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The prospects for NT-pro BNP level determining in physical activity conditions in patients during the rehabilitation period after the myocardial infarction, complicated with decompensated heart failure
No full textThe aim of the study was to determine the futility of NT-pro BNP level analysis during dosed physical exercise for diagnosing decompensated HF in the postinfarction period and the possibility to determine the HF functional class.
Materials and methods. 160 patients with previous MI were examined, patients’ average age was (56.67±5.72) years. The patients were randomized in 2 groups dependently on the presence of the signs of II А-B according to V. Kh. Vasylenko and M. D. Strazhesko classification and FC III-IV (according to NYHA) decompensated chronic HF. Group I consisted of 120 patients with Q-QS and non-Q MI; group II (the control one) had 40 patients with MI without signs of decompensated HF; 20 healthy people made up a norm group.
Results. Signs of coronary insufficiency such as dizziness and signs of poor peripheral perfusion (cyanosis/paleness) occurred in 104 (86.7 %) and 79 (65.8 %) cases that differ from the same values in the second group 4 (10.0 %) and 14 (35.0 %) respectively. 88 (73.3 %) patients with the signs of decompensated HF felt general weakness, fatigue, and expressed a request to stop the test.
The HR in the postinfarction patients with the signs of decompensated HF was before the exercise (88.2±3.18) bpm (p≤0.05); in the patients with past MI without the signs of decompensated HF, it was (75.32±3.41) bpm (p≤0.05); and in the practically healthy people, it was (77.73±3.02) bpm. We found out a reverse moderate correlation between the distances that had been covered by a patient during the 6MWT NT-proBNP level in blood serum of examined patients.
Conclusions. Inadequate response to dosed physical exercises and increased immunological parameters as quantitative HF markers could be useful not only for diagnostics, but also for the risk stratification for decompensated HF that had occurred in patients on different rehabilitation stages after an acute MI
Influence of the placental cord insertion site on the placental mass and the birth weight in dichorionic diamniotic twins
Get PDFThe aim of the study was to determine the effect of the displacement of the umbilical cord insertion site from the centre of the placenta on the placental mass and the birth weight of dichorionic diamniotic twins and to consider the importance of the direction of the displacement, as well as to assess the influence of the umbilical cord displacement on the placental mass and the birth weight of dichorionic diamniotic twins taking into account the direction of displacement.
Material and methods. The study was performed on 135 dichorionic diamniotic pairs: 68 opposite-sex, 35 same-sex males, and 32 same-sex females. The impact of an absolute cord displacement from the centroid of the placental disc and the direction of its shifting were compared with the birth weight and the placental mass.
Results. In the investigated group, a central insertion was revealed in 6 (2.2 %), eccentric – in 224 (83.0 %), marginal – in 31 (11.5 %), and velamentous – in 9 (3.3 %) cases. The first two types of cord insertion are considered to be normal, the third and the fourth are seen as abnormal. The placental mass was in a strong positive correlation with the birth weight (r=0.71, p<0.0001). The placentas with an eccentric cord insertion had a smaller surface area. A negative correlation was established between the displacement of the cord insertion site and the placental mass (r=-0.4284, p<0.0001) as well as the birth weight (r=-0.6115, p<0.0001). The shift along the long axis was of greater importance than in relation to the shorter one. The placental mass and the birth weight were higher in the new-borns with a normal cord insertion site. In the abnormal cord insertion group, 32.5 % of the infants were under the 10th birth weight percentile, in the normal cord insertion group – only 8.3 %.
Conclusions. The birth weight of dichorionic diamniotic twins and their placental mass are negatively correlated with the distance of the umbilical cord insertion site from the placental centre. The insertion site displacement along the long axis has a stronger negative effect on the birth weight and the placental mass in comparison with the shifting along the short axis. The placentas with an eccentric cord insertion have a smaller surface area
Monitoring of parasitic diseases of dogs
Get PDFDuring the study, dogs were diagnosed with the following helminthic diseases: toxocariasis, echinococcosis, uncinariosis, trichuriasis, capillariosis, dipilidiosis, which took the form of mono and mixed invasions.
The aim of this study was to identify the intensity of helminth infestation of dogs of different ages and methods of keeping.
Materials and methods. Experimental studies were conducted during 2018–2020 on the basis of the laboratory “Innovative technologies and safety and quality of livestock products” and “Veterinary Pharmacy” of the Department of Veterinary Examination, Microbiology, Zoohygiene and Safety and Quality of Livestock Products; epizootology and parasitology of the Faculty of Veterinary Medicine of Sumy National Agrarian University.
In cities and villages, faecal samples were taken from dogs, taking into account the method of keeping (tethered or untethered) and their use (office, hunting, decorative, etc.), which were placed in airtight containers, labeled samples and sent to the laboratory for the research.
The object of clinical and laboratory research were dogs aged one to seven years, admitted to veterinary clinics in the period from 2018 to 2020, with suspected helminthic diseases. Testing of dogs was performed by collecting medical history and clinical examination.
Results. According to the results of the research, it was established that among helminthic diseases during 2018–2020 the following diseases were registered: toxocariasis, cestodes, uncinariosis of dogs. Among the blood-parasitic diseases for the period 2018–2020 were diagnosed with heartworm disease, babesiosis of dogs.
Among ectoparathyroidism, the laboratory diagnosed demodectic mange, otodectosis, canine sarcoptosis, and carnivorous syphonepterosis. A total of 513 surveys were conducted in 2018, of which 80 were positive; for 2019–509, of which positive – 58; for 2020 – 488, of which 62 are positive.
Conclusions. Intestinal helminthiasis has been found to account for the lowest proportion (11 %) of carnivorous parasitic diseases compared to blood parasitic diseases (19 %) and ectoparasitosis (70 %), but they are of great interest for study because of their significant epidemiological significance and may be the cause of disease in humans.
It has been proven that helminthic diseases of dogs run as mixed invasion, and a minority of cases 31.7 % of cases run as mono invasion. Of the total number of patients with helminthic diseases, 73.4 % of the total number of animals were accompanied by other diseases of infectious and non-infectious etholog
Immunohistochemical features of gastrointestinal stromal tumors and their role for differential diagnosis and prognosis
Get PDFThe aim. To clarify all most important immunohistochemical features of gastrointestinal stromal tumors with different histological patterns and analyze the role of expression of Ki-67, MMP-9, VEGF and p16ink4A as a predictive markers of tumor progression.
Materials and methods. The study is based on analysis of 100 primary GISTs for description of their morphological features and 36 GISTs taken from this 100 for study of prognostic markers.
Results. All spindle cell GISTs have shown diffuse expression of CD117 in tumor cells. The levels of CD117 expression varied from strong expression (3+) until mild expression (1+). Strong expression were seen in 75,8 % of spindle cell GISTs. Epithelioid GISTs demonstrated heterognous moderate or mild expression of CD117. All primary epithelioid GISTs from patients that had relapse of tumor in period from 1 till 3 years demonstrated focal mild expression of CD 117 in tumor cells. Expression of DOG-1 were seen in all 100 cases of GISTs, that were included in our study. The strong expression of DOG-1 (3+) were seen in all 45 GISTs that had low mitotic rate (≤5 mitoses per 50HPF) and not associated with their histological pattern. GISTs with high mitotic rate demonstrated heterogeneous expression of DOG-1 in tumors: moderate expression (2+) with patchy areas of strong expression (3+). Expression of CD56 was not found in spindle cell GISTs, but single tumor cells of epithelioid GISTs that had high mitotic rate demonstrated expression of this marker. The average expression of p16ink4A were higher in tumors that gave relapses compared with tumors without relapses (50,3 % versus 5,7 % respectively, U-test=16.5; p≤0,01).The average expression of MMP-9 also were significantly higher in GISTs that gave relapses: 63,2 % compared with 13,4 % in GISTs without relapse (U-test=16; p≤0 ,01).The strong VEGF expression was found in 66,7 % of GISTs that had relapses and only in 8,3 % of GISTs without relapses. 50 % of GISTs without relapses was negative for VEGF. Finally, the average expression of Ki-67 were 13,4 % in GISTs with relapses and 8,7 % in GISTs without them (U-test=16; p≤0,01).
Conclusion. We highly recommend using DOG-1 for epithelioid GISTs. Additionally in epithelioid GISTs can be used CD56 that can give focal positive reaction in some tumour cells. The following minimal panel of markers for differential diagnosis of spindled GISTs from other mesenchymal tumors of gastrointestinal tract is proposed: CD117, DOG-1 and SMA, where the first too markers will demonstrated the moderate or strong diffuse expression and SMA can be occasionally positive in some tumor cells. p16ink4A, ki-67, VEGF and MMP-9 can be used as additional prognostic markers in GISTs
Evaluation of vestibular function in children with purulent media otitis by computer stabilometry
Get PDFThe aim of the research – assessment of vestibular function in children with acute purulent otitis media by computer static stabilometry compared with typically developed children of the same age.
Materials and methods: 22 children with purulent otitis media aged 4 to 7 years and 30 practically healthy peers were examined by static stabilometry on the device “MPFI stabilograph 1” (Kharkiv, Ukraine). Indicators of variation and shape of the pressure center distribution, spectral-correlation indicators of stabilograms, as well as integral indicators of stability (length, velocity and angle of postural oscillations) were taken into account and the equilibrium functions of the two sensory states (open and closed eyes) are calculated in the StabiliS software.
Results: purulent otitis media causes posterior displacement of the absolute coordinates of the pressure center. In the state with closed eyes, children with purulent otitis differ from their healthy coevals by 14 of 24 stabilometric parameters, including stabilogram length, speed, angle and amplitude of oscillations, giving way to them in the stability of equilibrium. Children with purulent otitis media are more sensitive to the visual canal of postural control than their coevals. Involvement of visual afferents in postural control significantly improves balance maintenance in children with purulent otitis by reducing deviations of postural oscillations, which is reflected in the probable changes of 9 out of 24 stabilometric parameters compared to control.
Conclusions: In preschool age, purulent otitis media leads to latent vestibular dysfunction, which is manifested by a violation of the stability of the vertical posture in a state with closed eyes and is compensated by visual-vestibulo-proprioceptive integration in the process of postural control.The aim of the research – assessment of vestibular function in children with acute purulent otitis media by computer static stabilometry compared with typically developed children of the same age.
Materials and methods: 22 children with purulent otitis media aged 4 to 7 years and 30 practically healthy peers were examined by static stabilometry on the device “MPFI stabilograph 1” (Kharkiv, Ukraine). Indicators of variation and shape of the pressure center distribution, spectral-correlation indicators of stabilograms, as well as integral indicators of stability (length, velocity and angle of postural oscillations) were taken into account and the equilibrium functions of the two sensory states (open and closed eyes) are calculated in the StabiliS software.
Results: purulent otitis media causes posterior displacement of the absolute coordinates of the pressure center. In the state with closed eyes, children with purulent otitis differ from their healthy coevals by 14 of 24 stabilometric parameters, including stabilogram length, speed, angle and amplitude of oscillations, giving way to them in the stability of equilibrium. Children with purulent otitis media are more sensitive to the visual canal of postural control than their coevals. Involvement of visual afferents in postural control significantly improves balance maintenance in children with purulent otitis by reducing deviations of postural oscillations, which is reflected in the probable changes of 9 out of 24 stabilometric parameters compared to control.
Conclusions: In preschool age, purulent otitis media leads to latent vestibular dysfunction, which is manifested by a violation of the stability of the vertical posture in a state with closed eyes and is compensated by visual-vestibulo-proprioceptive integration in the process of postural control
Development of methods of identification and quantitative determination of active substances in semi-solid dosage forms with sapropel extracts
Get PDFFor use in veterinary medicine for the treatment of the wound process and the prevention of mastitis, the composition and technology of an emulsion-based cream, conventionally called “Saprocream”, has been developed. Clinical trial of the drug “Saprocream” proved its effectiveness and safety for use in the healing of microtraumas, erosions and cracks (wounds) of the udders of cows.
The aim of the research were was the standardization of the cream under the conventional name “Saprocream” for use in veterinary medicine as a wound healing agent, the development of methods of identification and quantification and their validation.
Materials and methods. Test samples of emulsion cream type o / v, containing 15 % aqueous extract of sapropel (VES), 10 % oil extract of sapropel (OES), 6 % emulsifier No. 1, 1 % cetylstearyl alcohol, preservatives – 0.01 % nisin, 0.1 % euxil K 100 and purified water up to 100 g were made by phase inversion.
The methods of pharmacopoeial articles of the European Pharmacopoeia of the 10th edition, SPhU 1.0, as well as industry standards were used to develop methods for identification and quantification of active pharmaceutical ingredients (API) in the developed cream and its standardization.
Results. The chromatographic profile of the acetone extract from the cream coincides with the chromatographic profile of the reference solution ((PRS) β-carotene), which indicates the presence of substances of carotenoid structure. The absorption spectrum of hexane extraction from the cream in the range from 500 nm to 750 nm has a maximum absorption at a wavelength of 670±2 nm, which coincides with the maximum absorption of hexane solution OES, indicating the presence of chlorophyll.
A method for quantifying the total mass fraction of humic acids (HA) has been developed and it has been established that the total mass fraction of HA in cream samples with sapropel extracts is 0.828 %.
The results of the validation of the method show that there is a linear relationship between the concentration of the total mass fraction of HA and the mass of the AES sample with a correlation coefficient of 0.9981 (³ 0.9981). The developed technique is precise, because the value of the relative confidence interval is less than the critical value for the convergence of the results: D %=1.34≤1.60 and the criterion of insignificance of systematic error d=0.51 is fulfilled.
Conclusions. An emulsion-based cream under the conventional name “Saprocream” has been standardized, methods for identification and quantification of active substances have been developed and validation of the developed methods for use in veterinary medicine as a wound-healing and anti-inflammatory agent has been carried out
Histotopographic and morphometric characteristics of the oral mucosa postoperative wounds healing, depending on the method of connecting the wound edges
Get PDFImplementation of high-quality tissue connections and hemostasis in oral surgery is an urgent problem of modern dentistry, due to the lack of available universal methods that would help to facilitate the work of oral surgeon and reduce wound healing time.
The aim of the research. To investigate and study the regeneration processes in the oral mucosa after high-frequency electric welding, suturing and medical adhesive composition.
Materials and methods. This study compared the effect of three connection methods and hemostasis: high-frequency electric welding (EKVZ-300M1 “PATONMED®”, Ukraine), suture method (nylon 5/0 “PIRUS®”, China), adhesive composition (“Histoacryl®”, Germany). 72 rabbits were involved in experiment. An incision of the soft tissues of the vestibulum of the oral cavity of the maxilla with a length of 1.3–1.5 cm was made. On days 3, 7, 14 and 21, tissue samples were excised, histological and morphometric examination of the material were performed.
Results. By statistical data processing of 72 rabbits was found that the reliability of differences in the levels of morphometric parameters between groups on each day is very high, as evidenced by the calculated values of the U-test. In 38 cases (90.5 %), the significance level was p≤0.01, in the other 4 cases – p≤0.05. The lowest value level of neutrophilic granulocytes was in rabbits of group No.1 (electric welding). In rabbits of group No. 1 GFBC were not observed in the 8 fields of view throughout the experiment.
Conclusions. High-frequency electric welding of soft tissues can be used for effective intraoperative hemostasis and connection of the intraoral wound edges.
Due to the absence of a foreign body (adhesive masses, filaments) and moderate alterative effect, histological examination indicates accelerated activation of regenerative processes in the early stages of observation in rabbits of group No. 1
INFLUENCE OF DIFFERENT TYPES OF ANESTHESIA FOR LAPAROSCOPIC HYSTERECTOMY ON THE DYNAMICS OF STRESS HORMONES
Get PDFThe aim of the study – to evaluate the influence of different variants of anesthesia, including low-opioid (LOA) and opioid-free anesthesia (OFA), on the dynamics of the stress response during laparoscopic hysterectomy.
Materials and methods: 102 patients were randomly allocated into 3 groups: 37 women assigned to receive a standard opioid-based anesthesia (OBA group), 33 women – LOA group and 32 patients OFA group.
Results: The patients of OFA group after induction and intubation of the trachea showed a significant (p<0.05) increase in cortisol level by 155.4 % and 160.9 % compared with the OBA group and LOA group. After completion of the hysterectomy, regardless of the variant of anesthesia, the level of cortisol exceeded the preoperative one (pOBA=0.116, pLOA=0.049, pOFA=0.043). Two hours after surgery with standard anesthesia (OBA group) there was a further increase in the concentration of cortisol in the blood, exceeding the initial values by 142.9 % (p=0.043). Patients in the LOA group and OFA group tended to decrease cortisolemia. The changes in adrenaline & glucose levels were somewhat similar.
Conclusion: Use of OFA is accompanied by an aggravation of the stress response at the stage of hysterectomy, which is manifested by an increase in the level of adrenaline and cortisol. The most adequate perioperative protection is inherent in low-opioid anesthesia, which is accompanied by a lower release of stress hormones during hysterectomy and in the postoperative period. Opioid-based anesthesia provides adequate intraoperative protection, but is accompanied by insufficient postoperative analgesia
Pharmacopeial aspects of preparation of infusions and decoctions in pharmacies
Get PDFAn analytical review of pharmacopoeial aspects of preparation of infusions and decoctions in pharmacies is presented.
The aim of this work is to conduct a comparative analysis of pharmacopoeial requirements for the technology of infusions and decoctions in pharmacies.
Materials and methods of the research. Comparative analysis of pharmacopoeial requirements was performed using methods of systematic and structural-logical analysis.
Results and discussions. It was found that in many pharmacopoeias (European, British, Italian, French, Czech, Kazakh) there are no instructions on the pharmacy technology of these dosage forms. Only the pharmacopoeias of Japan, Austria, Belarus and Russia contain separate monographs on the extemporaneous preparation of infusions and decoctions.
After analyzing these monographs, it was found that the definition of infusions and decoctions as a dosage form differs. It was found that the Japanese Pharmacopoeia regulates the preliminary preparation of medicinal plant raw materials (soaking for 5 minutes in water), in other pharmacopoeias there is no such requirement. When conducting a comparative analysis of the technology of preparation of infusions and decoctions, we observe that the ratio of medicinal plant raw materials (MPRM) and extractant and extraction modes differ.
Conclusions. An analytical review of pharmacopoeial aspects of preparation of infusions and decoctions in pharmacies is presented.
A comparative analysis of the requirements for technology and quality control of infusions and decoctions in accordance with pharmacopoeial articles revealed both different and similar information. The results of the research showed that despite the differences in the structures of articles and names, as well as approaches to the definition of this dosage form, some requirements are similar (particle size of MPRM). The differences that were found include the ratio of MPRM and extractant, extraction modes.
Taking into account the data of the analysis and the existing national requirements, the authors proposed a draft general pharmacopoeial article “Infusions and decoctions made in pharmacies”
Rationale for the efficiency of transcranial magnetic stimulation in multiple sclerosis
Get PDFThe aim. Based on the analysis and comprehensive clinical and neurological evaluation of the results to substantiate the effectiveness of transcranial magnetic stimulation (TMS) in the treatment and rehabilitation of patients with multiple sclerosis (MS).
Methods. A total of 110 MS patients were included in the study. The control group consisted of 30 patients who received pathogenetic therapy and 80 patients who underwent a course of rhythmic transcranial magnetic stimulation (rTMS) together with pathogenetic therapy.
Results. The results obtained during the study indicate the complex multifactorial nature of fatigue and its significant impact on the clinical manifestations of MS. Also, the use of rTMS reduced the severity of the main neurological symptoms of MS. The improvement in the overall EDSS scale in the group of patients receiving rTMS was statistically significant: from 5.0±1.9 points to 4.5±2.0 points (p<0.01), in the comparison group (p>0.05). Under the influence of TMS, gait function improved, but these indicators were statistically insignificant (p>0.05). The greatest effect of rTMS was obtained on the manifestations of fatigue and also extended to its cognitive and psychosocial components. The obtained patterns are confirmed in the analysis of indicators on the SCA and FS scales. Involvement in the treatment of patients with MS rTMS allowed to achieve a significant reduction in the manifestations of all components of fatigue: from 76.0±20.9 points to 75.5±20.5 points (p<0.05).
The data obtained during the study confirm the effectiveness, safety and viability of non-invasive neuromodulation by rTMS in the treatment and rehabilitation of patients with MS.
Conclusions. The use of rTMS has a positive effect on the manifestations of fatigue, both motor and cognitive, in patients with MS at all types of course and at different stages of progression. Non-invasiveness, safety and ease of use, the possibility of differentiated use allow the use of rTMS in the clinic of rehabilitation treatment and become an important component of active drug and non-drug rehabilitation of patients with MS