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Characteristics of Violations in the Aggregate State of Blood Regulation System of Women with a High Degree Anemia on the Background of Endometrium Hyperplastic Processes
Get PDFEndometrial hyperplasia is a benign pathology of the uterine mucosa, characterized by certain histological changes, characterized as simple and complex, non-atypical and atypical forms. Hyperplastic processes of endometrium, according to various authors, in the structure of gynecological pathology make up 15 to 40%. Clinically, the endometrial hyperplasia manifest by uterine bleeding. Maternal bleeding that is not susceptible to hormonal, symptomatic, and hemostatic therapy, leads to chronic post-hemorrhagic anemia and is the indication for surgical intervention. Consequently, systemic disorders of the hemostasis parameters on the background of uterine bleeding with endometrial hyperplasia, in particular the regulation of the aggregate state of blood systems, require further research to identify new pathogenetic links and develop correction methods.Materials and methods.State of platelet-vascular hemostasis was assessed by the percentage of platelets adhesion in the blood and by the index of spontaneous platelet aggregation. Total potential coagulation of blood, plasma fibrinolytic activity, plasminogen potential activity, antiplasmin, fibrinogen in blood plasma, the activity of antithrombin III, the concentration of soluble fibrin monomer complexes in the blood was determined by reagents made by Simko Ltd company (Ukraine). Using the «Thromboelastohraph ACG» machine we identified parameters of thrombin clotting rate, thromboelastograph K constant, specific platelets convolution constants, a- angle and coagulation composite index.Results. In women with anemia of ІІІ-rd degree against background of the uterine bleeding, at high activity of primary hemostasis, structural and chronometric hypocoagulation develops; it is predefined by the acute decreasing of fibrinogen in the blood. The principal reason of hypofibrinogenaemia is the excessive activating of non-fermentative fibrinolysis. In conclusion, changes in the system of regulation of the aggregate state of blood in women with severe degree of anemia are the display of subclinical inopexia that develops as a result of thrombocytes high functional activity
Part of the Fat Component in the Structure of Gestational Weight Gain
Get PDFGestational weight gain (GWG), which is more or less of the recommended guidelines, has serious short- and long-term negative consequences for the health of the mother and children. Determining the dynamics of body composition during pregnancy is important for full antenatal care in order to prevent pathological weight gain and prevention of gestational complications.Objective: Our goal was to determine the proportion of fat component in the structure of GWG in women with normal body weight before pregnancy. Design: 153 pregnant women aged 18-43 years with normal pre-pregnancy body mass index (pBMI) were examined. BMI was calculated by using the standard formula of person’s weight in kilograms divided by the square of his height in meters (kg/m2). Total weight gain was calculated by subtracting the pre-pregnancy weight from the last measured weight before delivery. The body composition (fat mass (FM), fat-free mass (FFM), and the percentage of fat mass (%FM)) was calculated on the basis of bioelectrical impedance analysis (BIA) using the ‘DIAMANT-AIST’ analyzer (St. Petersburg). Statistical analyses were carried out using Statistical program "Statistica 5.5".Results: It has been established that in women of normal weight before pregnancy, GWG was directly proportional to an increase in the fraction of FM (r=0.87; p<0.001). In pregnant with the recommended GWG, FM increased monotonous in the first and second trimesters and subsequently stabilized. In patients with insufficient GWG, fat component increased similarly (p>0.05), however, it was accompanied by low growth of the FFM, especially in the third trimester (p<0.05). Pregnant women with excessive GWG were more likely to gain weight in the first trimester mainly due to the accumulation of FM (p<0.05), and this tendency remained until delivery r=0.99 (p<0.01).Conclusion: In women with normal GWG there is a monotonous increase in fat component in the first and second trimesters, and subsequently stabilized, which promotes adequate weight reduction after childbirth. In patients with high GWG, the excessive increase in the proportion of FM and, consequently, a rapid increase in weight in the first trimester of pregnancy, initiates further accumulation of adipose tissue and slows down its reduction in the postpartum period. In pregnant women with low weight gain there is adequate increase of FM but an insufficient increase of FFM, especially in the third trimester, which leads to the development of placental hypoplasia and small-for-gestational age
Risk Factors for the Development of Low Quality of Life in Adults with Juvenile Idiopathic Arthritis
Get PDFJuvenile idiopathic arthritis is known to persist into adulthood which is associated with the development of a large number of long-term consequences, including low quality of life. The objective of the research was to evaluate quality of life in young adults with juvenile idiopathic arthritis and to analyze the risk factors for the development of its low level using the 36-Item Short Form Health Survey. Materials and methods. There were examined 135 adult patients with juvenile idiopathic arthritis without severe comorbidity at the age of 18 to 40 years and 25 apparently healthy young adults of the same age and gender. Quality of life was evaluated using the 36-Item Short Form Health Survey. Results. In patients with juvenile idiopathic arthritis, the physical health score (44.8±9.9) was lower (p=0.001) as compared to healthy individuals (55.7±6.9). Patients with juvenile idiopathic arthritis had lower indicators of physical functioning (p=0.001), role functioning (p=0.001) and bodily pain (p=0.001) than healthy individuals. However, in patients with juvenile idiopathic arthritis, the indicators of the mental health score and associated vitality, social functioning, role limitations due to emotional problems and mental health did not differ from those in the control group. Prolonged morning stiffness (p<0.05) and polyarticular variant of joint damage (p<0.05) were the risk factors for the development of low physical health score in young adults with juvenile idiopathic arthritis. According to the articular juvenile arthritis damage index (p<0.001), the presence of long-term articular damage was associated with high physical health score. There were found no risk factors for the development of low mental health score. Conclusions. Young adults with juvenile idiopathic arthritis at the age of 18 to 40 years had worse quality of life than healthy individuals of the same age and gender. They had worse physical well-being scores including physical functioning, role functioning and bodily pain. The risk factors for the development of low physical health score in young adults with juvenile idiopathic arthritis were the presence of prolonged morning stiffness as a manifestation of disease activity and polyarticular variant of joint damage, while the presence of prosthetic joints improved their physical health score
Recommendations for the Use of Removable Dentures in Patients with Acantholytic Pemphigus and their Evaluation
Get PDFThe recommendations, offered by us, as for the use of removable dentures in patients with acantholytic pemphigus using a multicomponent remedy based on chitosan are described in the article to provide an analgesic and wound-healing effect in patients with acantholytic damage of the prosthetic bed tissues.Objective of the study. To improve the conditions for the use of removable dentures for acantholytic pemphigus patients.Materials and methods. The study involved 56 patients with acantholytic pemphigus, aged 45 to 63 years old, who were divided into 2 clinical groups. The main group used removable dentures according to our recommendations; the comparison group used removable dentures in accordance with generally accepted recommendations. Methods for determining the intensity of the pain syndrome and the subjective responses of patients about the state of health were used to evaluate the ultimate results.Results of the research and their discussion. Improvement of general state according to the data of a subjective survey in the main group was observed in 20 patients, which was 71.42% during the 7th day; and in 27 patients during the 14th day, which was 96.42%. In the comparison group, patients who subjectively felt better were 35.71% during the 7th day and 57.14% during the 14th day, respectively.Conclusions. The results of the study confirm the necessity to develop, implement and improve the recommendations for the inclusion into the protocol of the use of removable orthopedic structures of dentures in patients with acantholytic lesions of the prosthetic bed tissues
Moral and Ethical Principles of Education of Future Physicians: the Holy Doctor Giuseppe Moscati – an Example to Follow
Get PDFThe article deals with the biographical data of the Italian doctor Giuseppe Moscati (1880-1927), who was recognized as a saint. Moral and ethical principles that he was guided in life are an example to follow by future doctors
Mechanism Development of Diabetic Microangiopathy and Opportunity of Diabetic Warning
Get PDFSpecific general defeat of arteriols, capillaries and veins at a diabet mellitus consists in the bulge of basale membrane of shallow vessels, laying of glycoproteins in a wall and proliferation of endothelium. A hyperglycaemia results in increasing of blood plasma, membranes and cages of level of free radicals on a background insufficiency of enzymes of the protective antioxidant system. Determination of the state insulin tolerance to the people with excessive body weight and obesity, by a hyperpiesis, problems with the lack of fats, by a gout and other endocrine diseases already on the stage of credible violation of carbohydrate exchange gives an opportunity in good time to conduct the correction of possible defeats of microvasculature toxic action of high concentration of glucose
Peculiarities of Carbohydrate Exchange in Patients with Generalized Periodontitis of Young Age Persons
Get PDFThere were studied 92 somatically healthy persons of young age (18-25 years old), with generalized periodontitis (GP) of initial-I degree of development, among them: 30 patients with chronic generalized periodontitis (CGP), who were included into group І; and 32 patients with exacerbation of the chronic generalized periodontitis (ECGP) – into group II; and 30 healthy patients. The carbohydrate metabolism indexes were studied, namely: the content of glucose, pyruvate (pyruvic acid) and lactate (lactic acid) and lactate dehydrogenase activity (LDG) in the oral liquid.We have determined that in the presence of CGP of the initial-I degree of development, and especially in its exacerbation, there is a significant increase of indicators of carbohydrate metabolism. In young patients with CGP indicators of glucose, pyruvate, lactate and LDG activity in the oral liquid increased by 2.0, 1.34, 1.58 and 1.37 (p<0.001, p<0.01) times respectively, and in case of ECGP they grew even more: by 2.71, 1.98, 1.76 and 2.07 (p<0.001) times, respectively.Among all the indicators, that characterize the carbohydrate metabolism, in addition to the level of pyruvate, in case of different course of GP a significant difference was revealed: in patients with ECGP compared with the data in CGP, glucose and lactate levels and LDG activity in the oral liquid were significantly higher - at 35.75% (p<0.05), 34.29% (p<0.01) and 36.59% (p<0.001) respectively.Detected violations of carbohydrate metabolism indeces in the oral liquid indicate the involvement of these processes in the pathogenesis of GP and the necessity of their correction.
Comparative Histologic Evaluation of Vertebrate Ovaries
Get PDFComparative Anatomy is a subspecialty of Anatomical Sciences that deals with/involves the possible existing structural relatedness in organisms. By careful description of specific structures, organs or systems, comparisons are made that draw similarities or differences between organs. The aim of this area in Anatomy was to provide evolutionary or adaptive explanations for detected characteristics – including maintaining the ancestral line.Materials and MethodsPermission for this descriptive and observational study was obtained from the research and ethics committee of the Department of Human Anatomy and Cell Biology, Delta State University, Abraka (Number DELSU/CHS/ANA/118). Five female animals of the vertebrate class were used for the study (one from each vertebrate class). The animals included: cat fish (Clariasgariepinus); toad (Bufobufo); agama lizard (Agama agama); domestic chicken (Gallus gallusdomesticus) and the Wistar rat (Rattusnorvegicus).ResultsAll the studied vertebrates except mammals showed growth and maturation of several follicles confirming the characteristic of multiple gestation characteristic of these animals. The phases of growth were very similar in all of the studied organisms. These follicles were disposed in a fibrous stroma capable of influencing the activity of the ovary, Lacunae were only found in birds and mammals.ConclusionThe index study revealed several significant findings especially the occurrence of multiple stages of germ cell development in the female vertebrate gonads. These observations provided a vivid histologic basis for the argument of a common ancestral origin of the animal phylum albeit against the background of extensive impact of adaptational factors
Remission and Active Disease in Young Adult Patients with Juvenile Idiopathic Arthritis During the Transition Period from Paediatric to Adult Healthcare
Get PDFThe objective of the research was to study the frequency of remission in young adults with juvenile idiopathic arthritis during the transition period from paediatric to adult healthcare and factors contributing to its development. Materials and methods. In our study, there were included 165 adult patients from different regions of Ukraine diagnosed with juvenile idiopathic arthritis according to the classification criteria of the International League of Associations for Rheumatology. All the patients were examined in the Oleksandrivska City Clinical Hospital, Kyiv during 2015-2018. There were assessed the presence of rheumatoid factor, anti-cyclic citrullinated peptide, antinuclear antibodies, human leukocyte antigen B27, disease duration, disease activity (the Juvenile Arthritis Disease Activity Score-10 and the Disease Activity Score-28), C-reactive protein, past medical history, quality of life (the 36-Item Short Form Health Survey), the degree of depression (the Patient Health Questionnaire-9) and alexithymia (the 20-item Toronto Alexithymia Scale). In all the patients, bone mineral density was studied using dual-energy x-ray absorptiometry with the evaluation of T- and Z-scores in different regions of the skeleton. The disease was considered inactive at the Disease Activity Score-28 <2.6 and the Juvenile Arthritis Disease Activity Score-10 <1 and <2 for oligoarticular and polyarticular variants of juvenile idiopathic arthritis, respectively. Results and discussion. All the patients were divided into 2 groups: Group I included 136 (82.4%) patients with active disease at the time of examination; Group II comprised 29 (17.6%) patients who achieved remission according to the Disease Activity Score-28 or the Juvenile Arthritis Disease Activity Score-10. In Group I, females prevailed accounting for 58.1% of patients as compared to Group II (31.0%). Disease duration was longer in patients of Group I (p<0.01); however, they did not differ from patients of Group II in age at disease onset and the International League of Associations for Rheumatology variants of juvenile idiopathic arthritis. In Group II, lesions involving more than 3 joints (p<0.01), hand arthritis (p<0.01), symmetric arthritis (p<0.01), enthesitis (p<0.01), spinal pain (p<0.01) were observed less frequently. Fewer patients required joint replacement (p<0.01); the number of deformed and painful joints (p<0.05, p<0.001, respectively) was smaller. However, there was no difference in the level of rheumatoid factor, anti-cyclic citrullinated peptide, antinuclear antibodies, and the presence of human leukocyte antigen B27. The achievement of remission improved physical well-being of patients (the physical component score, p<0.001), although overall mental well-being (the mental component score) did not change according to the 36-Item Short Form Health Survey. In patients with remission, the indicators of physical functioning (p<0.001), role functioning (p<0.001), social functioning (p<0.001), bodily pain (p<0.001), general health (p<0.001), mental health (p<0.001) improved. There was observed a reduction in the level of depression to the normal one according to the Patient Health Questionnaire-9 (p<0.05); however, in both groups, there were observed elevated levels of alexithymia. Both groups did not differ in the frequency of immunobiological therapy prescription; however, the results should be intepreted with caution, since only 5 (17.1%) patients in Group II received immunobiological therapy earlier or at the time of examination. In Group II, patients did not receive glucocorticoids at the time of examination (p<0.001) and earlier more often (p<0.001). Both groups did not differ in both the duration of treatment with disease-modifying antirheumatic drugs and the doses of methotrexate and sulfasalazine. Conclusions. Remission of juvenile idiopathic arthritis was detected in 17.6% of the surveyed young adult patients from different regions of Ukraine during the transition period from paediatric to adult healthcare, that indicated that in most cases the goal of treat-to-target strategy was not achieved. Patients with active disease often developed joint deformities and required their replacement; they had worse physical well-being according to the 36-Item Short Form Health Survey, although mental well-being was affected in both patients with active disease and those with remission, which may be due to high levels of alexithymia in both groups. Patients with active disease had higher levels of depression according to the Patient Health Questionnaire-9, whereas patients in remission showed no depression.
Area of Competence of Primary Healthcare Specialists in the Implementation of Person-Centered Programs of Educational and Behavior Modification in Chronic Dermatoses
Get PDFDue to a significant shortage in both physicians and practical nurses that is of special relevance for healthcare services in rural areas, the distribution and cooperation of health production functions are of great importance.In this context, the effectiveness of EMB is associated, on the one hand, with the patient adherence to the substantiated recommendations and, on the other hand, with the qualification level of medical personnel in the GFM ambulatories while carrying out EBM.The objective of the research was to conduct the problem-oriented analysis of cooperating and distributing the duties of specialists in the implementation of EBM among patients with CD at the stage of primary healthcare.ResultsThere was conducted the problem-oriented analysis of qualification competencies to verify the possibility of implementing EBM by practical nurses considering typical activities of professionals. The analysis revealed the compliance of the main components of professional competence of physicians and nurses with their involvement in the process of EBM implementation among patients with CD