Archive of Clinical Medicine
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Hemostasis Condition in Pregnant Women with a Threat of Late Spontaneous Miscarriage Associated with Metrorrhagia and Ascending Infection
No full textThe subject of the research was the condition of hemostasiogram in chronic bleeding and vaginal microbiocenosis in pregnant women with the threat of late spontaneous miscarriage.The objective was to define a condition of vaginal microbiocenosis in pregnant women with the threat of late spontaneous miscarriage associated with chronic metrorrhagia and to investigate hemostasis changes.Materials and methods. Pregnant women with the threat of late spontaneous miscarriage were under the supervision. Clinical, microbiological, hemostasiological, and statistical methods were used in the research.The results. According to the results of the research, the number of lactobacillus (LB) decreases and the growth of obligatory and facultative anaerobes increases in pregnant women with threat of initial late involuntary miscarriage associated with chronic metrorrhagia. Moreover, the vaginal microecology worsens with prolongation of bleeding and the risk of ascending fetal infection and pregnancy loss appears.Conclusions. Local inflammatory response to the arisen infection is manifested in activation of blood coagulation system. Generalized hypercoagulation on the background of blood fibrinolytic properties dicrease leads to chronic DIC. Whereas, the majority of coagulative cascade components stimulate the inflammatory response. Therefore, metrorrhagia during the threat of late spontaneous miscarriage should be considered as a negative factor which causes changes of the vaginal microecology and promotes the ascending placenta and fetal infection and demands specific anti-infectious actions and use of antihemorrhagic preparations.
Features of Way of Life in Women with Premenstrual Syndrome
No full textToday premenstrual syndrome (PMS) has leading positions in endocrine gynecology. In addition to hormonal, vegetative-vascular, metabolic mechanisms in the development of this disease biosocial factors are also important. The objective of research was to estimate features of lifestyle in women with PMS. The research included 200 women of reproductive age with diagnosis of PMS. Moos Menstrual Distress Questionnaire was used for diagnosis of this pathology. Control group consisted of 50 women without diagnosis of PMS. We found that lack of physical activity was associated with the presence of PMS (c2=20.90, p<0.001, OR=0.22, 95%CI=0.12-0.43, p<0.001). High percentage of individuals with irrational and unbalanced regime of work and rest was detected among women with this neuroendocrine syndrome (c2=4.39, p=0.04, OR=2.11, 95%CI=1.10-4.05, p=0.02). Specifically marked association of this factor was in patients with cephalgic form of the disease (c2=4.71, p=0.03, OR=3.73, 95%CI=1.23-11.29, p=0.02). Constant systematic stress situations in patients with PMS occurred much more frequently than in healthy women (c2=10.91, p<0,001, OR=3.88, 95% CI=1.73-6.89, p=0.001), and were the most typical for persons with neuropsychic form of the disease. Irregular diet was typical for patients of all PMS clinical forms (c2=12.75, p<0.001, OR=3.30, 95% CI=1.73-6.30, p<0.001). Thus, our results indicate the significance of certain biosocial factors in the incidence of this neuroendocrine syndrome. This will allow to predict PMS occurrence as well as to develop preventive measures of the disease taking into account risk factors
Some Aspects of Postoperative Hypoparathyroidism Prevention and Treatment
No full textThe objective of this work was to improve the results of surgical treatment of patients with various diseases of the thyroid gland (TG) in the aspect of postoperative hypoparathyroidism (HPT) development by new approaches to its prevention.The analysis of surgical treatment of 48 patients at the age of 12 to 78 with various pathology of the thyroid gland (TG) was conducted. The patients were treated in Ivano-Frankivsk Regional Oncology Dispensary and Ivano-Frankivsk City Central Clinical Hospital from 2013 to 2015. Depending on the postoperative period management, patients with signs of postoperative hypoparathyroidism were divided into 2 groups. The first group of patients received basic therapy during the postoperative period according to the Treatment Protocol, approved by the order of the Ministry of Health of Ukraine from 05.08.2009, No. 574. Patients of the second group received drug Cytoflavin in a dose of 10 ml by intravenous infusion into 200 ml of 0.9% NaCl solution for 7 days in addition to the basic therapy. The use of Cytoflavin during the postoperative period after thyroidectomy reduces symptoms of hypoparathyroidism (HPT) resulting in better oxygenation of the tissues of the parathyroid glands (PTG) and restoring the balance of the oxidative modification of proteins system and enzymes of the antioxidant system (OMP-AOS), which is manifested in significant antihypoxic and antioxidant effect of the drug and justifies indications for its use in this disease treatment.
Influence of Percutaneous Coronary Intervention on Heart Failure in Patients with Q-Wave, Qs-Wave Myocardial Infarction
No full textIn patients with myocardial infarction without revascularization chronic heart failure is characterized by burdened course of disease manifesting in deterioration of clinical condition, decrease in exercise tolerance, significant changes in hemodynamics, intense manifestations of myocardial ischaemia, significant left ventricular remodeling compared to those individuals who underwent endovascular myocardial reperfusion by culprit coronary artery stenting. Percutaneous coronary intervention was found to promote significant increase in left ventricular ejection fraction, a significant decrease in end-systolic volume, myocardial mass and left ventricle myocardial performance index compared to patients without revascularization.Reperfusion therapy improves the course of post-infarction period and therefore should be a priority treatment of patients with acute myocardial infarction.
Ovarian Cancer and Mutation 5382insC in BRCA1 Gene (Clinical Case)
No full textCase report was described and familial cancer syndrome in proband’s family was established. Based on the results of complex examination and medical-genetic counseling proband’s disease was associated with mutation 5382 insС in BRCA1 gene indicating the role of molecular genetic testing for timely detection of malignant ovarian and breast pathology in families with burdened history of cancer
Case Study. Cerebral Angiodystonia with Syncopes.
No full textThe 20-year-old patient lost his consciousness for the second time in his life. After the first case, 3 years ago, he was treated at the regional pediatric hospital with diagnosis “Cerebral angiodystonia with syncopes”. In this case the hepatosplenic syndrome was detected that initially was estimated as the sign of chronic intoxication. The final diagnosis of dysplastic heart was made
Role of Genetic Polymorphisms of the Renin-Angiotensin System and Immune Inflammation in the Development of Glycometabolic Disorders in Patients with Arterial Hypertension
No full text129 patients with arterial hypertension (AH) were examined. They were divided into three groups depending on the presence or absence of concomitant glycometabolic disorders including pre-diabetes, type 2 diabetes mellitus (T2DM) and the control group (10 individuals). The distribution of genotype frequencies of the renin-angiotensin system (RAS) genes was characterized by a significant prevalence of the TT genotype of the AGT M235T polymorphism in patients with AH, pre-diabetes and T2DM. When comparing the levels of inflammatory markers in the control group and patients with AH depending on the presence of pre-diabetes and T2DM an activation of pro-inflammatory immune response was detected, as evidenced by a significant increase in interleukin-18 (IL-18) plasma levels in patients with AH of 3 groups. There was observed a production of anti-inflammatory cytokines IL-10 in patients with AH and those with AH secondary to prediabetes compared to patients of the control group, which may be regarded as a protective reaction. Informative pronating markers influencing the development and forecasting glycometabolic disorders including pre-diabetes and T2DM in patients with AH were seven indicators - body mass index (BMI), heart rate (HR), serum IL - 10 levels, glucose levels after exercise tolerance test, HbA1c levels and genetic signs of C allele of AGTR1 gene A1166S polymorphism and T allele of the AGT M235T polymorphism
Influence of Metabolic Syndrome on Clinical Characteristics of Psoriasis
No full textTo study the clinical course of psoriasis in metabolic syndrome (MS) 93 patients with plaque psoriasis were examined. All patients were divided into 2 groups: Group I included 48 patients with psoriasis and MS and Group II included 45 patients with psoriasis without MS. The psoriasis area and severity index (PASI) was used to measure overall psoriasis severity and coverage. MS was diagnosed according to the recommendations of the International Diabetes Federation (2005). There were determined the body mass index (BMI), insulin resistance index (HOMA-IR) as well as quality of life and social adaptation of patients (DLQI). It was established that MS is accompanied by more severe clinical course of psoriasis. The indicators of skin lesions BSA and index PASI were 37.33% and 31.1% (p <0.05) higher compared to patients without MS. There was a relationship between BMI, HOMA-IR and PASI: (r = 0.34; r = 0.65, respectively, p <0.05). In patients with psoriasis and MS more pronounced reduction in psychosocial adaptation and quality of life in terms of DLQI was observed.