Archive of Clinical Medicine
Not a member yet
268 research outputs found
Sort by
Optimization of Therapeutic Measurements in Rotavirus Infection in Infants with Perinatal Exposure to HIV
Get PDFThe features of the clinical course of rotavirus infection in infants with perinatal exposure to HIV were studied. Serum level of procalcitonin as a marker of inflammatory activity and the need for antimicrobial therapy was determined. The efficiency of the proposed additions to basic treatment (low-lactose mixture for two months, antibiotic therapy in case of elevated procalcitonin level) was demonstrated
Optimization of Life-Threatening Ventricular Ectopy and Sudden Cardiac Death Prevention in Patients with Postinfarction Cardiosclerosis
Get PDFThe objective of the research was to optimize treatment of patients with ischemic heart disease (postinfarction cardiosclerosis) and concomitant phenomenon of heart rate turbulence based on the study of heart rate turbulence and heart rate variability.Materials and methods. The study included 100 patients with ischemic heart disease and postinfarction cardiosclerosis complicated by cardiac rhythm disorder (ventricular ectopic beats). Patients were divided into 2 groups according to the type of prophylaxis: Group I received bisoprolol; Group II received quercetin in addition to bisoprolol. A daily dose of bisoprolol was 0.07 mg/kg body weight while a daily dose of quercetin was 1g for 7 days. The control of therapy effectiveness was performed using Holter monitoring of heart rate turbulence and heart rate variability.Results. Bisoprolol intake by patients with ischemic heart disease and concomitant heart rate turbulence led to significant increase in the stress index as well as the decrease in the overall tension of body regulation, either parasympathetic or sympathetic divisions of the autonomic nervous system and the vasomotor center. Drug intake did not lead to the abnormal physiological correlation between the activity of the subcortical and peripheral components of the nervous systems. While analyzing the changes in the indices of heart rate turbulence and heart rate variability, there was found, that during combination treatment of patients with ischemic heart disease using bisoprolol and quercetin, positive changes appeared in the regulatory parts of the body.Conclusions. Combination treatment of post-myocardial infarction patients with bisoprolol and quercetin allows us: a) to achieve complete reduction in ventricular ectopic activity in more than half of patients; b) to reduce the number of patients with life-threatening ventricular ectopic beats significantly; c) to maintain the physiological value and the activity of the autonomic nervous system as well as the vasomotor center of the body; d) to decrease the level of turbulence onset and maintain the value of turbulence slope
Quality of Life as an Integrative Indicator of Health Status in Patients with Chronic Hepatitis C and Concomitant Diabetes Mellitus Type II
Get PDFThe main indicators of quality of life in patients with chronic hepatitis C with concomitant diabetes mellitus type II were studied on the basis of SF-36. A sharp decrease in physical and mental health was observed in patients with combined comorbidity in comparison with the group of patients without concomitant diabetes mellitus type II. Improvement of the patients’ quality of life by all parameters was detected under the influence of alpha-lipoic acid and lactulose use in addition to antiviral therapy
Blood Lipids and Leptin Levels in Patients with Ischemic Heart Disease and Concomitant Non-Alcoholic Fatty Liver Disease after Treatment with Atorvastatin
Get PDFNon-alcoholic fatty liver disease which is regarded as an independent predictor of cardiovascular diseases plays a significant role in the development of ischemic heart disease. In patients with verified ischemic heart disease, hyperleptinemia causes hypertrophy of vascular smooth muscle cells, increases the synthesis of endothelial growth factor as well as the accumulation of reactive oxygen species in the vascular wall and leads to elevated expression of endothelin-1, which is also an indicator of its influence on vascular remodeling. Leptin is a predictor of a higher functional class of angina pectoris and heart rhythm disorders; it may be used as an indirect marker of systemic inflammation as well. Pathogenic basis for ischemic heart disease treatment is hypolipidemic therapy with statins as the medications of choice; in addition to basic hypolipidemic action, they improve endothelial function increasing nitric oxide synthesis possessing anti-inflammatory, anti-ischemic, antiaggregatory, antithrombotic and profibrinolytic action, as well as antioxidant and antiproliferative effects.The objective of the research was to study changes in blood lipids and leptin levels in patients with ischemic heart disease and concomitant non-alcoholic fatty liver disease after a course of atorvastatin. Materials and methods. 54 patients with ischemic heart disease and concomitant non-alcoholic fatty liver disease were examined; there were 26 individuals who did not take atorvastatin and 28 individuals taking atorvastatin at a dose of 40 mg per day for 3 months. All the patients underwent anthropometry, determination of blood lipids, leptin and liver transaminase levels, electrocardiography, echocardiography, ultrasound of the internal organs.Results. A significant decrease in the average level of total cholesterol (p<0.01), concentration of low-density lipoproteins (p<0.01) and leptin level (p<0.01) was detected in patients after 3 months of atorvastatin use. Moreover, there was detected a direct correlation between leptin level and triglyceride concentration, leptin level and the body mass index, leptin level and waist circumference, leptin level and hip circumference, as well as a high correlation between total cholesterol and low-density lipoproteins, and total cholesterol and the body mass index.Conclusions. The administration of atorvastatin to patients with ischemic heart disease and concomitant non-alcoholic fatty liver disease at a dose of 40 mg per day improves the patients’ general condition and promotes a significant decrease in the levels of pro-atherogenic fractions of blood lipids and leptin level, as well as promotes the reduction in risk factors for comorbid pathology and prevents the occurrence of its complications
Biopharmaceutical Studies of Pharmacopoeial Excipients Based on Pectin and Indicators of Advisability of Their Application in Specific Oral Cavity Environment
Get PDFThe biopharmaceutical studies have undoubtedly proven that the samples of pharmacopoeial excipients based on polyethylene oxide and sodium carboxymethyl cellulose being heated for 15 minutes lost their viscous consistency and became fluidal functioning as an ointment till the end of the experiment. In contrast, the samples based on apple pectin being heated thickened without hardening slightly accelerating the release of the excipients and functioning as a paste. The experiment data indicated the advisability of using substances based on pectin to develop pharmacopoeial excipients in the form of pastes for application in the specific oral cavity environment
Endothelial Dysfunction as a Factor in the Pathogenesis of Chronic Heart Failure of Various Genesis
Get PDFThe objective of the research was to study the pathogenetic role of the levels of endothelin-1 (ET-1), tumor necrosis factor-alpha (TNF-alpha) and C-reactive protein (CRP) in the development of endothelial dysfunction (ED) in patients with preserved and lost renal function.Materials and methods. The study involved 86 patients: Group I included 42 patients with arterial hypertension and chronic heart failure (CHF) IIA FC ІІІ; Group II consisted of 44 patients with terminal chronic kidney disease (stage V CKD) with concomitant CHF IIA FC ІІІ who were on treatment by outpatient program hemodialysis (HD).Results. In patients of Group II the levels of ET-1 and inflammatory markers were significantly higher than those in the comparison and control groups (p<0.001 and p<0.001). In patients of Group I there was a direct moderate correlation between TNF-alpha and ET-1 (r=0.48; p<0.05) and between CRP and ET-1 (r=0.56; p<0.05). In Group II, the relation between TNF-alpha and ET-1 was significantly stronger (r=0.58; p<0.05); between the levels of CRP and ET-1 it was weaker (r=0.37, p<0.05). Increased levels of ET-1, TNF-± and CRP affected the development of ED in both groups.Conclusions. It was found that CRP levels of TNF-alpha, ET-1 in patients on HD were significantly different from the same data in patients with preserved renal function, which is clearly associated with more pronounced signs of inflammation and ED in a cohort of dialysis patients. The impact of TNF-± in the development of ED in both groups was proved. Despite the higher level of CRP in patients with stage V CKD being corrected by HD with CHF, this biomarker had less impact on the prognosis of ED than in the general population of patients with CHF
Criteria for Progression of Primary Open-Angle Glaucoma Based on the Study of Neurophysiological Mechanisms of Glaucoma Development
Get PDFPrimary glaucoma is a disease causing the greatest number of vision-related problems. The latest clinical research methods such as scanning laser polarimetry and optical coherence tomography measure structural changes at different functional levels of the retina and the optic nerve. The studies of the optic nerve head, the peripapillary retinal nerve fiber layer and the macula area are considered as informative ones. According to literature data, structural changes in progressive glaucomatous optic neuropathy occur prior to apparent functional and clinical manifestations of the disease, however, this statement is true until the peripapillary retinal nerve fiber layer thickness is less than 72 mcm. Retinal ganglion cells are known to reduce in number with age (by 5,000 a year). In optical coherence tomography of glaucomatous eyes a scan of the macula is recommended to be performed using the Fast Macular Thickness Map protocol; it allows detecting the additional information on the pathological process. Neurophysiological methods - visual evoked potentials and electroretinography – allow us to study the processes in the visual cortex of the brain and at different morphofunctional levels of the retina as well as to clarify the localization and nature of pathological changes in the above-mentioned structures of primary damage at various stages of the glaucomatous process.The objective of the research was to determine diagnostically significant criteria for the progression of primary open-angle glaucoma based on the study of neurophysiological mechanisms of glaucoma development.Materials and methods. Complex clinical and neurophysiological study of eyes of 144 patients (274 eyes) with primary open-angle glaucoma was performed at the Filatov Institute of Eye Diseases and Tissue Therapy of National Academy of Medical Sciences of Ukraine. The main group included 59 (51.75%) females and 55 (48.08%) males with different stages of the glaucomatous process. The average age of patients was 58.41±3.96 years. Neurophysiological methods - visual evoked potentials (both flash and checkerboard type) and electroretinography using a RETI-scan multifocal ERG system (Roland Consult, Wiesbaden, Germany) - were used to diagnose the pathological condition.Results. There were established criteria for the progression of primary open-angle glaucoma considering neurophysiological indicators: the reduction in the bioelectrical activity of retinal ganglion cells according to the amplitude of the N75-P100 peaks and the elongation of the P-100 latency when using visual evoked potentials elicited by checkerboard stimuli; the reduction in the bioelectrical activity and the elongation of latency according to the characteristics of the a- and b-waves in photoreceptor cells and second-order neurons of the retina when using electroretinography. Pathological changes in the external, internal and deep retinal layers were found to occur simultaneously at all the stages of the glaucomatous process since the initial one. They are progressive and significantly expressed in the cell body of the third-order neuron of ganglion cells
Changes in Densitometric Values in the Comprehensive Treatment of Generalized Periodontitis in Patients with Osteopenia
Get PDFThe issue of surgical treatment of patients with generalized periodontitis and osteopenia is particularly topical. Numerous studies have confirmed the benefits of surgical treatment procedures using osteoplastic material to stimulate repair process of periodontal tissues. The objective of the research was to improve the effectiveness of surgical treatment of patients with generalized periodontitis and osteopenia through the combined use of osteoplastic material and antiresorptive drugs in the preoperative and postoperative periods.93 patients underwent treatment and clinical observation. The patients were divided into three groups. Group I included 20 patients who underwent surgical treatment according to conventional procedure. Group II included 25 patients who underwent surgical treatment with local application of osteoplastic material “Easy Graft”. Surgical treatment in Group III (26 patients) was conducted using osteoplastic material “Easy Graft” and antiresorptive drug “Bonviva”. Experimental group consisted of 22 apparently healthy individuals. The obtained results indicated that surgical treatment using osteoplastic material and antiresorptive drug contributes to the most significant positive effect determined according to the dynamics of densitometric values. Combined use of osteoplastic material “Easy Graft” and antiresorptive drug “Bonviva” leads to stable process stabilization being confirmed by densitometric study indices both in early and in remote postoperative period
Mechanisms of Development of Hypothalamic Pubertal Syndrome in Children
No full textThe analysis of Ukrainian and foreign literature with the aim to study the causes, mechanisms of development, the main approaches to classification, and clinical manifestations of hypothalamic pubertal syndrome in children and adolescents was made. An overview of the literature showed the importance of in-depth analysis of hypothalamic pubertal syndrome in children and adolescents and a number of options to solve the problem was identified. Medical and social importance of hypothalamic syndrome is determined by young age of patients, rapidly progressive disease course, severe neuroendocrine disorders which are often accompanied by reduced or total disability. The objective of the research was to consider hypothalamic pubertal syndrome in children and adolescents as neuroendocrine syndrome occurring during puberty and post puberty as a result of functional disorders of the endocrine system. In most cases it was difficult to find out its main cause as manifestations often occurred some years after the action of the causal factor leading to serious reproductive-health consequences among girls (infertility, polycystic ovary syndrome, subsequent obstetric and perinatal complications). Set of symptoms associated with pathological changes in the hypothalamic region characterized by autonomic, endocrine, metabolic and trophic disorders and dependent to some extent on the localization of lesions in the hypothalamus and features of violation of neurohormonal regulation of hypothalamic-pituitary relationships was studied. It could also be argued that the main pathogenetic and clinical aspect of hypothalamic pubertal syndrome is hypertension. The mechanisms contributing to the relationship between hypertension and obesity are complex and multifactorial
Using Modern Telecommunication Technology in Postgraduate Education of Surgeons
No full textThe system of postgraduate education of surgeons at the Ivano-Frankivsk National Medical University extensively uses contemporary telecommunications media. They include multimedia equipment during lectures and seminars with interns and surgeons during the thematic courses and pre-credentialing cycles; streaming video from operating theatre to the classrooms (using video cameras installed in every operating room) which provides not only watching the course of operations, but also analyzing simultaneously the stages of intervention, and discussing them; video round at the surgery departments of the Regional Clinical Hospital during professional training courses of surgeons with participation of the head of the Regional Association of Surgeons, the chief surgeon of the region, heads of the surgical departments of the Ivano-Frankivsk National Medical University, the head and attending physicians of the surgical department with subsequent rolling the footage in the classroom. The use of contemporary computer and telecommunication technology should be combined with face-to-face communication of interns and students with patients and surgeons working at the department and in the operating rooms. Telecommunication technologies increase efficiency of theoretical education of doctors but do not solve the problem of improving practical skills, and mastering new techniques during surgical interventions