbalance, activation of the humoral link, a change in the balance of immunoregulatory mediators towards Th2 cells. Significant changes in the cellular immune system were observed in the acute period and were characterized by the increase in the number of cells with killer activity, namely mature T-lymphocytes (CD3+), cytotoxic T-suppressor cells (CD8+), cells expressing the activation marker CD25+ (IL-2 receptor), and by the Th1/Th2 ratio increase. The appointment of combination therapy including ribonucleic acid was accompanied by immunomodulatory and antiviral effects, that was reflected in a more pronounced positive dynamics of immunological parameters, namely in strengthening the proliferative response, compared with the group of patients receiving only basic therapy.
Conclusion. The expediency of the combination therapy application: the drug Nuclex (ribonucleic acid) (250 mg) 2 capsules 3 times a day for 14 days and valacyclovir (500 mg) at a dose of 1000 mg (2 tablets) 3 times a day for 14 days, is justified for the correction of immune disorders in patients with IM caused by EBV
Association of psychological status with first diagnosed pulmonary tuberculosis in men
Get PDFThe aim. Assessment of the initial psychological status of men with first diagnosed pulmonary tuberculosis and the study of its associations with the clinical course of the disease.
Materials and methods. The study involved 54 men with first diagnosed pulmonary tuberculosis. Patients had a dynamic complex clinical, laboratory and instrumental examination with an assessment of the psychological status according to the State-Trait Anxiety Inventory (STAI) and the Beck Depression Inventory (BDI).
Results. The evaluating of initial psychological status in patients with first diagnosed pulmonary tuberculosis, depressive states of varying severity were found in 47.05 % of patients, moderate state anxiety – in 74.51 % of patients, moderate trait anxiety – in 35.29 %. We revealed associations of the levels of anxiety and depression with the degree of bacterial excretion and the duration of the intensive phase of therapy.
Conclusions. To assess the psychological status of patients with first diagnosed infiltrative pulmonary tuberculosis, it is advisable to use the STAI and the BDI.
Patients with first diagnosed infiltrative pulmonary tuberculosis in 100 % of cases have psychological status disorders with a predominance of moderate state anxiety and the absence of depressive disorders in only half of them. More expressed violations of the psychological status (anxiety, depression) identifies patients who are married and have a steady job.
In patients with first diagnosed infiltrative pulmonary tuberculosis, an increase in the severity of anxiety and depression is associated with more expressed bacterial excretion, decrease in body weight, greater frequency of destruction of lung tissue, prevalence of the tuberculosis process by more than 2 lung segments, decrease in the effectiveness of standard therapy and prolongation intensive phase of treatment
Combined prevention of fetal growth restriction based on determination of diagnostic markers
Get PDFDue to the morbidity of mothers and newborns caused by fetal growth restriction (FGR) and preeclampsia, preventive measures should be taken, especially in women at high risk of developing these conditions. Many studies have been conducted on the prevention of FGR and preeclampsia in high-risk women, especially anticoagulants, aspirin, paravastatin, nitric oxide, microelements (L-arginine, folic acid, vitamins E and C, phytonutrients, vitamin D) and calcium.
The aim is to improve perinatal consequences by preventing FGR in high-risk women.
Materials and methods: A prospective study of 137 pregnant women in the period of 110–136 weeks was conducted at the Perinatal Center in Kyiv. Pregnant women were divided into 3 groups. The main group included 47 women at high risk of FGR who received therapy (low doses of aspirin, low molecular weight heparin (LMWH) and vitamin and micro elements drugs). The comparison group included 45 women who had a high risk of FGR but did not receive treatment. The control group consisted of 45 women who were not at risk of FGR. The frequency of FGR and placental dysfunction were analyzed as well as a fetal distress was analyzed ante- and intranatally.
Results: Therapy with low doses of aspirin, LMWH and a complex preparation of vitamins and micro elements improves the course of pregnancy and gestational complications. In the main group FGR was detected in 8.5 %, in the comparison group – in 17.8 %, in the control group – 4.4 %. Placental dysfunction was detected in 13.3 % in the control group, and only 6.4 % in the main group that was close to the control group – 2.2 %. Similar tendencies were found for fetal distress ante- and intranatally.
Conclusions: The proposed prophylactic measures can improve maternal outcomes by reducing the level of gestational complications in pregnant women with biochemical signs of risk of FGR development. In addition, these preventive measures can reduce the frequency of children births with growth restriction, which significantly reduces early neonatal and perinatal morbidity and mortality
Experimental research of cerebroprotective activity of the new 4-aminobutatanoic acid derivative
Get PDFThe aim. To study the cerebroprotective activity of a new derivative of 4-aminobutanoic acid the compound KGM-5 on the effect on survival and behavioural responses, cognitive impairment and neurological deficits in rats with acute cerebrovascular accident.
Materials and methods. Acute cerebrovascular accident (ACVA) was simulated in rats by irreversible unilateral carotid occlusion (UCO) under anesthesia with sodium thiopental (35 mg/kg, intraperitoneally, IP). Five groups of animals were used: intact control (IC, n=6), a group of animals with ACVA, which were not treated (control pathology, CP, n=13); group of animals with ACVA, which were treated for 5 days after surgery (first injection 30 min before surgery) with the compound KGM-5 (ACVA+KGM-5, n=14) at a conditionally effective dose of 30 mg/kg body weight of animals, a group of animals with ACVA (ACVA+CD “Picamilon”, n=13), who received IP for 5 days, the comparison drug (CD) “Picamilon” at a dose of 17 mg/kg and pseudo-operated animals (POA), n=8), which were operated without ligation of the carotid artery, which allows to level the effect of anesthesia and surgery on the studied indicators. The cerebroprotective effect of the studied agents was assessed by an integral criterion – survival of animals (throughout the experiment), indicators of neurological deficit (24, 48, 72, 94 hours after ACVA modelling), the state of cognitive functions in the test of extrapolation escape test (EET) (72 hours after ACVA modelling)
Results. The KGM-5 compound contributed to a significant reduction in the severity of neurological deficit, as evidenced by significant differences in this indicator compared with CP, respectively, the first (0.5 points vs. 1.25 points, p<0.05), the third (0.0 points against 1.0 point, p<0.05) and the fourth day (0.0 points vs. 0.5 points, p<0.05) after OCO. Under the influence of CD “Picamilon” reduction of neurological deficit compared with CP was observed on the first, third and fourth days, but these differences were insignificant (p>0.05). Both studied agents - the compound KGM-5 and CD “Picamilon” contributed to the improvement of cognitive functions of rats with ACVA, as evidenced by a significant reduction (p<0.05) of the latent period of diving in the EET, respectively, 1.8 and 1.7 times compared with CP and did not show a significant effect on animal survival.
Conclusion. The cerebroprotective activity of a new 4-aminobutanoic acid derivative in the conditions of acute cerebrovascular accident in rats was established in terms of the ability to reduce the severity of neurological deficits and improve cognitive functions in the extrapolation escape test. The severity of cerebroprotective activity of the new compound is not inferior to GABA-ergic drug “Picamilon”
Peculiarities of intrauterine pathological processes in women of the postmenopauseal period
Get PDFAim of the research is studying the pecularities of the endometrium pathological processes in postmenopausal women on the basis of the hysteroscopy data evaluation, as well as conduction of histopathological and immunochemical studies.
Materials and methods. To study the pecularities of intrauterine pathological processes, 100 postmenopausal women were selected and studied. All women underwent hysteroscopy with separate diagnostic scraping of the uterine cavity. Also, 10 samples of glandular-fibrous endometrial polyps (GFEP) in women of reproductive age and 9 samples of such pathology in the postmenopausal period were studied by immunohistochemical method, using 6 primary specific monoclonal antibodies.
Results. The results showed that in 64 (64 %) postmenopausal women pathological changes of the endometrium were presented with GFEP, and in 2 patients (2 %) endometrial adenocarcinoma was found. It was also determined that the nuclei of epithelial and stromal cells of GFEP in postmenopausal women are characterized by lower expression of estrogen and progesterone receptors, compared with women with such formations in the reproductive age. In addition, it was found that in postmenopausal women the expression of the apoptosis inhibitor bcl-2 and aromatase P450 in the epithelial and stromal cells of GFEP was more expressed, and the expression of the Bах antigen, on the contrary, was significantly lower than in women of reproductive age.
Conclusions. Fundamental molecular-biological differences of GFEP in postmenopausal women compared with women of reproductive age were revealed. It was found that in postmenopausal women there is a significantly lower dependence of such polyps on the effects of estrogen and progesterone. In addition, the data indicate an increased risk of neoplastic transformation in such women