Publishing House of Ivano-Frankivsk National Medical University
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Clinical evolution of Spitz nevi
Get PDFNevus Spitz is a benign melanocytic proliferation, first described in 1948 by Sophie Spitz as a childhood melanoma. Initially, it was described as an erythematous papule or node, but further studies of the Spitz nevus proved that in 71-92% cases it is a pigmented formation. This pigmentation is often quite intense due to the rapid growth of the formation, which leads to the need for differential diagnosis with skin melanoma. After all, dermatoscopy can be used for this purpose and, when applying this research method, typically a pattern of an exploding star formed by streaks of linear pigmentation and symmetrically located pigment globules placed in the peripheral zone can be revealed. In case of non-pigmented Spitz nevus, spot vessels and reticular depigmentation are visualized. Both pigmented and non-pigmented forms of Spitz nevus in the process of evolution can regress partially or completely. Several clinical cases of different types of spitzoids, both typical and atypical, based on the non-clinical, dermatoscopic and histological diversity of the Spitz nevi, have been demonstrated in the article. Their macroscopic and dermatoscopic features as well as probable signs of dynamic changes are indicated in order to facilitate their recognition by other specialists
Morphological Characteristics of Changes in the Duodenal Wall Within 14-56 Days of the Development of Streptozotocin-Induced Experimental Diabetes Mellitus
Get PDFThe objective of the research was to determine the morphological features of the duodenal wall of animals within 14-56 days of developing streptozotocin-induced diabetes mellitus using light optical microscopy.
Materials and Methods. The research was carried out on 40 white nonlinear adult male rats. Diabetes mellitus was simulated by a single intraperitoneal injection of streptozotocin (Sigma, USA) at a dose of 60 mg/kg body weight. The material was taken from the duodenum on the 14th, 28th and the 56th days after the onset of experimental diabetes mellitus. For histological study, the preparations were made using the conventional method, which included the staining of sections with hematoxylin and eosin.
Results. Streptozotocin-induced diabetes mellitus was experimentally found to lead to dystrophic changes in the epithelial components of the duodenal mucosa from the 14th day of developing. There were observed a shortening of the villi of the mucous membrane and a lack of distinctness of striated border contours on the apical surface of epitheliocytes. Between the connective-tissue fibers of the lamina propria of the mucosa and thin-walled vessels, the cellular elements, including mainly macrophages, lymphocytes, were found. There was a shortening of the villi, edema and histiolymphocytic infiltration of the villous stroma 28 days after developing experimental diabetes mellitus. The epithelium covering was discontinuous; numerous areas of desquamation were found at the apex of the villi. Fifty-six days after developing experimental diabetes mellitus, the destruction and desquamation of the epithelium of the villi and crypts were observed. The surface of the duodenal mucosa smoothed down due to the shortening and flattening of the villi (indicating their atrophy), while the crypts elongated and their depth increased.
Conclusions. Histological study of the duodenal wall of diabetic animals showed pronounced desquamation at the apex of the villi, destructive and dystrophic changes in the surface epithelium, edema and increased cellular infiltration of the lamina propria of the mucosa. Thus, in diabetes mellitus, structural changes in the duodenal wall of rats are characterized by the dystrophic processes, which can be considered as the morphological reflection of enteropathy
Використання сучасних технічних засобів при вивченні хімічних дисциплін фармацевтами
Get PDFAbstract. The introduction of computer technologies into the educational process creates a special information environment that motivates students to learn chemistry disciplines. This facilitates understanding and solving many intelligent tasks, contributes to better understanding and illustrating chemical laws and phenomena. The use of modern information technologies takes students’ independent work to a new level, where both network resources of the university and publicly available Internet resources play a significant role. Responsible use of gadgets transforms them from cheating tools into the powerful source of obtaining necessary information to solve the tasks.Впровадження комп’ютерних технологій в процес навчання створює особливе інформаційне середовище, яке стимулює інтерес студентів до вивчення хімічних дисциплін. Це полегшує розуміння й вирішення багатьох завдань інтелектуального характеру, сприяє кращому розумінню та унаочненню законів та явищ хімії. Використання сучасних інформаційних технологій виводить самостійне навчання на новий рівень, де значну роль в організації навчання приділяється як мережевим ресурсам кожного ВНЗ, так і загальнодоступних ресурсів інтернету. Свідоме використання гаджетів перетворює їх з засобів списування на потужне джерело отримання необхідної інформації для розв’язання навчальних завдань
Impact of Periodontal Pocket Depth on the Efficiency of Surgical Treatment of Generalized Periodontitis
Get PDFThe paper is aimed at increasing the efficiency of surgical treatment by using a combination of platelet-rich fibrin, a synthetic hydroxyapatite Kergap, minimizing the body’s response to operative wound, and improving diagnostic and therapeutic approaches in surgical treatment of stage II-III generalized periodontitis.
The objective of the research was to study the efficiency of using the combination of platelet-rich fibrin, synthetic hydroxyapatite Kergap, magnesium preparation in comprehensive treatment of stage II-III generalized periodontitis at various stages and in different depths of the periodontal pockets.
Materials and Methods. The efficiency of surgical treatment was evaluated using clinical (periodontal pocket depth, attachment level, gingival bleeding, tooth mobility) and laboratory methods (X-ray, computed tomography) 3, 6, and 12 months after surgical treatment.
Results. The clinical picture was characterized by positive changes in all clinical indicators 3, 6 and 12 months after treatment. The best results by clinical and laboratory findings were obtained in case of an average pocket depth of 5-7 mm.
Conclusions. There was demonstrated a high clinical efficiency of using the combination of platelet-rich fibrin, synthetic hydroxyapatite Kergap and magnesium preparation in comprehensive treatment of stage II-III generalized periodontitis
Laser-Induced Spectral-Selective Autofluorescent Microscopy as a Prospective Method of Research in Biomedicine
Get PDFIn modern medical diagnostics, optical methods of studying living tissues have become widespread and are collectively called "optical biopsy". One such method is autofluorescence microscopy, which provides additional information about the structural and functional features of the sample. In this paper, an analysis of existing data was performed on the properties of autofluorescence of cells and tissues to evaluate the available instrumental systems and methods for monitoring autofluorescence and the potential for its application in the biomedical field.
Over the past few years, advanced optical-electronic methods have become available to detect various pathological conditions of tissues and environments of the human body by evaluating signals emitted by endogenous fluorophores. Because these molecules are often involved in basic biological processes, they are important parameters for checking the condition of cells and tissues. In our opinion, analytical methods based on autofluorescence monitoring have great potential in both research and diagnosis, and interest in the use of these new analytical tools is constantly growing. Methods based on autofluorescence can give more information about the object under study with relatively lower costs and less diagnostic error
Dental Orthopedic Morbidity Among Drafted Men Residing in Ivano-Frankivsk Region
Get PDFThe objective of the research was to establish the level of dental orthopedic morbidity among draftees in the western region of Ukraine.
Materials and Methods. A clinical dental examination of 294 drafted men residing in Ivano-Frankivsk region was carried out; among them, there were 185 urban residents and 109 rural residents.
Results. There were established a quite high prevalence of dental orthopedic morbidity and intensity of its development, especially among rural residents - 275.7 and 522.9 people per 1,000 population among urban and rural residents, respectively. The amount of orthopedic care in terms of total number of dentition defects and the teeth with destroyed coronal portion requiring orthopedic treatment, was found to be 2.4 times greater among rural residents as compared to urban ones and reached 1899.1 versus 787.6 defects, respectively. There was determined the identical structure of dentition defects among both urban and rural residents; bounded edentulous spaces accounted for 100% of cases, the absence of one tooth was observed in 92.3% of cases.
Conclusions. The urgent need for a radical reform of the system for providing comprehensive orthopedic care to drafted men with a mandatory active dispensary registration was substantiated
Thrombophilia as a Risk Factor for Thrombosis
Get PDFThe review article presents a contemporary view on the most common causes of hereditary and acquired thrombophilias and their role in the development of venous and arterial thromboses. The examination of patients in accordance with modern requirements consists in determining the causes and risk factors for blood clot formation, as well as implementing secondary prevention of recurrent thrombosis. Analysis of genetic and acquired hemostatic disorders allows us to identify a group of patients who require long-term anticoagulant therapy and mandatory anticoagulant prophylaxis in cases involving a high risk of thromboembolic complications
Study of the Association Between Antihyperglycemic Therapy and Cancer in Patients with Type 2 Diabetes Mellitus
Get PDFThe objective of the research was to investigate the features and association of antihyperglycemic therapy and cancer in patients with type 2 diabetes mellitus.
Materials and Methods. The study included the analysis of medical records of patients with type 2 diabetes mellitus who were diagnosed with cancer during 2012-2016. The obtained results were processed by statistical methods using the software packages Microsoft Excel and Statistika-12. The significance of differences between the frequency of using different treatment schemes was assessed by the Pearson’s test (χ²). To determine the risk of predicted events, the odds ratio, the 95% confidence interval, the positive and negative prognostic values were calculated.
Results. There were diagnosed 533 cases of cancer in patients with type 2 diabetes mellitus. The most common scheme of antihyperglycemic therapy prior to the detection of malignant diseases was a combination of metformin and sulfonylurea derivatives (35.65%), as well as monotherapy with sulfonylurea derivatives (17.26%) and metformin (11.28%). Prior to diagnosing cancer in 396 (74.30%) patients, antihyperglycemic therapyalong with sulfonylurea derivatives and insulin was used. Among obese patients 68.82% used sulfonylureas and insulin as part of antidiabetic therapy before diagnosis of cancer. The connection between insulin therapy and the risk of cancer development in patients with type 2 diabetes mellitus was proved (the odds ratio=2.35; the 95% confidence interval (1.91 - 2.91); p<0.001).
Conclusions. Prior to the detection of cancer in patients with type 2 diabetes mellitus, the combination therapy with metformin and sulfonylurea derivatives was most often used. The association between insulin therapy and the development of cancer in patients with type 2 diabetes mellitus was revealed. Cancer screening is advisable for patients with type 2 diabetes mellitus and obesity, who receive as a therapy sulfonylurea derivates and/or insulin
Role of Diffusion-Weighted and Chemical Shift Magnetic Resonance Imaging in Differentiation of Benign and Malignant Spinal Fractures
Get PDFAtraumatic spinal compression fractures are common clinical problem. Differentiating benign osteoporotic fractures from pathological fractures due to malignant/metastatic lesions affects the management and prognoses in patients with known extraspinal malignancy. The objective of the research was to assess the role of conventional magnetic resonance imaging sequences with diffusion-weighted imaging and chemical-shift imaging in differentiating benign and malignant acute spinal compression fractures.
Materials and Methods. The study included 40 patients with acute spinal compression fractures. Patients were evaluated using magnetic resonance imaging with diffusion-weighted imaging and chemical-shift imaging to differentiate benign etiology from malignant one. The results obtained were compared with histopathological follow-up for 6 months for definite clinical diagnoses.
Results. No significant difference was noted in signal characteristics of benign and malignant fractures on T1, T2 and short-tau inversion recovery. However, posterior element involvement, soft tissue component and post-contrast enhancement were seen more frequently in malignant fractures (p<0.05). On diffusion-weighted images, 77.8% of malignant fractures were hyperintense and 59.1% of benign fractures were hypointense (p<0.05). The mean apparent diffusion coefficient value was 0.81 ± 0.19 for malignant and 1.24 ± 0.24 for benign fractures (p<0.5). The mean signal intensity ratio for malignant fractures was 0.91 ± 0.125, whereas the signal intensity ratio for benign fractures was 0.64 ± 0.096 (p<0.001).
Conclusions. Signal characteristics on T1, T2 and short-tau inversion recovery sequences do not differentiate benign from malignant fractures; however, posterior element involvement, soft tissue and post contrast enhancement help in differentiating the etiology. Diffusion-weighted imaging and apparent diffusion coefficient values, as well as using chemical shift imaging further improve the diagnostic accuracy of magnetic resonance imaging
Multi-Vessel Coronary Artery Disease: Choice of Myocardial Revascularization Strategy
Get PDFMulti-vessel coronary artery disease is quite a common state, which is often diagnosed by coronary angiography in patients with both stable coronary artery disease and acute coronary syndromes. Major difficulties in percutaneous coronary intervention include stent thrombosis and the need for antiplatelet therapy (aspirin and a P2Y12 inhibitor). Stent thrombosis leads to the recurrence of myocardial infarction and may occur within the first few hours after percutaneous coronary intervention. The use of dual antiplatelet therapy, especially that combined with low-molecular-weight heparin in the first days after myocardial infarction, poses a risk of bleeding, which often occurs in real clinical practice. Among P2Y12 inhibitors, ticagrelor causes bleeding somewhat more frequently than clopidogrel. A case of multi-vessel coronary artery disease is described in this paper. Coronary angiography revealed right-dominant circulation; occlusion of the proximal and medial segments of the right coronary artery, thrombolysis in myocardial infarction flow grade 0; stenosis of the left main coronary artery (50-60%), thrombolysis in myocardial infarction flow grade 2; diffuse stenosis of the medial and distal segments of the left anterior descending artery, thrombolysis in myocardial infarction flow grade 1; stenosis of the proximal segment of the left circumflex artery (> 75%), thrombolysis in myocardial infarction flow grade 1. The patient underwent percutaneous coronary intervention; the stents were implanted in the infarct-dependent right coronary artery. The clinical course was complicated by early stent thrombosis with subsequent thrombus extraction; a day later melena developed. Bleeding was stopped, the intensity of antithrombotic therapy was reduced: the combination of aspirin and ticagrelor was replaced by the combination of aspirin and clopidogrel. Six weeks after stenting of the infarct-dependent coronary artery, complete myocardial revascularization (hybrid intervention) was performed: coronary artery bypass grafting [the left internal mammary artery → the left anterior descending artery], coronary autogenous bypass grafting [the aorta → the right coronary artery and the aorta → the left circumflex artery]. The role of fractional flow reserve or instantaneous wave-free ratio-controlled complete myocardial revascularization techniques is discussed. The following algorithm for myocardial revascularization was used: percutaneous coronary intervention for the right coronary artery + coronary artery bypass grafting-3: the left internal mammary artery → the left anterior descending artery, the aorta → the left circumflex artery, the aorta → the right coronary artery