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Neurogenic Myositis Ossificans of the Hip in a Patient with Axonal Polyneuropathy
Get PDFBackground. Neurogenic myositis ossificans is a rare entity defined by the development of soft tissue ossifications in patients with paraplegia or tetraplegia following neurological pathologies, often after cranial or spinal cord trauma. The diagnosis is based on imaging, in particular CT scan, which often reveals the presence of intramuscular ossifications of periarticular location. Treatment is based on analgesics, physiotherapy, and surgery as a last resort.
Case Report. We present a case of neurogenic myositis ossificans in a 26-year-old patient followed for axonal polyneuropathy secondary to vitamin deficiency.
Conclusions. Neurogenic myositis ossificans is a rare entity but is easily diagnosed, given the context of severe neurological disorders and the characteristic appearance on CT scan. In doubtful and atypical cases, a biopsy with histological study is recommended
Osteoporosis – a Silent Epidemic of XXI Century: Secondary Forms
Get PDFThe objective of the study was to determine the main causes of osteoporosis in chronic kidney disease, chronic obstructive pulmonary disease, pulmonary sarcoidosis and understand how the disease develops in these conditions.
Materials and Methods. To study the mechanisms of developing secondary osteoporosis, a literature review was conducted.
Results. Secondary forms of osteoporosis account for approximately 15-20% of reported cases and result mainly from concomitant diseases or from using drugs that have a negative effect on bone tissue. Despite its inert and stable appearance, bone tissue is a metabolically active, continuously renewing system. Throughout life, it continuously undergoes remodeling cycles involving the two main processes: the first one is called bone resorption and involves the breakdown of old bone followed by the destruction and removal of both the mineral substance and the organic matrix from resorption sites; the second one is called new bone formation and involves bone matrix synthesis and its subsequent mineralization. The imbalance between these two processes, the predominance of bone resorption over bone formation, is the key link in the pathogenesis of osteoporosis. Such an imbalance reflects the impairment of the major mechanisms of systemic hormonal and local (cytokine) regulation of cellular activity and occurs in secondary osteoporosis.
Conclusions. To date, at the stage of providing medical care to patients with chronic bronchopulmonary diseases and chronic kidney disease, inadequate attention is paid to timely diagnosis and treatment of concomitant osteoporosis. The latter often develops as a secondary condition due to systemic inflammation, severe hypoxia, low physical activity, taking inhaled and systemic glucocorticoids. Its signs are not clinically apparent; hence, it is referred to as the ‘silent epidemic. Since osteoporosis has no pathognomonic symptoms and its clinical presentation is rather vague, in patients with chronic bronchopulmonary diseases and chronic kidney disease, its early diagnosis by determining mineral bone density is recommended to prevent the development of severe complications, including low-energy fractures
Hyperostosis Frontalis Interna and Temporalis Interna: A Rare Case Report
Get PDFHyperostosis is a slow-growing benign bone tumour often seen in the bones of the cranial vault, more commonly found in elderly females. It is an incidental finding noted during radiological examination. The clinical manifestation of such tumour depends on its location inside the cranial cavity: the proximity to the paranasal sinuses, brain tissue, nerves, or blood vessels, etc. Its clinical findings may range from mild obstruction of the paranasal sinuses or blood vessels to severe compression of the surrounding cranial nerves. Here a rare case of hyperostosis of the frontal and temporal bones found during a routine cadaveric dissection in the Department of Anatomy is presented. Causes of the formation of such unusually enlarged bone masses inside the cranial cavity and their clinical presentation are discussed
Perceived Stress and Quality of Life in Healthcare Workers of Non-COVID-19-Designated Hospitals During the COVID-19 Pandemic in Ukraine
Get PDFIntroduction. Healthcare workers are more vulnerable to negative influences of the Covid-19 pandemic than cross-border travelers as they experience greater occupational stress, exacerbated by the possibility of self-contamination or contamination of their relatives through direct contact with patients, reduced social communication, deterioration in self-care and quality of life due to lack of energy and time.
The aim of the study was to assess the level of stress and quality of life in healthcare workers of non-COVID-19-designated hospitals in Ukraine during the COVID-19 pandemic.
Materials and Methods. There was carried out a case-control study that included 150 respondents divided into three groups: experimental groups (EG) 1 and 2 comprised 50 physicians and 50 nurses of non-COVID-19-designated hospitals, respectively; the control group (CG) included 50 healthy individuals not working in the healthcare field. The data were collected using paper questionnaires involving sociodemographic questions, the Perceived Stress Scale, and the 36-Item Short Form Health Survey.
Results. EG 1 and EG 2 had significantly increased stress levels as compared to the CG. Physical functioning criterion in EG 2 was significantly lower than those in EG 1 and the CG. Vitality and social functioning indicators were significantly lower in EG 1 and EG 2 as compared to the CG. Quality of mental health was worse in EG 1 than in the CG.
Conclusions. During the COVID-19 pandemic, healthcare workers of non-COVID-19-designated hospitals experienced a significant reorganization of their work environment, which required them to adjust rapidly to new conditions and psychological difficulties. The medical staff was found to have an increased level of perceived stress and decreased quality of life, which could affect the quality of medical care. Our findings suggest that the COVID-19 pandemic necessitates the development and implementation of stress coping measures to improve mental and physical health of healthcare workers, which can be used to achieve proper work and rest routines, create a microclimate within the team, and restore the work-life balance
Components of the Effectiveness of Endodontic Treatment Based on Long-term X-ray Criteria
No full textThe objective of the research was to determine the effectiveness of obturation of the root canals and crown part of the teeth, and to identify the most important factors influencing its results, based on the X-ray examination.
Materials and methods: The study was conducted at the Dental Center (University Clinic, Ivano-Frankivsk National Medical University). Evaluation of 140 orthopantomograms, computed tomograms and digital intraoral images of patient, aged 18-68 years with endodontically treated teeth, was made with the aim to determine the obturation state of root canals and the state of periodontal tissues. The radiological picture of 579 teeth and 1120 roots in particular was evaluated.
Results: the state of apical constriction, the state of obturation of root canals, sealing conditions of coronal part of the tooth, the state of periodontal tissues were analyzed, compared and discussed.
Conclusions: According to the results obtained in this study, the relationships between the presence of periapical changes and state of apical constructions, obturation level of filling material in roots canals, coronal leakage, and periodontal tissue changes were found.
Keywords: periapical changes, endodontic treatment, coronal leakage, x-ray examinatio
Pathogenetic Role of Disorders of Insulin Signaling Pathways and Diabetes-Associated Hyperglycemia in the Mechanisms of Diabetic Encephalopathy Formation and Hypersensitivity of the Brain to Ischemia-Reperfusion
Get PDFThe aim of the study was to analyze the literature data regarding the pathogenetic role of insulin signaling disorders and diabetes-associated hyperglycemia in the mechanisms of diabetic encephalopathy and hypersensitivity of the brain to ischemia-reperfusion.
Conclusion. Analysis of the literature data shows a number of common links between the pathogenesis of diabetic encephalopathy and ischemic-reperfusion brain injury, which may, to some extent, explain the predisposition of diabetics to acute cerebral circulatory disorders and their adverse course. However, it is clear that the severity of such comorbid pathology cannot be explained only by the additive effect of individual links in the pathogenesis, which indicates the necessity for further in-depth study of its molecular-genetic aspects
The Effect of the Mucinous Component Presence on the Clinical Outcomes of Colorectal Cancer
Get PDFBackground. The effect of colorectal cancer (CRC) histological subtypes on the prognosis is still a controversial issue. We aimed to compare clinical findings, histopathologic data, and survival outcomes in CRC patients with classical and mucinous subtypes.
Methods. Patients who were operated on for CRC between 2010 and 2017 were included in the study. Patients were classified into two groups according to the presence of a mucinous component: mucinous adenocarcinoma (MAC) - mucinous component > 50% and classical adenocarcinoma (CAC). Clinical and histopathologic findings, recurrence, metastasis, and survival rates were compared.
Results. Data of the 484 CRC patients were documented. Sixty-nine patients (14.3%) were in the MAC group and 415 (85.7%) patients were in the CAC group. The mean age of patients with MAC and CAC was 63.4 ± 13.5 and 68.5 ± 12.7 years, respectively (p = 0.002). Proximal colon localization was found in 30 (43.5%) MAC patients and 123 (29.6%) CAC patients (p = 0.029). The number of patients with metastatic lymph nodes was higher in the MAC group (58% vs. 41.2%, p = 0.03). Nevertheless, there was no significant difference between the CAC and MAC groups in terms of disease-free survival (63.1% vs. 69.6%, p = 0.37) and disease-related mortality (23.6% vs. 23.2%, p = 0.94) over the follow-up period. Multivariate analysis showed that the presence of perineural invasion, patient’s age, and disease stage were associated with mortality in CRC patients.
Conclusions. MACs occurred at a younger age than CACs and were more likely localized in the proximal colon as compared to CACs. Despite increased lymph node metastasis in MAC patients, no statistical significance was detected in overall survival or disease-free survival. Multivariate analysis revealed that age, perineural invasion, and disease stage were relevant to mortality in CRC patients
Microbiological Assessment of Glycyrrhizic Acid Effectiveness in Bacterial Vaginosis – A Comparative Study
Get PDFBackground. Bacterial vaginosis (BV) is one of the most common female diseases, which is currently characterized by an increasing rate of clinical sign reccurence, the appearance of asymptomatic carriers, and atypical forms.
This study was aimed to evaluate the effectiveness of glycyrrhizic acid administration in the prevention of BV recurrence.
Materials and Methods. The study involved 88 women after BV treatment (metronidazole per os for seven days). Participants were randomly divided into two groups: the main group included 46 patients who were administered 0.1% glycyrrhizic acid intravaginally for three months after the main treatment; the control group comprised 42 women who received no anti-recurrence BV course. The effectiveness was assessed three and six months after the beginning of treatment and included gynecological examination and laboratory assessments (pH, amine test, microbiological investigation).
Results. After recommended BV treatment without anti-recurrence course, the recurrence of laboratory criteria for BV increased three months after the treatment, including the increase in vaginal pH to > 4.5 in all subjects, positive amine test in 35.7% of patients, the presence of Gardnerella vaginalis at a concentration of 104-105 CFU/ml in 31.0% of women, reduction in the frequency of Lactobacillus detection with worsening of the condition and the onset of clinical manifestations of the disease six months later. In the main group, after glycyrrhizic acid administration, laboratory criteria of BV recovery three months after the treatment, and clinical and laboratory markers of BV recovery six months after the treatment were lower as compared to the control group.
Conclusions. The anti-recurrence course of BV (vaginal administration of 0.1% glycyrrhizic acid) demonstrated a decrease in the frequency of complaints, clinical and laboratory markers, stabilization of the species composition of Lactobacillus, and a decrease in facultative anaerobe concentration in the vaginal microbiome as compared to group without anti-recurrence treatment
ОСОБЛИВОСТІ ФЕНОТИПОВИХ ОЗНАК У СУЇЦИДЕНТІВ
No full textAbstract. The article is devoted to the study of phenotypic characteristics of persons prone to suicidal actions. Analysis of the number of suicides, factors and conditions of their occurrence is difficult and subjective, as it is associated with insufficient information about the causes of suicides.
In this regard, the search for markers that allow identifying persons prone to suicidal states, in order to carry out preventive measures with him in order to prevent cases of suicide, becomes particularly relevant.
The aim of to determine the complex of anthroposcopic and dermatoglyphic parameters of fingers and toes, which make up the dermatoglyphic constitution of persons who committed suicide.
Materials and methods of the study. 2 groups of people were studied: 1 group – corpses of people who committed suicide (100 people: 50 men and 50 women); Group 2 - individuals of the control group who died as a result of an accident (100 people: 50 men, 50 women). Research methods: anthroposcopic, dermatoglyphic, statistical analysis.
Results of the study. After studying and processing the questionnaire data, which contained information about descriptive characteristics, we obtained the following indicators, which slightly differed in gender groups, therefore, they are presented in aggregates without division by gender.
Skin color, taking into account the fact that all studied groups belong to Caucasians, ranged from light shades. The group of suicide victims was dominated by people with white (54.6%) and yellow skin tones (38.6%). However, a relatively higher percentage (38.6%) of people with a yellow skin tone occurred among the suicide victims in the control group. among suicide victims, persons with straight black (39.5%) and dark blond (27.9%) hair predominate, and relatively few persons with brown hair (4.7%). In comparison with the control group, the specified ratio is preserved. It was found that in the group of suicides, compared to the control group, there were more people with triangular (11.6%), rectangular (13.9%) and round (25.6%) face shapes. However, within the group of suicides, individuals with an oval-elongated face predominated (48.9%). The facial features of suicide victims were mostly average (79.1%), the forehead height was average (53.5%) or high (44.2%), the forehead slope was vertical (30.9%) or tilted back (66.7 %), the forehead was wide (51.2%), the frontal ridges were moderately expressed (46.5%); the lower jaw did not protrude forward (90.7%), the lips were mostly narrow (61.4%), and the nose was wide (88.6%). As for the color of the eyes, among the suicide victims there was a predominance of persons with blue (34.0%) and light (28.3%) and dark (18.9%) brown eyes. Compared to the control group, blue-eyed people were more common, and persons with checkered-green and mixed eye color were less common. In 93.2% of cases, the incision of the eyes of suicide victims is almond-shaped. The study of the obtained dermatoglyphic parameters of the fingers showed that in persons prone to suicidal actions, the frequency of occurrence of an arc-type pattern (A) on the distal phalanges of the II and IV fingers of both hands was 10.1% (control group - 5.1%), the pattern type radial loop (Lr) on the right hand was 15.2% (control group 30%). On the distal phalanges of the toes of suicide victims, type A patterns predominated (30.2% vs. 15.05 in the control group), a high frequency of curls (W) on the II toes of both feet (25% of cases on the right and 32.3% of cases on the left).
Conclusions. In the course of the study, the presence of phenotypic (anthroposcopic and dermatoglyphic) signs characteristic of suicides was established.
Keywords: forensic medicine, suicide, dermatoglyphics. Резюме. Стаття присвячена вивченню фенотипових характеристик осіб, схильних до суїцидальних дій. Аналіз кількості самогубств, факторів і умов його спричинення є складним і суб’єктивним, так як пов’язаний з недостатньою інформацією відносно причин суїцидів.
У зв'язку з цим особливо актуальним стає по пошук маркерів, що дозволяють виявляти осіб, схильних до суїцидальних станів, для проведення з ним профілактичних заходів з метою запобігання випадків суїциду.
Мета дослідження. Визначити комплекс антропоскопічних та дерматогліфічних параметрів пальців рук та ніг, що складають дерматогліфічну конституцію осіб, котрі вчиняли самогубство.
Матеріал та методи дослідження. Досліджено 2 групи осіб: 1 група – трупи осіб, які вчинили самогубство (100 осіб: 50 чоловіків та 50 жінок); 2 група - особи контрольної групи, які загинули внаслідок нещасного випадку (100 осіб: 50 чоловіків, 50 жінок). Методи дослідження: антропоскопічний, дерматогліфічний, статистичний аналіз.
Результати дослідження та їх обговорення. Після вивчення та обробки анкетних даних, які містили відомості про описові ознаки, ми отримали такі показники, які незначно різнилися у гендерних групах, тому представлені у сукупностях без поділу за статтю.
Колір шкіри, враховуючи належність усіх досліджуваних груп до європеоїдів, коливався у межах світлих відтінків. У групі суїцидентів переважали особи з білим (54,6%) та жовтим відтінком шкіри (38,6%). Однак серед суїцидентів траплявся порівняно вищий, у контрольній групі, відсоток (38,6%) осіб зі жовтим відтінком шкіри. серед суїцидентів переважають особи з чорним прямим (39,5%) та темно-русявим (27,9%) волоссям і порівняно мало осіб з коричневим волоссям (4,7%). У порівнянні з контрольною групою вказане співвідношення зберігається. Встановлено, що у групі суїцидентів, порівняно з контрольною, частіше зустрічалися особи з трикутною (11,6%), прямокутною (13,9%) та круглою (25,6%) формами обличчя. Однак всередині групи суїцидентів переважали особи з овально-видовженим обличчям (48,9%). Риси обличчя у суїцидентів були переважно середніми (79,1%), висота лоба – середня (53,5%) або висока (44,2%), нахил лоба був вертикальним (30,9%) або відхиленим назад (66,7%), лоб був широким (51,2%), лобні бугри були виражені помірно (46,5%); нижня щелепа не виступала до переду (90,7%), губи переважно були вузькими (61,4%), а ніс – широким (88,6%). Щодо кольору очей, то серед суїцидентів переважали особи з блакитними (34,0%) та світло-(28,3%) та темно- (18,9%) карими очима. У порівнянні з контрольною групою, частіше зустрічались блакитноокі, і рідше – особи з каро-зеленим та змішаним кольором очей. Розріз очей у суїцидентів у 93,2% випадків мигдалеподібний. Вивчення отриманих дерматогліфічних параметрів пальців рук показало, що у осіб, схильних до суїцидальних дій, частота зустрічання візерунку типу дуга (А) на дистальних фалангах ІІ та ІV пальців обох рук становила 10,1 % (контрольна група – 5, 1 %), візерунку типу петля радіальна (Lr) на правій руці становила 15,2% (контрольна група 30%). На дистальних фалангах пальців ніг у суїцидентів переважали візерунки типу А (30,2 % проти 15,0 5 у контрольній групі), висока частота зустрічання завитків (W) на ІІ пальцях обох ніг (25% випадків на правій і 32, 3% випадків на лівій).
Висновки. У ході дослідження встановлено наявність фенотипових (антропоскопічних та дерматогліфічних) ознак, притаманних суїцидентам.
Ключові слова. Судова медицина, суїцид, дерматогліфіка
Immunohistochemical Expression of IMP3 in Cutaneous Basal Cell Carcinoma
Get PDFBackground. Insulin-like growth factor-II mRNA-binding protein 3 (IMP3) is an oncofetal protein upregulated in tumor cells during carcinogenesis. It has been linked to adverse clinical outcome in many malignancies.
This study was aimed to evaluate an immunohistochemical expression status of IMP3 in cutaneous basal cell carcinoma (BCC) and to correlate it with the Ki-67 index values.
Methods. Biopsy specimens from 32 cases of BCC were enrolled into this analysis. All samples were immunohistochemically stained for IMP3 (Clone 69.1) and Ki-67 antigen (Clone MIB-1).
Results. IMP3 showed a weak expression in 11 (34.4%) cases, a moderate expression in 11 (34.4%) cases, a strong expression in 5 (15.6%) cases, and negative staining in 5 (15.6%) cases. Among seven BCCs exhibiting aggressive-growth features, all but one showed weak reactivity. In contrast, all five BCCs manifesting strong IMP3 positivity consisted of the indolent-growth histologic subtypes. BCCs with infiltrative histomorphology did not appear to have a tendency towards more striking production of IMP3. There was no significant relationship between the IMP3 expression status and the proliferation status (Ki-67 ≤ 50% vs. Ki-67 > 50%) of the tumor tissue (p > 0.05).
Conclusions. The vast majority of cutaneous BCCs express IMP3, suggesting this oncoprotein is implicated in BCC carcinogenesis. However, more pronounced expression does not seem to be associated with aggressive-growth phenotype of BCC or higher proliferative activity of neoplastic cells