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Methodical Issues of the Interns' Training Regarding the Treatment of Patients with Acute Pancreatitis
No full textObjective: To improve the mastering of tactics of treatment of patients with acute pancreatitis by interns of the specialty "Surgery".
Material and methods: We performed an analysis of the effectiveness of the education-methodological process in interns of the specialty "Surgery" for mastering the surgical tactics of treatment of patients with acute pancreatitis at the Department of General Surgery of Bukovinian State Medical University during 2017-2020 years.
Results: Optimization of intern training was carried out due to the introduction of modern minimally invasive methods of surgical interventions and the latest highly informative diagnostic and prognostic criteria for the complicated course of acute pancreatitis. The effectiveness of training is improved through the use of modern interactive technologies, for assessing the knowledge of interns the method of discussion polling is preferred.
Conclusion: Perfect mastery of modern minimally invasive methods of interventional treatment, understanding of their place and significance is an important component of effective learning of tactic of the treatment of acute pancreatitis by interns in the specialty "Surgery".
Key words: acute pancreatitis, surgical tactics, interns.Мета роботи — покращити засвоєння лікарями-інтернами зі спеціальності «Хірургія» тактики лікування пацієнтів із гострим панкреатитом.
Матеріал і методи. Проведений аналіз ефективності організації навчально-методичного процесу в лікарів-інтернів з фаху «Хірургія» щодо засвоєння хірургічної тактики лікування пацієнтів із гострим панкреатитом на кафедрі загальної хірургії Буковинського державного медичного університету в 2018-2022 рр..
Результати. Оптимізація підготовки інтернів здійснена за рахунок впровадження сучасних мініінвазивних методів оперативних втручань та новітніх високоінформативних діагностичних та прогностичних критеріїв ускладненого перебігу гострого панкреатиту. Ефективність навчання покращено за рахунок використання сучасних інтерактивних технологій, для оцінки знань інтернів перевага надається методу дискусійного опитування.
Висновок. Досконале оволодіння сучасними мініінвазивними методами інтервенційного лікування, розуміння їх місця та значення є важливим компонентом ефективного навчання лікарями-інтернами із спеціальності «Хірургія» тактики лікування гострого панкреатиту.
Ключові слова: гострий панкреатит, хірургічна тактика, лікарі-інтерни
Methods of Prevention of Postoperative Peritonitis
Get PDFThe aim of the study. To explore the causes and improve methods of prevention of postoperative peritonitis.
Materials and methods. From 2012 to 2022 in the surgical department of municipal non-profit enterprise “Regional clinical hospital of the Ivano-Frankivsk Regional Council” were performed 10687 surgical interventions for various diseases and injuries of organs of the abdominal cavity. In 244 (2.3%) patients the postoperative period was complicated by the development of peritonitis, which led to repeated surgical intervention. We analyzed the results of treatment of this category of patients aged 20 to 84 years. Local peritonitis was diagnosed in 125 (51.2%) of them, diffuse peritonitis in 119 (48.8%).
Research results. For today approaches to methods of surgical prevention of postoperative peritonitis are quite uninformative, due to the fact that in most cases the main rules of asepsis and antiseptics and appropriate surgical tactics are followed in combination with conservative intensive infusion therapy and antibacterial drugs.
Complete removal of pathological contents from the abdominal cavity is a mandatory stage of surgery for postoperative peritonitis and one of the key factors in preventing such complications in the postoperative period as septic shock and multiple organ failure. Based on the information from the analysis of the literature, as well as on our own observations, we have developed a method of lavage of the abdominal cavity, which affects various pathogenetic factors in postoperative peritonitis.
Conclusion. Fundamental meaning in the prevention of the development of postoperative peritonitis are the timely execution and adequate volume of the operation, the maximum evacuation of the pathological contents with subsequent lavage of the abdominal cavity by the proposed method, careful handling of the organs of the abdominal cavity (suture of questionable areas and injuries of the intestine), careful hemostasis, active-passive drainage of not only loose areas of the abdominal cavity, but also of anastomosis and abscess cavities
The Examination of Remodeling Processes of Hard Periodontal Tissues in Rats with Disorders of Pancreatic Incretory Function
Get PDFTopicality. Pancreatic hormones play an important role in the process of remodeling of hard periodontal tissues. Violations of carbohydrate metabolism that occur under conditions of isolated insulin resistance (IR) and in combination with iodine deficiency (ID) can be the cause of dysmetabolic disorders of mineralization/demineralization physiological system of tooth-maxillary complex.
The aim. To study the changes of remodeling processes of hard periodontal tissues in rats with isolated IR and impaired glucose tolerance against the background of ID.
Materials and methods. The examination was carried on 90 male rats, which were divided into three groups: control (intact animals), group of rats with IR under conditions of adequate iodine supply, and with IR against the background of ID. The system of carbohydrate metabolism was studied by the level of insulin in blood serum, glucose and glycosylated hemoglobin (HbA1c) of blood with the following calculation of HOMA-IR index. The processes of mineralization/demineralization were detected by the content of calcium, magnesium, zinc, manganese, copper in cementum of tooth root and alveolar process, and by the activity of acid and alkaline phosphatases in blood serum.
Results. Keeping of animals on a high-fructose diet led to the development of carbohydrate metabolism disorders (increase blood glucose and HbA1c levels, blood serum insulin, HOMA-IR index) and changes of remodeling processes in hard periodontal tissues (decrease the level of calcium, magnesium and manganese against the background of increase the zinc content in cementum of tooth root; decrease the content of macroelements in alveolar process; activation of acid phosphatase against the background of inhibition of alkaline phosphatase activity). The development of combined endocrinopathy was accompanied by more pronounced changes of studied parameters.
Conclusions. The violation of glucose tolerance against the background of ID slows down the mineralization processes of hard periodontal tissues mainly due to the intensification of osteoresorptive processes.
Keywords: acid and alkaline phosphatases; calcium homeostasis; bioelement panel of tooth-maxillary system; insulin resistance; iodine deficiency.Актуальність. Важливу роль у процесі ремоделювання твердих тканин пародонта відіграють гормони підшлункової залози. Порушення обміну вуглеводів, які виникають за умов ізольованої інсулінорезистентності (ІР) та у поєднанні з йододефіцитом (ЙД) можуть бути причиною дисметаболічних розладів у системі фізіологічної мінералізації/демінералізації зубоальвеолярного комплесу.
Мета. Вивчити зміни процесів ремоделювання твердих тканин пародонта у щурів із ізольованою ІР та порушеною толерантністю до глюкози на тлі ЙД.
Матеріали і методи. Дослідження проведені на 90 щурах-самцях, які були розділені на три групи: контрольну (інтактні тварини), групу щурів з ІР за умов належного забезпечення йодом та з ІР на тлі ЙД. Систему вуглеводного обміну досліджували за рівнем інсуліну в сироватці крові, глюкози й глікозильованого гемоглобіну крові (HbА1с) із наступним розрахунком індексу HOMA-IR. Процеси мінералізації/демінералізації вивчали за вмістом кальцію, магнію, цинку, марганцю, міді у цементі кореня зуба й комірковому відростку та за активністю кислої й лужної фосфатаз сироватки крові.
Результати. Перебування тварин на високофруктозній дієті призвело до розвитку порушень вуглеводного обміну (збільшення рівня глюкози й HbА1с крові, інсуліну сироватки крові, індексу HOMA-IR) та змін процесів ремоделювання твердих тканин пародонта (зниження рівня кальцію, магнію та марганцю на тлі зростання вмісту цинку у цементі кореня зуба; зменшення вмісту макроелементів у комірковому відростку; активація кислої фосфатази на тлі пригнічення активності лужної фосфатази). Розвиток комбінованої ендокринопатії супроводжувався більш вираженими змінами досліджуваних показників.
Висновки. Порушення толерантності до глюкози на тлі ЙД сповільнює процеси мінералізації твердих тканин пародонта головним чином за рахунок інтенсифікації остеорезобтивних поцесів.
Ключові слова: кисла та лужна фосфатази; кальцієвий гомеостаз; біоелементна панель зубощелепної системи; інсулінорезистентність; йододефіцит
Nursing Care Satisfaction among Patients Infected with Covid-19: A Turkish Perspective
Get PDFThe aim of this study was to determine the satisfaction with nursing care among patients diagnosed with Covid-19 and related factors.
Materials and Methods. The study was conducted between June and July 2020. The population of the study consisted of 102 patients treated in the Covid-19 clinics of the University Teaching and Research Hospital. The data were collected using the Newcastle Satisfaction with Nursing Care Scale with a total of 19 items, and the Patient Description Form designed to record the sociodemographic characteristics and medical histories. The data were evaluated using the program package IBM SPSS 20.0. To test the significance of the difference between two independent groups, the Student’s t-test was used, and the one-way ANOVA was used to test the significance of the difference between more than two groups.
Results. The results showed that most patients were satisfied with nursing care. A higher level of satisfaction was seen in patients treated in the Covid-19 intensive care units, those with chronic conditions, and those who received information about their health state from nurses. Patients’ family type, sharing fears and worries with nurses, getting information from nurses and the quality of nursing care were the variables significantly associated with patient satisfaction with nursing care.
Conclusions. Satisfaction with nursing care among Covid-19 patients was moderate. When nurses use effective communication skills to meet patients’ care needs, provide patients with adequate information, allow them to express their feelings, and keep them safe, this will further enhance patient satisfaction
Awareness of and Attitudes Towards Domestic Violence in Turkish Society
Get PDFThe objective of this study was to identify domestic violence awareness and attitudes towards violence among adult individuals in Turkish society.
Materials and Methods. This descriptive and cross-sectional study was conducted online between September 15, 2021 and November 15, 2021 and included 353 individuals. The data were collected using the snowball sampling method, the Google Forms, the Socio-Demographic Descriptive Information Form, the Domestic Violence Awareness Scale, and the Attitudes Towards Domestic Violence (ADV) Scale. For data analysis, the number, percentage, mean, standard deviation, Student’s t-test, one-way analysis of variance (ANOVA), post hoc (Tukey, LSD) analyses, Cohen’s d and Eta squared (η 2) coefficients, and correlation analysis were used.
Results. Most research participants were females (79.0%), with the average age of 30.53 ± 13.11 years. Of all the participants, 56.9% stated that they witnessed domestic violence, 22.7% stated that they experienced violence against women, 8.2% stated that they used violence. While the mean Domestic Violence Awareness Scale score was calculated as 41.09 ± 3.98, the mean score of the ADV Scale was calculated as 20.18 ± 7.82. The scores of domestic violence awareness differed significantly depending on education level (p=0.042; η 2=0.018). The scores of women’s attitude towards domestic violence (19.10) were lower than those in men (24.26) (p=0.05; d=0.684; η2=0.072). Participants’ attitudes towards domestic violence varied significantly by family type (p=0.006; η2=0.029), education level (p=0.007; η2=0.028), and occupation (p=0.007; η2=0.040). There was a significant positive relationship between awareness of and attitudes towards domestic violence (r=0.226).
Conclusions. Study participants had a high sense of awareness towards domestic violence and a negative attitude towards violence. Their awareness of domestic violence was affected by education level, while their attitudes towards domestic violence was affected by gender, type of family, education level, and occupation.
 
Training High School Teachers for the Formation of Research-Oriented Student’s Personality
Get PDFThe objective of our paper was to highlight the roles and responsibilities of research supervisors; to reveal the structure of training teachers for the formation of research-oriented student’s personality; to identify psychological and pedagogical features of didactic technology in developing the research potential of a personality; to characterize the system of experimental models underlying this technology.
Improving the preparation of students for research activities is extremely relevant at the present stage of socio-economic development. To ensure the effectiveness of developing research-oriented personality of a future professional is possible due to the optimization of teacher training system. It includes important scientific and practical tasks such as ensuring the scientific and creative worldview of an individual and their ability to introduce the latest achievements in science, as well as to develop and implement innovative technologies, to contribute to the accumulation of the spiritual, cultural, scientific, technical, and economical potential of the state. An analysis of the recent studies that have begun to solve this issue allows for outlining the following directions of its study:
developing the methods of creating scientific creativity of students;
covering the means of training high school teachers for implementing person-centered approach;
disclosing the functional and methodological aspects of professional culture formation in high school teachers
Long-term Clinical Results of Treatment of Periodontal Tissue Diseases in Teenagers and Young Adults Who Smoke
Get PDFDiseases of periodontal tissues rank second among dental pathologies after caries and constitute an important medical problem. According to the modern concept, periodontal tissue diseases arise under the influence of many causes, both local and general in nature. The harmful habit of smoking is a manageable risk factor that causes diseases specific to smokers, and also contributes to the occurrence, deepening and progression of dental diseases, such as periodontal tissues. Therefore, the issue of developing effective schemes of a complex of therapeutic and preventive measures for teenagers and young adults who smoke is urgent.
The aim of the study is to study the long-term results of the clinical effectiveness of the proposed complex treatment of periodontal tissue diseases in teenagers and young adults who smoke.
Materials and methods of the study. To achieve the goal, changes in periodontal tissues were studied immediately after treatment and in the long term in 114 teenagers and young adults aged 15 to 24, who were divided into groups: 26 people who regularly smoke traditional cigarettes were included in the first group; group II - 22 people, who smoke Vapes; in the III group - 23 people who regularly smoke devices for heating tobacco (IQOSs); in the IV group - 43 people, without the harmful habit of smoking.The dynamics of the OHI-S, PMA and PBI indexes before, after and in the long term of treatment with the proposed complex were analyzed: in general - "Quertin", "Supervit" and "BioGaya ProDentis"; locally - "Stomolik" and "Holisal" in comparison with the generally accepted treatment protocol for this disease.
Results of the study. In the course of treatment, a positive trend of the studied indices was recorded in all observation groups, however, better results were recorded in the groups where the proposed local treatment was applied, which was confirmed by objective examination data. Analyzing the results obtained in the long term of treatment, it was established that the results achieved immediately after treatment slightly worsened after six months of follow-up. Moreover, worse results were registered in patients of subgroups who received generally accepted treatment, compared with patients who received the proposed complex treatment. These results indicate the high effectiveness of the proposed complex treatment, but the need to repeat the treatment and preventive actions more often after six months.
Conclusions. Comparison of the results of treatment of periodontal tissue diseases in the observation groups in the remote periods of treatment by various methods indicates the advantages of the proposed complex treatment and allows us to conclude about its high clinical effectiveness.
Key words: teenagers and young adults, diseases of periodontal tissues, treatment, smoking.
 
The Effect of the Progressively Lowered Stress Threshold Model Training Program on Depression and Care Burden in Dementia Patient Caregivers
Get PDFThe objective of this study was to determine the effect of the Progressively Lowered Stress Threshold training program on depression and care burden in dementia patient caregivers.
Materials and Methods. We applied an experimental model based on a pretest-posttest control group. The sample consisted of 140 dementia caregivers (the experimental group and the control group with 70 participants per group). The sample size was determined, and the participants were allocated to groups using power analysis. Data of the study were collected between April 15, 2016 and July 15, 2016. For the pre-test, both groups were provided with the Sociodemographic Characteristics Form, the Beck Depression Inventory (BDI), and the Caregiver Burden of Dementia Patient Caregiver Scale (CBDPCS) to be filled in. Then, the experimenter visited the homes of the experimental group patients twice at 2-week intervals to provide nursing care based on the Progressively Lowered Stress Threshold Model. Finally, after 8 weeks, the post-test was conducted by letting both groups complete the Sociodemographic Characteristics Form, the BDI, and the CBDPCS once again. Percentage, chi-square, in independent and dependent sample t-tests were used to evaluate the related data.
Results. The mean BDI score was 15.61 ± 10.97 in the pre-test and 11.08 ± 8.82 in the post-test (t=6.738, p=0.001). The mean pre-test and post-test total CBDPCS scores of caregivers were 67.02 ± 16.23 and 59.27 ± 15.25, respectively (t=5.974, p=0.001). The difference between the intergroup comparison of the mean experiment and control group post-test scores was statistically significant (p=0.001) on the CBDPCS and the total BDI score.
Conclusions. Our results suggest that education provided to caregivers can efficiently decrease their care burden and depression levels
The Relationship between the Fear of Childbirth and Anxiety during the Covid-19 Pandemic
Get PDFIntroduction. The novel coronavirus disease (COVID-19), which emerged in Wuhan, China, in late 2019, has affected the whole world. Pregnant women who are expected to give birth during this period are one of the most important groups affected by these processes.
The aim of this study was to identify the relationship between the fear of childbirth and anxiety among pregnant women during the COVID-19 pandemic.
Materials and Methods. The cross-sectional study was conducted on 181 pregnant women in a city in the eastern region of Turkey between July and November 2020.
Results. Mid-level fear of childbirth was experienced by 44.8% of pregnant women. A positive correlation was found between the average anxiety score of pregnant women and childbirth fear.
Conclusions. The findings of the study will guide healthcare professionals in finding applicable solutions to the problems experienced by pregnant women during the COVID-19 pandemic period
Antibacterial Polyacrylamide and Dextran-Graft-Polyacrylamide Hydrogels for the Treatment of Open Wounds
Get PDFBackground. Open wound treatment requires a use of bandage material to prevent the development of pathogenic microflora and to provide the necessary conditions for tissue regeneration.
The aim of the study was to compare the effectiveness of polyacrylamide (PAA) and dextran-graft-polyacrylamide (D-PAA) hydrogels loaded with silver nanoparticles (AgNPs), antibiotics, and photosensitizers for the treatment of bacterial infection of open wounds.
Materials and Methods. PAA and D-PAA hydrogels with AgNPs, methylene blue (0.001%) without (MB) and with red light irradiation (660 nm) (MB+L), chlorhexidine (0.05%) and cefuroxime (0.1%) were used. There were tested in vitro and in vivo (a rat model) antibacterial activities against wild-type Staphylococcus aureus, Escherichia coli, antibiotic-resistant Escherichia coli and Klebsiella pneumoniae strains obtained from the wound. Clinical investigations were performed in patients with chronic venous ulcers of the lower extremities with no response to traditional treatments.
Results. S. aureus, E. coli, and K. pneumoniae strains were sensitive to PAA and D-PAA hydrogels with AgNPs, chlorhexidine, and cefuroxime. Antibiotic-resistant E. coli was not inhibited by the hydrogels with cefuroxime. This strain was less sensitive to chlorhexidine and MB+L. There were no differences between unloaded PAA and D-PAA hydrogels; the antibacterial properties of the dressing were determined by an antibacterial component loaded into the hydrogel. The use of unloaded D-PAA hydrogels in vivo helped reduce the size of the wound by 28.6% and 42.8% three and five days after wound modeling, respectively. Similar results were obtained for D-PAA hydrogels loaded with cefuroxime, chlorhexidine, and MB+L. D-PAA hydrogel with AgNPs reduced wound size by 50% and 62.5% three and five days after wound induction, respectively, demonstrated greater antibacterial activity and was selected for clinical investigations. In a patient, 14 days after bandage application, the fibrin membrane disappeared, the ulcers were covered with pink granulations, marginal epithelialization appeared.
Conclusions. PAA and D-PAA hydrogels can be loaded with the antibacterial compounds of various types. The type of polymer does not affect the antibacterial properties of the final hydrogels. The hydrogels with chlorhexidine and MB+L can be potentially used to treat bacterial contamination of wounds and ulcers. Nevertheless, their disadvantage is the inability to absorb or precipitate tissue breakdown products that interfere with normal regeneration and inflammation. D-PAA/AgNPs are the best option for treating ulcers due to the ability to control the properties of the hydrogels and nanoparticles, as well as multiple mechanisms of antibacterial action