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Peculiarities of Hepatic Encephalopathy in Patients with Alcohol Liver Cirrhosis Against the Background of Chronic Bronchitis Exacerbation
Get PDFObjective. To evaluate the clinical manifestations of hepatic encephalopathy (HE) in patients with alcohol liver cirrhosis (ALC) in exacerbation of chronic bronchitis (CB).Materials and methods. 100 patients with ALC class B and C according to Child-Pugh, 82.00% of men and 18.00% of women aged (47.2±3.9) years, were examined: 48 patients without combination with CB (group I); 52 patients on the background of CB exacerbation (group II). Clinical-laboratory and instrumental examination was performed. The West-Haven criteria were used to assess the HE.Results. In 54.17% of patients in group І, the I degree of HE was determined, in 35.42% – the ІІ degree, in 10.42% – the ІІІ degree. In patients of group ІІ the HE of the І degree was found in 17.31%, the ІІ degree – in 50.0%, the ІІІ degree – in 32.69% (p<0.05). In patients with ALC and ALC in combination with CB, respectively, clinically HE was manifested by drowsiness in the daytime and the inversion of sleep (58.33%; 75.00%), lengthening the duration of the TMT-time test (61.59±2.38 sec; 72.84±3.03 sec), mood disorders (20.83%; 28.85%), appearance of asterixis (54.17%; 76.92%), constructive apraxia (41.67%; 55.77%).Conclusions. 1. Exacerbation of CB in patients with ALC contributes to the increase in the degree of HE, worsening the prognosis. 2. The relationship between the hyponatremia and the degree of HE is revealed
Surgical treatment of bite wound of the upper lip with simultaneous use of plastic repair with local tissues
Get PDFThe article describes a clinical case of surgical treatment of bite wound of the upper lip by primary surgical treatment of the wound, the wound suturingwith simultaneous use of plastic repair with local tissues. Peculiarities of the surgical treatment of bite wounds of this area, methods of complications’prevention are discussed
The Prospect of Cluster Analysis’ Use to Obtain the New Scientific Results at the Example of Urotheliocytes’ Study in Experimental Diabetic Cystopathy
Get PDFDuring the experiment on 70 adult male rats of the Wistar line the priority mechanisms of development of streptotrozotocin diabetic cystopathy were determined. It’s morphometrically and statistically proved that the imbalance of the systemic mechanisms of the functioning of the transitional epithelium of the bladder starts from the first stages of the development of diabetic cystopathy and is not restored to the end of the experiment; it is associated with a violation of the structural and functional balance between the uroletocytes of clusters 4 and 1 and clusters 2 and 3, as well as with a loss of urothelial bladder of morphological stratification.The general pathological processes accompanying the diabetic cystopathy of a bladder development were revealed. According to the results of histological, morphometric, ultrastructural methods, biochemical studies of blood and urine, determination of water balance and cluster analysis, the main systemic and non-systemic factors that cause the development of these pathological processes were established
A Case of Arteriovenous Malformation Involving the Hand
Get PDFArteriovenous malformations of the hand and wrist are uncommon and may involve any anatomic structure of the body. They may often lead to chronic pain and dysfunction. Treatment ranges from conservative measures to amputation with a high risk of complications and recurrence. We hereby report a rare case of an arteriovenous malformation in a 47-year-old woman who presented with a painless swelling of the dorsum of her left hand, which was treated successfully by surgical excisio
Frequency and Spectrum of Chromosomal Aberrations, Acrocentric Chromosome Associations Among Long Livers with Arterial Hypertension and Osteoarthritis Residing in the Carpathian Region
Get PDFTo maintain thyroid homeostasis, a key role is played not only by the adequate provision of a body with iodine, but also with other essential micronutrients, iron in particular. Iron is involved in the conversion of the amino acid L-phenylalanine into L-tyrosine, which is the part of active center of thyroid peroxidase which catalyzes the reactions of oxidation and organification of iodine during the biosynthesis of thyroid hormones. At the same time, insufficient secretion of thyroid hormones leads to mucinous edema of the gastric mucosa and closure of its ductless glands and reduction in both gastric juice secretion and iron absorption.
The objective of the research was to determine the influence of latent iron deficiency onto the thyroid status of schoolchildren.
Materials and methods. The study involved 68 boys and 65 girls at the age 6-11 years (Group I) and 12-18 years (Group II). To assess iron metabolism, the levels of hemoglobin in capillary blood, serum iron and ferritin, serum iron binding capacity were determined. To clarify the thyroid status in blood serum samples, there were determined the content of free triiodothyronine and thyroxine, thyroid-stimulating hormone of adenohypophysis, urinary iodine concentration; the dimension of the thyroid gland was determined and evaluated considering gender as well as body surface area according to the standards of thyroid volume (97 percentile).
Results. It was established that latent iron deficiency can cause thyroid homeostasis disorders, as indicated by the growth of TSH in blood serum of girls by 37.5% (p<0.01) as compared to the control data. The probability of the formation of thyroid dysfunction significantly increases in case of combined iodine and iron deficiency. The development of subclinical hypothyroidism was established in 90.0% of boys and 89.0% of girls at the age of 6-11 years and 100.0% of boys and 75.0% of girls at the age of 12-18 years with mild iodine deficiency and latent iron deficiency. In schoolchildren with microelementosis, an increase in the thyroid gland was revealed in 66.6% of boys and 75.0% of girls of Group I and in half of boys and girls of Group II.
Conclusions. Iron deficiency can cause changes in thyroid homeostasis even at the stage of preclinical disorders. Latent iron deficiency potentiates the development of subclinical hypothyroidism in case of mild iodine deficiency
Effect of Urogenital Infections on the Development of Placentary Dysfunction in Women Belonging to Risk Groups
Get PDFThe study involved 36 pregnant women with inflammatory diseases of female genital organs and 40 placentas of women with the physiological course of pregnancy and childbirth. Immunohistochemical and histological methods were used. It has been established that pregnant women with urogenital infections compared to those with physiological pregnancy had a lower concentration of the placental lactogen hormone and more active proapoptic protein of the BAX against the background of the unchanged concentration of the anti-apoptotic protein Bcl-2 in the cytoplasm of the invasive cytotrophoblast of the basal lamina
Juvenile Idiopathic Arthritis in Adults: Long-Term Observation of Ukrainian Patients
Get PDFThe assessment of long-term outcome of functional disability and disease activeness in adult patients with juvenile idiopathic arthritis appears to be complicated due to the absence of a unified approach to the classification and estimation of disease activeness, as well as the loss of supervision over a patient because of remission or his/her transition from pediatric to adult rheumatic service. The objective of the research was to determine how adults with the history of juvenile idiopathic arthritis fulfill the classification criteria for adult rheumatic diseases, as well as to assess activeness of these diseases, the degree of functional disorders, and social activeness of patients in Ukraine. Materials and methods. Patients with juvenile idiopathic arthritis older than 18 years and with more than 3 years of disease duration living in different parts of Ukraine were included into the study. Data regarding sociodemographic features, fulfillment of adult classification criteria, Health Assessment Questionnaire, articular and extra-articular Juvenile Arthritis Damage Index and disease activity were analyzed.Results. We observed 122 adult patients with the history of juvenile idiopathic arthritis irrespective of the presence of active inflammation at the moment of the examination. This group included patients from different regions of Ukraine diagnosed with juvenile idiopathic arthritis during 1984-2013. An adult rheumatologist examined all patients and the diagnosis was revised according to the adult classification of rheumatic diseases. Typical diagnostic criteria for rheumatoid arthritis were estimated in 32.8% of patients, ankylosing spondylitis – in 31.1% of patients, undifferentiated arthritis – in 13.9% of patients, Still’s disease – in 4.9% of patients, psoriatic arthritis – in 0.8% of patients, steady clinical laboratory remission – in 16.5% of patients. Most patients (81.8%) with rheumatoid factor positive polyarticular juvenile idiopathic arthritis fell under rheumatoid arthritis criteria in adulthood, and in 85% of patients with enthesitis-related arthritis as well as 53.8% of patients with extended oligoarthritis ankylosing spondylitis developed in adulthood. 68.8% of patients with systemic juvenile idiopathic arthritis, 68% of patients with rheumatoid factor negative polyarthritic subtype and 55% of patients with enthesitis-related arthritis had disability and incapacitation. Minimal disorders of the patients’ general condition according to the Health Assessment Questionnaire in adult age were found in most subtypes of juvenile idiopathic arthritis classified according to the International League of Associations for Rheumatology (extended and persistent oligoarthritis, rheumatoid factor positive polyarthritis, systemic subtype); moderate disorders of the general condition were found in enthesitis-related arthritis and rheumatoid factor negative polyarthritis. Side effects of juvenile idiopathic arthritis according to the articular Juvenile Arthritis Damage Index included severe articular damage being most frequently found in systemic and rheumatoid factor positive polyarthritis subtypes of juvenile idiopathic arthritis, while side effects of juvenile idiopathic arthritis according to the extra-articular Juvenile Arthritis Damage Index included extra-articular damage being found in systemic and rheumatoid factor negative polyarthritis subtypes of juvenile idiopathic arthritis, that was confirmed by the assessment of physical health according to the Short Form Health Survey-36, which was the worst in patients with systemic (40.3±12.6) and rheumatoid factor negative polyarthritis (38.9±9.4) subtypes of juvenile idiopathic arthritis.Conclusions. Further research of remote consequences of juvenile idiopathic arthritis in adult age and long-term observation of such patients require a detailed study to improve diagnostics and provide adequate treatment of rheumatic diseases with juvenile onset in adult age
Our Experience in Treatment of Testicular Torsion in Children
Get PDFThe objective of the research was to analyze personal experience and world literature on the diagnosis and treatment of boys with testicular torsion and to improve the process of providing specialized care.Materials and methods. The study included 141 boys with testicular torsion. 133 patients underwent emergency surgery, 8 patients underwent manual detorsion.Results. Treatment was successful in 88 patients; in 53 cases, orchiectomy was performed.Conclusion. Personal observations and the analysis of the literature on testicular torsion in boys indicate the need for early diagnosis and immediate surgery
How to Teach Students Mastering Practical Skills Without Stress by the Example of Fourth-Year Dental Students
Get PDFThe article presents the results of the experimental study devoted to stress prevention in the course of directed formation of practical knowledge and skills in students. Since all the students constantly suffer from chronic constructive stress, the traditional system of acquiring knowledge and skills becomes time-consuming. There is a low assimilation of the material by students due to a lack of understanding of their tasks.The objective of the study was to increase the efficiency of mastering practical skills in therapeutic dentistry considering the students’ psycho-emotional state.Materials and methods. There were formed 2 groups of fourth-year students studying in different groups who attended the course of periodontology. In Group I (35 students), the teacher explained the specific purpose and benefits of manual removal of dental deposits using Gracey curettes and provided a specific manipulation scheme. The teacher slowly demonstrated each action: the instrument and the specific tooth for which it is used. Then, the students were offered to independently remove dental deposits according to the scheme. 34 students of Group II learned traditional removal of dental deposits using Gracey curettes. The teacher explained the manipulation, and, then, slowly demonstrated it on dental moulage. Afterwards, students independently performed the manipulation. We compared the success of mastering practical skills by students and developing an automatic skill.Results. 34 students of Group I (97.1%) removed dental deposits properly on the first try, and after 10 identical manipulations, all students of Group I developed an automatic skill. In Group II, only 44.1% of students (15 individuals) developed an automatic skill after performing 10 identical manipulations. It should be noted that the main students’ actions in this group were accompanied by a considerable number of mistakes; students incorrectly selected dental tools for removing the deposits, and the teacher spent a lot of time correcting these mistakes.Conclusions. The proposed method is an effective means of directed formation of manual action complex in students. The creation of action schemes for specific manipulation allows us to simplify the learning process reducing the time for the formation of automatic skills in students
The research of the state of prosthetic bed tissues in patients with pemphigus vulgaris.
No full textThe clinical examination of condition of tissues prosthetic bed was conducted in 20 patients with pemphigus vulgaris. The results are compared with survey data of 20 persons of control group without somatic pathology. It was conducted the analyzes of subjective and objective assessment of tissues prosthetic bed, the results of clinical examination and frequency of various pathologies of the oral mucosa membrane in the studied groups, conducted the comparative evaluation of dental indicators