Archive of Clinical Medicine
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Substantiation of Initial-I Stage of Generalized Periodontitis Complex Treatment Choice Among Medical University Students According to Indicators’ Dynamics Changes of Oral Cavity Prooxidant-antioxidant System
Get PDFAccording to the results of epidemiological studies, the spread of periodontal tissue diseases has tendency to increase, despite recent decades’ significant achievements in dentistry. Studies of periodontal tissue diseases pathogenesis have found that oxygen-dependent production of reactive oxygen species (ROS) and antioxidant activity are involved in the pathogenic mechanism of the disease. ROS are highly toxic and can induce lipid peroxidation (LPO). Researchers have shown increased levels of LPO with generalized periodontitis (GP). "Noofen" is one of the drugs that normalizes the processes of LPO and shows positive effect in GP treatment. That is why in advanced complex treatment of generalized periodontitis of initial-I stage, we’ve used this pill.
The objective of the study was to analyze the efficiency of nootropic medicine "Noofen" usage in suggested initial-I stage of generalized periodontitis treatment, taking into account the dynamics of oral fluid prooxidant and antioxidant indicators among students with high level of emotional sensitivity.
Materials and methods. A study of 2nd year students (174) of Ivano-Frankivsk National Medical University were questioned in order to determine the level of individual emotional states (anxiety, frustration, aggression and rigidity) according to the method of H. Eysenck. Of those who have experienced increased and high level of emotional sensitivity to various stressors and situations, we have selected 50 students with initial-I stage of generalized periodontitis. To determine the efficiency of treatment, two groups were formed: observation (group I) and comparison (group II). Each group consisted of 25 individuals who were treated and monitored dynamically during the year. The condition of oral cavity prooxidant system was determined by the level of malondialdehyde (MDA) and diene conjugates (DC). To study the state of the antioxidant protection system, the activity of superoxide dismutase (SOD), glutathione-S-transferase (G-ST) and glutathione peroxidase (GPO) were determined. The advanced treatment, which included oral rinsing with "Octenisept" solution, dissolving of tablets "Lizak", intake of medicine "Noofen" and vitamin-microelement complex "Vita-Supradin Active".
Conclusions. The results of the performed treatment indicate that the use of advanced therapy of GP is significantly more effective, confirmed by prooxidant-antioxidant system parameters of oral fluid in the long term, compared with traditional treatment
Psychological Peculiarities of Professional Burnout of Teachers of High Medical Educational Institutions
Get PDFIn the article the relevance of the outlined problem in the context of the entrance of Ukraine in the world medical educational space is covered. The essence of the professional burnout of teachers of the higher medical educational institutions (HMEI), which is characterized by the gradual loss of life tone by the subject under influence of prolonged stress in the professional teaching activity and is manifested by symptoms of chronic fatigue, general exhaustion, depersonalization, reduction of professional achievements, etc., is determined too.
The objective of the study – to substantiate reasons, peculiarities, objective and subjective factors of the professional (emotional) burnout of teachers of the HMEI.
In the investigation the historical-systematic, comparative method and objective-specific method are used.
It is emphasized that the syndrome of professional burnout can lead to general decrease of the effectiveness of the professional activity of the teacher, deformation of interpersonal relationships as well as decrease of activity in the creative professional self-improvement, self-development. The threats and risks of the professional burnout of the teachers of medical university in providing the quality of professional training of future healthcare professionals, are characterized
Modern View on the Problem of Treating Minor Dentition Defects with the Use of Zirconium Oxide Ceramic Resin-Bonded Prostheses
Get PDFThe objective of the research was to substantiate the effective method of treating minor dentition defects in the lateral and frontal areas considering anatomic features, functionality and aesthetic appearance of the prosthesis.
Materials and methods. A new approach to the problem of treating minor dentition defects with the use of zirconium oxide ceramic resin-bonded prostheses was proposed. The method of its manufacturing was described and the indications to the application were clearly explained. The comparative analysis with similar prostheses was conducted and the advantages of the proposed prosthesis were proved. Ceramic resin-bonded prosthesis allowed us to restore the dentition integrity in the presence of small bounded edentulous spaces in the lateral region and to provide high aesthetic qualities and bio-inertness of the prosthesis with maximum approximation to the physiological characteristics of natural teeth.
Results. Thirty-eight patients with small bounded edentulous space in the lateral region were treated with the use of zirconium oxide resin-bonded prosthesis for 18 months. The obtained results of prosthetic treatment indicated that the proposed prosthesis provided an opportunity to restore the aesthetic appearance and integrity of the dentition, to prevent the occurrence of the deformations and to ensure the functionality of the dento-facial system.
Conclusions. The framework made of zirconium oxide allowed us to significantly reduce the depth of hard dental tissue preparation resulting in a great aesthetic appearance thereby providing an opportunity to significantly expand the indications for use. The remote results of treatment indicated the absence of marginal coloration at the margin of indirect restoration and hard dental tissues, namely the marginal ridge, ensuring good aesthetics and functional integrity of the restorative construction
Transanal Endorectal Pull-Through With or Without Laparoscopic Assistance
Get PDFHirschsprung’s disease requires surgical treatment. Depending on the form of aganglionosis and severity of pathology, open or minimally invasive, transanal endorectal pull-through with or without laparoscopic assistance may be used.
The objective of the research was to study the efficiency of using transanal endorectal pull-through with and without laparoscopic assistance for treating Hirschsprung’s disease in children. We compared outcomes between approaches.
Materials and Methods. Over the period 2011-2016, 145 children with Hirschsprung’s disease were surgically treated using transanal endorectal pull-through (n=81) and laparoscopic-assisted transanal endorectal pull-through (n=64). A systematic literature review and meta-analysis were carried out.
Results. We noticed that transanal endorectal pull-through without laparoscopic assistance could be easily used in children under 4 years of age with aganglionosis including the sigmoid colon without significant colon dilatation considering a significant mesosigmoid mobility at such age. In other cases, we used laparoscopic-assisted transanal endorectal pull-through. The advantages of laparoscopic stage included the possibility for correct planning of surgical strategy, a thorough revision of the affected colon, determination of aganglionosis level, mobilization of the mesenterium, elimination of the adhesions and ligaments holding the colon, thereby avoiding tension in coloanal anastomosis, control and prevention of pull-through colon twisting which may cause an obstruction. In older patients, the proximal end of the rectum could be dissected laparoscopically. This allowed transanal endorectal pull-through to be performed quicker and safer. In the postoperative period, patients underwent rehabilitation with good functional results. Two children developed coloanal anastomotic dehiscence which was corrected by open stage treatment.
Conclusions. Age-related and anatomical features of the colon in the patients with Hirschsprung’s disease allowed performing transanal endorectal pull-through with or without laparoscopic assistance. Significant dilation of the colon, aganglionosis above the sigmoid area and the patient’s age over 4 years were indications for performing transanal endorectal pull-through with laparoscopic assistance. In other cases, transanal endorectal pull-through could be performed without laparoscopic assistance. The laparoscopic-assisted transanal endorectal pull-through procedure turned to be a safe and feasible technique for patients with Hirschsprung’s disease
Study of Complications in Patients Using Removable Dentures Over Different Periods
Get PDFThe topicality of the problem is related to the ever-increasing volumes of provision of prosthodontic assistance to the patients with removable dentures. During the dental examination we’ve noted 300 patients, who used removable dentures, the increased number of complications because of these constructions’ use. In particular, there is a growing number of patients who aren’t using the already made removable dentures. A significant percentage of patients don’t know or don’t fully care properly for the existing constructions and the oral cavity itself. This leads to a number of serious complications. We consider perspective the identification of opportunities to reduce the number of complications and extend the period of the use of removable denture structures by improvement the techniques for selecting denture base materials depending on the microbiological status of the oral cavity
Morphometric Characteristics and Features of Metachronous Breast Cancer
Get PDFAn important morphological criterion for the development of the degree of malignancy of breast cancer is the change in the structure of cell nuclei. At the same time, both the morphometric parameters of metachronous breast cancer and their connection with the molecular biological characteristics of these tumors are currently unknown.
The objective of the research was to identify metachronous malignant disease in the patients with breast cancer.
Materials and methods. The study is based on a retrospective analysis of tumors in 63 patients with breast cancer, who developed uterine cancer or ovarian cancer within 5 years after diagnosis of breast cancer. All the patients received treatment at the Ivano-Frankivsk Regional Clinical Oncology Center. The criterion for selecting patients in the study was the presence of gynecologic cancer after the treatment of breast cancer. The age of patients with breast cancer involved in the study ranged from 24 to 83 years, averaging 56.8±1.5 years.
Results and discussion. The maximum values of the perimeter, radius, and area of cell nuclei (19.21±0.7, 3.05±0.4 and 36.3±0.9, respectively) were observed in tumors of the patients with metachronous breast cancer. The improvement of the perimeter, radius, and area of tumor cell nuclei in the patients with metachronous breast cancer was associated with an increase in the size of the tumors and the presence of metastases in regional lymph nodes.
Conclusions. The morphometric sign of the high risk of developing metachronous breast cancer is the increase in the perimeter, radius, and cell nucleus area on the background of increased proliferative activity of low-grade cancer in the presence of large tumors and metastases in regional lymph nodes
Argonoperitoneum Effect on Pain Syndrome Intensity in Laparoscopic Cholecystectomy
Get PDFThe objective of the research was to compare the objective and subjective indicators of intra- and postoperative pain and surgical stress intensity.Materials and Methods. There were examined 360 patients suffering from gallstone disease. There were used the intraoperative monitoring of nociception index by means of Analgesia Nociception Index - monitor, the determination of serum cortisol concentration, the assessment of pain syndrome in the postoperative period by means of the Numerical Rating Scale in accordance with life quality assessment and the number of injections at the patient’s request.
Results. The analysis conducted indicated the reduction in pain irritation, low indices of pain syndrome and postoperative stress intensity under the effect of argonperitoneum. Considerable reduction in the need for analgesics in the study groups served as evidence to this predicted pattern. The assumption that the noticed phenomenon can be explained by the absence of acid irritation of the peritoneum due to argon chemical neutrality being distinct from carbon dioxide was substantiated.Conclusions. The results proved the effectiveness of argonperitoneum application in laparoscopic surgeries
Improvement of Students’ Training Level in Higher Educational Institutions
Get PDFObjective: to determine the effective factors of impact on the internal motivation stimulation for students’ study
Clinical Effectiveness of Cardiocytoprotective Therapy in Patients with Acute Coronar Syndrome (ACS) – Myocardial Infarction (MI), Who Were Performed Balloon Angioplasty and Coronary Artery Stenting
Get PDFThe aim of the study was to increase the efficiency of restorative treatment of patients with Acute Coronary Syndrome (Miocardial Infarction) by incorporating the protocol therapy for the course of parenteral use of L-arginine and L-carnitine (Tivorel).
It has been determined that patients with ACS (MI) after percutaneous coronary intervention often develop reperfusion syndrome with manifestations of left ventricular insufficiency and rhythm disturbances. Substantial clinical and functional improvement was noted under the influence of standard medical treatment in patients of control group. At the same time postinfarction remodeling with systolic and diastolic function of the heart, with the development of heart failure syndrome and endothelial dysfunction of blood vessels, and also remained resistant to extrasystole therapy, progressed.
Patients in the experimental group under the influence of complex medical treatment with the inclusion of L-arginine and L-carnitine marked a significant decrease in the frequency of violations of rhythm and conduction for the second day of observation, as well as a decrease in the manifestations of post-infarction remodeling of LV, which ultimately manifested a significant improvement in myocardial contractility (EF increased by 13%) and decreased diastolic dysfunction. Improvement of the inotropic function of the heart and a significant reduction in the frequency and severity of reperfusion arrhythmias was achieved precisely due to cardiometabolic effects of L-carnitine. In addition, in patients undergoing additional treatment with L-arginine and L-carnitine after 10 days of treatment, the activity of ET-1 was significantly lowered and the concentration of nitrogen oxide metabolites in the blood plasma increased and reach the level of healthy subjects (p>0.05). So, they recovered the endothelial function of the vessels
Effeciency of Initial-I Stage Generalized Periodontitis Treatment Among Medical University Students According to Indicators of Oral Cavity Prooxidant-antioxidant System
Get PDFPeriodontal diseases are one of the most important problems in dentistry, due to its very high dissemination. Inflammatory processes in periodontal tissues are more common among young people, which, in the future, without adequate treatment lead to irreversible changes in structure of cellular bone. This causes development of new effective therapeutic complexes aimed at eliminating etiopathogenetic factors development of periodontal tissues inflammatory diseases and the targeted influence on the pathological processes in these tissues.
The objective of the study was to analyze the efficiency of suggested initial-I stage generalized periodontitis treatment among second-year students of medical university.
Materials and methods. To achieve this goal, we examined and treated 50 students with initial-I stage of generalized periodontitis without somatic pathology, which were divided into two groups, depending on treatment method. First group included 25 students who received advanced treatment; second group included 25 students, who received usual treatment. Control group consisted of 20 clinically healthy students. The state of oral cavity prooxidant-antioxidant system was determined by the level of malone dialdehyde (MDA), diene conjugates (DK), superoxide dismutase (SOD) activity, glutathione-S-transferase (G-ST), and the activity of glutathione peroxidase (GPO).
Results and discussion. Periodontal diseases, namely, initial-I stage of GP, are accompanied by an imbalance of oral cavity prooxidant-antioxidant system indicators. This is confirmed by an increase number of MDA and DK (p<0.001), and a decrease in SOD, G-ST, GPO (p<0.001) compared to clinically healthy students.
Conclusions. The results of GP treatment in first group were significantly better in relation to the second one (p<0.05), indicating the effectiveness of the proposed advanced treatment of initial-I stage of GP