Publishing House of Ivano-Frankivsk National Medical University
Not a member yet
993 research outputs found
Sort by
Дослідження інсулінорезистентності у пацієнтів з онкологічними захворюваннями.
Get PDFAbstract. The pro-oncogenic effects of obesity, insulin resistance and hyperinsulinemia have been proven in some types of cancer, as well as in type 2 diabetes mellitus.
The objective of the research was to investigate the state of insulin resistance in patients suffering from oncological diseases and to compare insulin correlations in patients with type 2 diabetes mellitus and those with cancer.
Materials and Methods. The study included the following groups of patients: Group I included healthy individuals (the control group); Group II comprised patients with type 2 diabetes mellitus; Group ІІІ included patients with cancer: subgroup IIIa comprised patients with breast cancer, subgroup IIIb included patients with endometrial cancer, subgroup IIIс comprised patients with colorectal cancer. Fasting blood glucose was determined by glucose oxidase method; hemoglobin A1c was determined by ion exchange chromatography; the levels of insulin and insulin-like growth factor-1 were determined by immune-enzyme method. Insulin resistance was assessed by the homeostatic model assessment for insulin resistance index. The results obtained were analyzed using statistical analysis.
Results. Obesity was confirmed in all the groups of patients with cancer. Significantly higher body mass index, as compared to the control group, was found in patients with endometrial cancer (p = 0.008). In comparison with the control group, the levels of insulin and insulin-like growth factor-1 increased significantly in all groups of patients with cancer (p < 0.001). Fasting blood sugar levels and hemoglobin A1c did not differ from the indicators in the control group (p > 0.05). Direct correlations between insulin and body mass index (p < 0.05), insulin-like growth factor-1 (p < 0.05) and the homeostatic model assessment for insulin resistance index in patients of Group II and Group III were detected (p < 0.05).
Conclusions. In obese patients with breast, uterine and colorectal cancer, there was found a decrease in insulin sensitivity, which might increase the proliferative effects of insulin and insulin-like growth factor-1. Correlation analysis showed a probable association of cancer and diabetes mellitus due to obesity and insulin resistance.Вступ. Проонкогенний вплив ожиріння, інсулінорезистентності та гіперінсулінемії доведений при деяких видах раку, а також при цукровому діабеті (ЦД) 2 типу. Мета роботи: дослідити стан інсулінорезистентності у хворих з онкологічними захворюваннями та порівняти кореляційні зв`язки інсуліну у хворих на ЦД 2 типу та рак.
Матеріали і методи. В дослідження включені наступні групи пацієнтів: І – здорові (контрольна група); ІІ – хворі на ЦД 2 типу; ІІІ – хворі з онкологічними захворюваннями: IIIa – з раком молочної залози, IIIb - з раком ендометрію, IIIс – з колоректальним раком.
Глікемію натще визначали глюкозооксидазним методом, HbA1c - методом іонообмінної хроматографії; рівні інсуліну та інсуліноподібного фактора росту-1 (IGF-1) - імуноферментним методом. Інсулінорезистентність оцінювали за індексом НОМА-IR. Проведений статистичний аналіз отриманих результатів.
Результати. У всіх групах пацієнтів з раком було підтверджене ожиріння. Достовірно вищий ІМТ, у порівнянні з групою контролю, виявлений у пацієнтів з раком тіла матки (Р = 0,008). Достовірно підвищений, у порівнянні з контрольною групою, рівень інсуліну та IGF-1 виявлений у всіх групах пацієнтів з раком (Р < 0,001). Показники глікемії натще та HbA1c не відрізнялись від показників контрольної групи (Р > 0,05). В пацієнтів ІІ і ІІІ груп виявлені прямі кореляційні зв`язки інсуліну з ІМТ (P < 0,05), IGF-1 (P < 0,05) та з індексом НОМА-IR ( P < 0,05).
Висновки. 1. У хворих з онкологічними захворюваннями молочної залози, тіла матки та колоректальної локалізації з ожирінням виявлене погіршення чутливості до інсуліну, що може посилювати проліферативні ефекти інсуліну та IGF-1. 2. Кореляційний аналіз показав ймовірну асоціацію раку та ЦД через ожиріння та інсулінорезистентність.
Ключові слова: ожиріння, інсулінорезистентність, онкологічні захворювання, цукровий діабет 2 типу
Modern Factors for Successful Work of a Teacher in Higher Medical Institution
Get PDFProfessional pedagogical activity of a teacher can be considered as a holistic dynamic system including continuous improvement of pedagogical skills. Modern trends in medical education pose new requirements for the teacher. Among them, knowledge of the English language (the main language of international scientific communication) at a level that would allow the teacher to work out the scientific literature and share the results of the research with a wider range of scientists is of critical importance. International internships at leading universities to study the best practices and enhance the scientific level of publications are important as well. Therefore, research work becomes the main component of the educational process - a factor determining the effectiveness of the teacher’s work
Chiari Network in Patient with Interatrial Septal Defect and Pulmonary Hypertension
Get PDFChiari network is a moving fibrous mesh-like structure that is visualized in 2% of cases in the right atrium. It is attached on one side to the valve of the inferior vena cava and on the other to different parts of the right atrium. In most cases this structure has no clinical significance and may be an accidental finding during echo- imaging. But sometimes it can be a source of thrombosis and in the future – the cause of thromboembolism, or, conversely, be an obstacle to the movement of thrombus
Non-Invasive Mechanical Ventilation in Children with Previous Unsuccessful Weaning from Respiratory Therapy
Get PDFThe objective of the research was to establish the impact of diaphragm-protective mechanical ventilation on the rate of successful weaning from invasive and non-invasive mechanical ventilation in children with acute respiratory failure.
Materials and Methods. We conducted a prospective, observational cohort study. Seventy-eight patients were randomly divided into 2 groups: patients of Group I received lung-protective mechanical ventilation; patients of Group II received diaphragm-protective + lung-protective mechanical ventilation. For age-specific data analysis, patients were divided into age subgroups: the 1st subgroup included children being 1 to 12 months old; the 2nd age subgroup comprised children being 12 to 36 months old. We started respiratory support in both groups with invasive mechanical ventilation and when patients met the criteria, we weaned them. We confirmed successful weaning, when patients had no need to be mechanically ventilated within next 48 hours, otherwise, they were intubated again. Before the second trial to wean, patients in Group I were simply extubated, while patients in Group II received non-invasive mechanical ventilation. The primary endpoint was the rate of successful weaning from mechanical ventilation in the first trial. The secondary outcomes were complications, namely reintubation rate, tracheostomy rate and death.
Results. We found a significant difference in the primary outcome for the 1st age subgroup: there were 72.4% in Group I vs. 52.6% in Group II successfully weaned patients (p=0.04). No significant difference in the primary outcome was observed in the 2nd age subgroup: there were 80% in Group I vs. 82.3% in Group II successfully weaned patients (p=0.78). There were significant differences in the secondary outcomes between groups in the 1st age subgroup, namely reintubation rate was seen in 9.1% patients of Group I vs. 36.8% patients of Group II (p=0.05); death happened in 18.2% cases in Group I vs. no cases in Group II (p=0.01). There were no differences in tracheostomy rate in the 1st age subgroup and there were no differences in the secondary outcomes between groups in 2nd age subgroup.
Conclusions. Diaphragm-protective mechanical ventilation significantly reduced the incidence of successful weaning from invasive mechanical ventilation; however, it increased the incidence of successful weaning from non-invasive mechanical ventilation, and, significantly decreased the mortality rate in the 1st age subgroup, while in the 2nd age subgroup, it had no impact on the incidence of successful weaning from invasive mechanical ventilation and mortality rate
Colonic Stoma Creation as the First Stage of Surgical Correction of Total Colonic Aganglionosis in Children
Get PDFAbstract. The use of a staged approach in surgical treatment of total colonic aganglionosis is controversial. The creation of a protective colonic stoma as the first stage of surgical correction of total colonic aganglionosis rather than one-stage correction has become an alternative in treatment of such patients. This approach contributes to better survival, reduces the incidence of ileoanal anastomotic failure and improves functional outcomes.
The objective of the research was to study and evaluate the need for colonic stoma creation as the first stage of surgical correction of total colonic aganglionosis in children.
Materials and Methods. The analysis of surgical treatment of 41 children with total colonic aganglionosis over the period 1980-2020 was conducted. Protective colonic stoma was created in all the patients, namely 36 children with isolated colonic aganglionosis and 5 children with the involvement of the entire colon and a segment of the small bowel.
Results. Twenty-four (58.54%) patients were diagnosed and underwent the first stage of treatment in National Specialized Children’s Hospital “Okhmatdyt”. There were 17 (41.46%) patients who were transferred from other clinics after being diagnosed with a pathology and undergoing colonic stoma creation. During staged treatment of children with total colonic aganglionosis, a single-barrel ileostomy (n=10, 24.40%), a double-barrel ileostomy (n=5, 12.19%), or a loop colonic ileostomy (n=26, 63.41%) were created. The periods between creating the protective colonic stoma and performing radical surgery ranged from 4 to 14 months. The colonic stomas were closed 2-4 months after radical surgery. The third stage of surgical correction of total colonic aganglionosis in children was carried out after the state of the neorectum formed and ileoanal anastomosis were assessed for readiness of inclusion in the passage. There were no complications after protective stoma closure. Within the first 3 months, the frequency of bowel movement ranged from 10 to 15 times a day, and, in a year, it was 2-4 times a day. All the children survived. Functional outcomes of treatment were found to be good. Bowel function was satisfactory. The X-ray images demonstrated the rectal reservoir of sufficient size with pronounced colonization.
Conclusions. Surgical correction of total colonic aganglionosis in children involves the three-stage approach consisting in the creation of the protective small bowel stoma (the first stage), radical surgery, namely colectomy with reconstructive plastic formation of functionally advantageous reservoir version of the neorectum (the second stage) and ileostomy closure after adaptation of the small bowel reservoir (the third stage). The creation of the protective small bowel stoma as the first stage of surgical correction of total colonic aganglionosis in children is emergency surgery. The creation of the loop small bowel stoma at 12 cm above aganglionosis level is the most rational type of the first stage of correcting total colonic aganglionosis in children
СТОРОННІ ТІЛА ПОРОЖНИНИ НОСА У ДОРОСЛИХ
No full textSeveral cases of foreign bodies in adults’ nasal cavities have been analyzed. There were represented some peculiarities of clinical course, diagnostics and medical care providing.Сторонні тіла потрапляють у ніс за різних обставин. Частіше вони зустрічаються у дітей, які ховають у порожнині носа дрібні іграшки або їх частинки, металеві кульки, зерна бобових, злаків, кісточки вишень тощо. Іноді психічно хворі особи вводять собі в ніс сторонні тіла. Під час виробничих травм у порожнину носа може потрапити розплавлений метал, уламки скла, металу, каміння тощо. Харчові продукти стають сторонніми тілами під час блювання чи прийому їжі, особливо у хворих з парезом м’ягкого піднебіння. При знаходженні стороннього тіла в порожнині носа тривалий час утворюється риноліт.
Проведено аналіз декількох окремих випадків сторонніх тіл порожнини носа у дорослих. Представлено особливості клінічного перебігу, діагностики та надання медичної допомоги
Clinical and Pathogenetic Causes of Developing Complications in Multiple Pregnancy
Get PDFTo assess the role of the placental growth factor in the development of gestational complications during multiple pregnancy, there was conducted a study of this indicator in serum of 320 pregnant women with multiple pregnancy in the first trimester and 40 pregnant women with singleton pregnancy (the control group).
The objective of the research was to study the effect of placental growth factors on the gestational process in multiple pregnancy.
Materials and Methods. There was conducted a prospective study of pregnancy and childbirth in 320 females with multiple pregnancy (the main group) and 40 healthy women with singleton pregnancy. The level of serum placental growth factor was determined by enzyme-linked immunosorbent assay using monoclonal antibodies in the first trimester of pregnancy. The indicators of the hemostasis system (vascular, platelet and coagulation components) were evaluated according to generally accepted methods. Doppler ultrasound of the placental and fetal blood flow was performed in the uterine arteries, the umbilical artery and vein, the fetal middle cerebral artery.
Results. Women with multiple pregnancy were at high risk of developing gestational complications such as preterm deliveries (67.8%, p<0.01), placental dysfunction, pre-eclampsia (17.5%, p<0.05). The disorders of the vascular platelet and coagulation hemostasis in the first trimester of pregnancy were the main risk factors for early termination of pregnancy. Low level of serum placental growth factor in pregnant women with multiple pregnancy in case of preterm delivery, placental dysfunction and pre-eclampsia (111.23 ± 8.4, 203.24 ± 6.4 and 305.86 ± 7.4 pg/ml), in comparison with the corresponding indicators in singleton pregnancy (418.2 ± 10.4 pg/ml), was proven to be a prognostic marker for the development of gestational complications.
Conclusions. Timely correction of gestational complications in multiple pregnancy with micronized progesterone, low molecular weight heparins, angio-protective agents allowed us to prolong pregnancy with monochorionic placentation type for 3.2 weeks (up to 34.2 ± 2.4 weeks) and provide full-time delivery of dichorionic twin pregnancy
Optimization of the Educational Process at the Department of Otorhinolaryngology of IFNMU Considering the Competency-Based Approach
Get PDFThe paper presents modern competency-based approach to teaching otorhinolaryngology using new technologies that will improve the assimilation of new material considering each student’ knowledge, skills, and experience. The competency-based approach can be successfully implemented based on active learning, introducing elements of professional activity in the educational process. While analyzing clinical cases, business and learning games, the student becomes a specialist and future’s team member. The quality of education should be improved through an effective organization and informatization of the educational process, the introduction of the latest research results in teaching practice, the provision of high-quality teaching and the development of modern learning and teaching base.В статті показано сучасний компетентністний підхід до викладання оториноларингології з використанням нових технологій, які дадуть можливість покращити засвоєння матеріалу з врахуванням знань, вмінь, навиків, досвіду кожному студенту. Компетентністний підхід успішно може бути реалізований на основі форми активного навчання, насичення навчального процесу елементами професійної діяльності. В процесі аналізу ситуацій, ділових і навчальних ігр студент формується як спеціаліст і член майбутнього колективу. Якість освіти необхідно покращити шляхом ефективної організації і інформації навчального процесу, впровадженням передових наукових розробок в практику викладання, забезпеченням високого професіоналізму викладачів, створенням сучасної навчально-методичної бази
CATANOVA Analysis of Knowledge and Control Practices of Hepatitis B Virus Infection amongst Tertiary University Students
Get PDFFrequency data, having no underlying metric, are frequently encountered in real-life situations. The analysis of such data is usually difficult as nominal data are inherently less informative than quantitative data and decisions are taken erroneously using such results.
The objective of the research was to study the significant effect of gender, faculties and interaction using categorical data in a two-way cross classification.
Materials and Methods. The study applied a cross sectional study with a total sample size of 434. Multistage sampling was adopted. Categorical analysis of variance (CATANOVA) technique was used for analysis. This is suitable as it uses a two-way ANOVA with quantal responses as equivalent of a three-way contingency table in which one of the classifications is treated as responses to the other two. The study considered frequency data involving response scores of students using a scale of good, fair and poor.
Results. Numerical results revealed poor level of student’s knowledge and control practices of hepatitis B virus infection. And it is significantly (p>0.05) the same in the study Universities. Moreover, gender and faculties, as well as interaction have no significant (p>0.05) effect on student’s knowledge and control practices of hepatitis B virus infection