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A Different Approach to Breast Self-Examination Training: Family Training
Get PDFBackground. Breast self-examination (BSE) is an effective, cost-free, early diagnosis method that enables women to take responsibility for their own health in the early diagnosis of breast cancer, which is the most common cause of death in women.
The objective of the study was to determine the effect of BSE training given by female nursing students to their mothers and sisters on their BSE behavior and self-esteem.
Materials and Methods. This study is of one-group pretest-posttest quasi-experimental design. It was carried out at the Faculty of Health Sciences of Erzincan University in Turkey between December 2019 and May 2020. The universe of the study consisted of 140 third- and fourth-year female students over the age of 18 enrolled in the Department of Nursing, Faculty of Health Sciences, Erzincan University, Turkey. The total number of mothers and sisters in the study sample was 126. The data were collected in two stages, before and one month after family training. IBM SPSS Statistics 22 software package was used for statistical data analysis. The percentage, mean, standard deviation, and Student’s t-test were used for statistical processing. The p-value of 0.05 was considered statistically significant for all tests.
Results. The knowledge level of study participants about breast cancer and BSE was analyzed, and the source of their knowledge was assessed. Applying family training approach showed a significant increase in BSE knowledge level of participants one month after training. It was accompanied by increasing BSE skills and self-esteem levels (according to the mean values of the Rosenberg Self-Esteem Scale).
Conclusions. Training for family members is an effective method to increase women' s knowledge and skills in BSE. In addition, BSE training enabled female students and their families to participate in BSE practice
Clinical Course and Lipid Metabolism Indicators in Patients with Chronic Heart Failure of Ischemic Genesis and Coexisting Hypothyroidism
Get PDFCardiac diseases, especially chronic heart failure which, according to the World Health Organization, affects 1.5-2% of the global population, are the number one cause of mortality and morbidity worldwide, including Ukraine. Chronic heart failure is often accompanied by endocrine disorders, especially hypothyroidism, the diagnosis of which has increased over the past 10 years, and which facilitates the rapid progression of heart failure due to reduced metabolic processes and altered lipid metabolism.
The objective of the research was to study clinical manifestations, lipid metabolism indicators and their relationship in patients with chronic heart failure of ischemic genesis and coexisting primary hypothyroidism.
Materials and Methods. 73 patients with the average age of 55.92±2.66 years were examined. They were divided into 2 groups: Group I included 38 patients with chronic heart failure and coexisting hypothyroidism; Group II comprised 35 heart failure patients without hypothyroidism. The clinical course of chronic heart failure itself and chronic heart failure with coexisting hypothyroidism was studied, the patients’ quality of life was evaluated, the myocardial function was studied by means of the 6-minute walk test, the indicators of lipid profile were analyzed by determining the serum levels of total cholesterol, low-density lipoprotein cholesterol. To assess thyroid function, thyroid-stimulating hormone and thyroxine levels were determined by the electrochemiluminescence immunoassay.
Results and Discussion. The clinical course and quality of life of patients with chronic heart failure and coexisting hypothyroidism were worse as compared to patients without hypothyroidism. The serum levels of total cholesterol, low-density lipoprotein cholesterol differed between both groups of patients (p<0.05).
Conclusions. Blood lipid profile was more significantly impaired in the patients with chronic heart failure of ischemic genesis and coexisting primary hypothyroidism that could result in the rapid progression of chronic heart failure, a more severe clinical course, and more frequent complications. The quality of life was higher in patients with heart failure without hypothyroidism and their condition was significantly better.В Україні та світі серцеві захворювання займають перші місця в структурі загальної захворюваності та смертності серед населення, зокрема, хронічна серцева недостатність (ХСН), ознаки якої, за даними ВООЗ, проявляються у 1,5-2 % населення усієї планети. Дуже часто ХСН поєднується з ураженням ендокринної системи, особливо з гіпотиреозом (ГТ), діагностика якого за останні 10 років збільшилась і який завдяки зниженим обмінним процесам та порушеному обміну ліпідів сприяє швидкому прогресуванню серцевої недостатності.
Мета роботи: вивчити клінічні прояви, показники жирового обміну та їх взаємозв'язки у пацієнтів із хронічною серцевою недостатністю ішемічного генезу, поєднаною з первинним гіпотиреозом.
Матеріали та методи. У дослідженні приймали участь 73 пацієнти (середній вік 55,92±2,66 року ), поділені на дві групи: перша - 38 хворих із ХСН, поєднаною із ГП, ІІ - 35 хворих із серцевою недостатністю без гіпотиреозу. В обстежуваних вивчали особливості клінічного перебігу ХСН з гіпотиреозом та без, оцінювали якість життя хворих, вивчали функціональний стан міокарда з допомогою 6-ти хвилинного тесту, аналізували показники ліпідного обміну методом визначення в сироватці крові вмісту загального холестерину (ЗХС), ліпопротеїдів низької щільності (ХС ЛПНЩ). Для оцінки функції щитоподібної залози (ЩЗ) визначали рівень тиреотропного гормону (ТТГ) та тироксину (Т4) імунохемілюмінесцентним методом.
Результати дослідження та їх обговорення. Виявлено, що клінічний перебіг та якість життя хворих з хронічною серцевою недостатністю, поєднаною з гіпотиреозом, були гіршими, ніж у пацієнтів без ГТ. Кількість ЗХС, ХС ЛПНЩ в сироватці крові відрізнялися в обох групах пацієнтів (р<0,05).
Висновки. У хворих з ХСН ішемічного генезу, що перебігає на фоні первинного ГТ, в порівнянні з хворими без ГТ, виразніше порушений ліпідний спектр сироватки крові, що може призвести до швидкого прогресування ХСН, важчого перебігу захворювання, частішого розвиток ускладнень . Якість життя хворих з ХСН без гіпотиреозу є вищою, ніж у пацієнтів з ГТ, а їх клінічний стан є значно кращим
Anticancer Agent Effect and Polychemotherapy Regimens for Malignant Tumor Treatment - A Review
Get PDFCancer is a leading cause of millions of deaths worldwide and, despite the improvements in molecular biology, issues concerning how to advance cancer treatment are still relevant. Cancer research must be focused on finding new and efficient chemotherapeutic regimens that can relieve severe side effects caused by conventional treatments. Modern technologies are currently under estimation in clinical trials or have already been introduced into clinical practice. Nowadays cancer therapy is characterized by ineffectiveness and serious side effects, as well as by hope of remission and cure in many cases. Antitumor drugs and radiation have been used as the treatment of choice in some cancer cases, except for the choice of surgery in case of solid tumors. Recently, immunotherapy has emerged as a significant therapeutic alternative, and in many cases, it is the first choice. These therapies can be applied either alone or in combination with other agents. Additionally, gene treatment and nanotechnology are promising methods for cancer treatment as well. The current review presents the progress of cancer treatments, starting with surgery, chemotherapy, radiation and immunotherapy, gene treatment and nanomedicine, giving emphasis to the most common anticancer agents and polychemotherapeutic regimens
Comprehensive Assessment of the Effectiveness of the Use of Alpha-lipoic Acid and Ipidacrine Hydrochloride for the Prevention of Paclitaxel-indused Peripheral Neuropathy in Breast Cancer Patients
Get PDFAbstract. Almost 97% of women undergoing chemotherapy with paclitaxel for breast cancer suffer from symptoms of peripheral neuropathy, the severity of which directly depends on the single, cumulative dose and duration of infusion of the agent. Neurological manifestations of paclitaxel-induced peripheral neuropathy, such as bilateral numbness, neuropathic pain and paresthesias in the distal parts of the limbs, often lead to the need to reduce doses, up to the refusal of taxanes, which negatively affects the immediate and long-term results of treatment. Despite numerous scientific studies, there are no known means for prevention of chemotherapy-induced peripheral neuropathy. Of the more than 20 drugs studied so far for the prevention of chemotherapy-induced peripheral neuropathy, none has shown sustained and systemic clinically significant results.
The aim of the study: to assess the effectiveness of the combination of alpha-lipoic acid and acetylcholinesterase inhibitor ipidacrine hydrochloride for the prevention of paclitaxel-induced peripheral neuropathy in breast cancer patients.
Materials and methods of the study: a comprehensive assessment of clinical (survey regarding subjective symptoms and quality of life, neurological examination), neurophysiological (electroneuromyography) and morphological indices of paclitaxel-induced peripheral neuropathy in breast cancer patients who received polychemotherapy in neoadjuvant, adjuvant or palliative settings carried out according to the schemes of AT (paclitaxel, doxorubicin) or ET (paclitaxel, epirubicin) regimens with or without preventive treatment of neuropathy, has been performed.
Results of the study. The use of the studied scheme for the prevention of paclitaxel-induced peripheral neuropathy led to a significant improvement in neurological manifestations, neurophysiological and morphometric parameters of peripheral nerves, as well as quality of life and the severity of subjective symptoms and their impact on daily life activities in comparison with patients who received chemotherapy without treatment for the prevention of neuropathy.
Conclusions. The combination of alpha-lipoic acid and the acetylcholinesterase inhibitor - ipidacrine hydrochloride, could be recommended for prophylaxis of paclitaxel-induced peripheral neuropathy.
Key words: breast cancer, chemotherapy, polyneuropathy, prevention, questionnaires, electroneuromyography, morphometric analysis.Резюме. Близько 97% жінок, яким проводиться хіміотерапія паклітакселом із приводу раку грудної залози, страждають від симптомів периферичної нейропатії, важкість якої напряму залежна від величини разової, кумулятивної дози та тривалості інфузії хіміопрепарату. Неврологічні прояви паклітаксел-індукованої периферичної нейропатії такі, як двостороннє оніміння, невропатичний біль та парестезії у дистальних відділах кінцівок, нерідко зумовлюють необхідність редукувати дози, аж до відмови від застосування таксанів, що негативно позначається на ефективності та віддалених результатах лікування. Незважаючи на численні наукові дослідження, достеменно відомих засобів профілактики хіміотерапевтично-індукованої периферичної нейропатії не винайдено. Із більш ніж 20-ти досліджуваних до цього часу препаратів для профілактики хіміотерапевтично-індукованої периферичної нейропатії, жоден не показав стійких та системних клінічно значимих результатів.
Мета дослідження: оцінити ефективність застосування комбінації препарату альфа-ліпоєвої кислоти та інгібітора ацетилхолінестерази – іпідакрину гідрохлориду з метою профілактики паклітаксел-індукованої периферичної нейропатії у хворих на рак грудної залози.
Матеріали та методи: проведена комплексна клінічна (опитування стосовно суб’єктивних симптомів та якості життя, неврологічне обстеження), нейрофізіологічна (електронейроміографія) та морфологічна оцінка паклітаксел-індукованої периферичної нейропатії у хворих на рак грудної залози, які отримували поліхіміотерапію у неоад’ювантному, ад’ювантному або паліативному режимах за схемами АТ (паклітаксел, доксорубіцин) або ЕТ (паклітаксел, епірубіцин) без та на фоні застосування препаратів для профілактики нейропатії.
Результати дослідження та обговорення. Застосування досліджуваної схеми профілактики паклітаксел-індукованої периферичної нейропатії, призвело до достовірно значимого покращення неврологічних проявів, нейрофізіологічних та морфометричних параметрів периферичних нервів, а також якості життя та важкості суб’єктивної симптоматики та її впливу на повсякденну життєдіяльність в порівнянні із пацієнтами, які отримували хіміотерапію без застосування препаратів для профілактики нейропатії.
Висновки. Комбінація препарату альфа-ліпоєвої кислоти та інгібітора ацетилхолінестерази – іпідакрину гідрохлориду, рекомендована для застосування в якості профілактики паклітаксел-індукованої периферичної нейропатії.
Ключові слова: рак грудної залози, хіміотерапія, полінейропатія, профілактика, анкетування, електронейроміографія, морфометричний аналіз
Cytokine Response of CD4+ T-Lymphocytes with Red Rose (Rosa Rosaceae – Pierre de Ronsard) Extracts by in Vitro Evaluation
Get PDFBackground. Red rose extract is known to have anti-inflammatory and immune-modulation effects. In this study, the red rose extract was tested on CD4+T lymphocytes in vitro, and cytokine response was evaluated.
Materials and Methods. The red rose (Rosa Rosaceae - Pierre de Ronsard) extract used in this study was prepared and stored at -20° C until use. CD4+T-cells were seeded in 96-well plates at 313,500 cells/well in 100μ l cell culture medium in duplicate. One-half of the wells were used for biomarker screening in the culture medium, and the other half was used for cytotoxicity assay. Twenty-four hours after plating, the cells were treated in duplicate with 100μ l of the red rose extract diluted at 0.5%, 0.1%, 0.05%, 0.01% and 0.005% (v/v) in the cell culture medium or with culture medium only as control for 72 hours. Some other wells were allocated for untreated cells, and cells treated with the rose extract at 0.005% for 48-h incubation time.
Results. Several cytokines (GRO; IFN-γ; IL-1α, 6, 10; MCP-1; RANTES; TGF-β1; TIMP 1, 2; Ang1, Ang2; G-CSF; MMP-9; and VEGF R2) were elevated. Except for MMP-9, which had fold changes > 2, other cytokines were minimally elevated at various concentrations and timing of rose extract treatment. None of the mentioned cytokines were less than 0.8-fold after treatment with the rose extract. Cytotoxicity assay revealed insignificant changes in the viability of T-cells.
Conclusions. There was a mild elevation in few inflammatory markers by CD4+ T-lymphocytes after in vitro treatment with the red rose extract (Rosa Rosacea - Pierre De Ronsard). Further in vitro and in vivo studies are required to evaluate the benefits of the red rose extract in immune regulation
Imaging Evaluation of Mesenteric Ischemia: Is There a Golden Period for This Entity?
Get PDFBackground.The study was aimed at assessing the role of ultrasonography and multidetector computed tomography angiography in evaluating patients with suspected mesenteric ischemia, as well as assessing the effect of the time from presentation to management on mortality and morbidity.
Materials and Methods. Patients with clinically suspected mesenteric ischemia underwent Doppler ultrasound and contrast-enhanced computed tomography. On ultrasonography, we assessed any filling defect in the superior mesenteric artery/vein, narrowing or occlusion of the proximal superior mesenteric artery, ascites, bowel wall thickening, and pneumatosis/portal venous gas. Computed tomography angiography was performed looking for any filling defect in the superior mesenteric artery/vein, superior mesenteric artery/vein calibre, bowel wall thickening, calibre and enhancement and pneumatosis/portal vein gas. Most of our patients underwent emergency surgery and the findings correlated with imaging. All the patients were divided into Group A (n=30) and Group B (n=17) based on the time from presentation to management: within 48 hours of presentation and 48 hours after presentation, respectively.
Results. On computed tomography scan, mesenteric vascular involvement was seen in 27 (55%) patients, mesenteric/intestinal twist was observed in 12 (25%) patients, and non-occlusive mesenteric ischemia was found in 6% of patients. The computed tomography findings were found to have a sensitivity of 86%, a specificity of 94% and an accuracy of 90% in cases of mesenteric ischemia. Among 35 patients operated on, those presenting within 48 hours, had a significantly less mortality (63%) in comparison to those presenting after 48 hours (90%).
Conclusions. Clinical, laboratory and ultrasound features are non-specific in diagnosing mesenteric ischemia. Computed tomography angiography is a sine qua non in mesenteric ischemia diagnosis. Patients with venous ischemia respond well to conservative management. Early intervention within the first 48 hours is associated with better prognosis
Learning or Memorization: Self-Directed Medical School Curriculum and the Dangers of Overemphasizing Student Selected Ancillary Resources
Get PDFThis article is a response to an opinion article, authored by Wu JH et al. and published in JAMA 2021, vol 326 (20) which suggested the that pre-clinical (first two) years of medical school curriculum should revolve around “high-yield” resources as the dominant teaching tool. The article posited that this highly controversial view was the best way to engage with students and was published in a well-read and utilized medical journal. Due to the growing divide between learning resources provided by medical schools and outside resources actually utilized by students, the conclusions drawn in the mentioned opinion article were understandable but interpreted in the wrong vein. Herein, the authors review landmark changes in medical education over the last century and the underpinning rationale to preface their examination of the suggested changes from the mentioned opinion article. The authors conclude with recommendations from a student perspective and a continuation of the last 100 years of advancements
Vitamin D Effect on the Severity of Chronic Pelvic Pain in Patients with Ovarian Endometriosis Combined with Pelvic Inflammatory Diseases
Get PDFNumerous publications in recent years indicate the impact of vitamin D deficiency on the course and severity of a number of gynecological diseases, including endometrial disease. As this transmitter is associated with immune disorders, its involvement in local immunosuppression in the progression of the systemic inflammatory response in the case of endometrial disease is not excluded. Considering the pathogenetic links between vitamin D metabolism and the severity of pelvic pain, it became appropriate to study the relationship between this parameter and the intensity of pelvic pain in patients with ovarian endometriomas associated with chronic pelvic inflammatory diseases, which was the objective of this research. Materials and methods of research. The study included 90 patients with ovarian endometriosis aged 20 to 41 years. The main group consisted of 44 patients with endometrioma combined with pelvic inflammatory diseases; the comparison group consisted of 46 patients with isolated ovarian endometrioma. The control group included 30 relatively healthy women without gynecological and somatic pathology. At the initial stage, the level of 25-hydroxyvitamin-D3 (25 (OH) D) was determined in patients of the three groups by mass spectrometry using standard methods. Analysis and discussion of research results. Patients with ovarian endometrial cysts on the background of pelvic inflammatory disease were statistically significantly older compared with the group of isolated endometriomas; more than half of the observations were patients aged 36-40 years (p<0.05). Laparoscopic diagnostic and therapeutic techniques allowed to present objective signs of combination of ovarian endometrioma with manifestations of external genital endometriosis: severe manifestations of external genital endometriosis were diagnosed in 31.8% vs. 15.21% in the comparison group. Depending on the severity of the pain syndrome according to VAS, patients of the main group were stratified as follows: 22.7% noted pelvic pain of low intensity, 40.9% – moderate pain, 25.0% – severe pain; in the comparison group there were no manifestations of severe pelvic pain. The combination of pelvic inflammatory disease with ovarian endometriosis was accompanied by an increase in the share of vitamin D deficiency – in 38.64% and the share of severe pain – in 25.0%.
Conclusion. A significantly moderate inverse correlation was found between the verification of the manifestations of external genital endometriosis and the level of vitamin D in the blood serum. The obtained data dictated the need to assess the therapeutic potential of vitamin D in combination with nonsteroidal anti-inflammatory drugs to enhance the analgesic effect and reduce the drug load.Резюме. Багаточисленні публікації останніх років свідчать про вплив дефіциту вітаміну D на перебіг та тяжкість проявів ряду гінекологічних захворювань, зокрема, і ендометріоїдної хвороби. Так як даний трансміттер пов’язаний із імунними порушеннями, не виключена його участь у місцевій імуносупресії при прогресуванні системної запальної відповіді у випадку ендометріоїдної хвороби. Враховуючи існуючі патогенетичні ланки між метаболізмом вітаміну D та ступенем вираженості тазового болю, доцільним стало дослідження взаємозв’язку даного параметру та інтенсивності тазового болю у пацієнток з ендометріомами яєчника, асоційованими із хронічними запальними процесами органів малого тазу, що і стало метою даного наукового пошуку. Матеріали та методи дослідження. У дослідження включили 90 пацієнток з ендометріозом яєчників віком від 20 до 41 року. Основну групу склали 44 пацієнтки з ендометріомами, поєднаними із запальними захворюваннями геніталій, групу порівняння - 46 пацієнток з ізольованими ендометріомами яєчників. У контрольну групу включили 30 умовно здорових жінок без гінекологічної та соматичної патології. Пацієнткам трьох груп на вихідному етапі визначали рівень 25-гідроксивітаміну-D3 (25(ОН)D) методом масс-спектрометрії за стандартними методиками. Аналіз та обговорення результатів дослідження. Пацієнтки з ендометріоїдними кістами яєчників на тлі запальних процесів органів малого тазу були статистично значимо старші у порівнянні з групою ізольованих ендометріом, більше половини спостережень серед цих пацієнток становила вікова категорія 36-40 років (p<0,05). Лапароскопічні діагностично-лікувальні техніки дозволили представити об’єктивні ознаки поєднання ендометріоми яєчника з проявами зовнішнього генітального ендометріозу: тяжкі прояви зовнішнього генітального ендометріозу були діагностовані у 31,8 % проти 15,21 % - у групі порівняння. В залежності від вираженості болевого синдрому за ВАШ пацієнтки основної групи були стратифіковані наступним чином: 22,7 % відмічали тазовий біль слабкої інтенсивності, 40,9 % - помірну біль, 25,0 % – виражену, у групі порівняння не відмічено проявів вираженого тазового болю. Поєднання запальних процесів органів малого тазу та ендометріозу яєчника супроводжується зростанням частки дефіциту концентрації вітаміну D - у 38,64 % та вираженого болевого синдрому – у 25,0 %.
Висновок. Встановлено достовірно помірну зворотню кореляцію між верифікацією проявів зовнішнього генітального ендометріозу та рівнем вітаміну D у сироватці крові. Отримані дані диктують необхідність оцінки терапевтичних можливостей використання вітаміну D у комплексі із нестероїдними запальними середниками з метою посилення протиболевого ефекту та зниження медикаментозного навантаження
Technologization of Innovative Educational Processes in Higher Education Establishments
Get PDFThe needs of Ukraine’s economic development require the creation of new, innovative technologies that take into account changes in the social and spiritual life of young people, the need to form a harmonious personality and optimize the learning process. New pedagogical technologies are aimed primarily at “providing conditions for self-realization of student’s essential capabilities in various kinds of theoretical and practical activities, in dynamic life in the new market conditions”.
An essential feature of modern innovation processes in the field of education and upbringing is their technologization – a strict compliance with the content and sequence of stages of innovation implementation.
The difference between technology and methodology is a fundamental issue for modern pedagogics. Technology and methodology are distinguished by two main points: the guarantee of the final outcome and planning of the future educational process.
The varieties of personality-centered pedagogical technologies include personality developmental teaching, productive teaching, personalized teaching and technology of higher labor, self-development, technology of humanism.
Analyzing the features of higher pedagogical education technologization, the attention should be paid to an increase in the need for the use of new information technologies in the training of new generation specialists for modern educational systems. New information technologies (NIT) are defined as a set of methods and technological means of collecting, organizing, storing, processing, transmitting and presenting information that increases people’s knowledge and develops their capabilities to manage technological and social problems.
Pedagogical technology is interpreted according to three aspects: the scientific aspect (pedagogical technology as a component of pedagogical science that creates pedagogical processes in pedagogical systems); procedural and descriptive aspect (description, process algorithm, a set of goals, content of methods and means to achieve guaranteed results according to the goal); procedural and effectual aspect (implementation of the technological process, functioning of all personal tools)
Combined Effects of Cadmium- and Cyanide-Contaminated Diet on Oxidative Stress Biomarkers in Different Tissues of Rats
Get PDFBackground. Several toxicants present simultaneously in the environment have combined toxicological effects. In addition, various xenobiotics have distinct effects on oxidative stress biomarkers in animal cells and tissues.
The aim of this study was to analyze the effect of cadmium (Cd) and cyanide (CN) through the food chain on some antioxidant indices in the tissues (lungs, testes, heart, and brain) of male Wistar rats.
Materials and Methods. The study included sixty African catfish allocated to four groups, each comprising fifteen fish, treated with potassium cyanide (KCN) and cadmium chloride (CdCl2), held at a temperature of 25°C in a 100-litre fish tank aquarium with water contaminated with 0.4 mg of both cyanide and cadmium/100 ml of water. All the fish were later killed, dried, and used to prepare diet for experimental animals. Twenty male rats divided into four groups, each comprising five rats, were used for this study as well, and fed for 28 days as follows: Group A - control diet; Group B - cyanide-contaminated diet; Group C - cadmium-contaminated diet; Group D - diet contaminated with cyanide + cadmium. Subsequently, they were sacrificed. Biochemical analysis of the tissues excised from the rats was done.
Results. There was a significant (p < 0.05) increase in lipid peroxidation level and a significant decrease in superoxide dismutase, catalase and reduced glutathione activities in the lungs, testes, heart, and brain of rats fed a catfish diet containing both cyanide and cadmium as compared to controls. In addition, contaminated diet altered acetylcholinesterase activity in the brain, glutathione peroxidase activity, glutathione-S-transferase activity, and glutathione reductase activity in the tissues of experimental rats.
Conclusions. Cadmium and cyanide, via the food chain, induce oxidative stress in the lungs, testes, heart, and brain of rats