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Changes in the Dynamics of Treating Patients with Generalized Periodontitis and Hypertension Depending on the Method of Treatment
Get PDFCalcium and its compounds play an important role in the regulation of many functions of the body. The concentration of calcium ions in the serum is one of the important constants of homeostasis.
The objective of the research was to study the level of total calcium, ionized calcium, and phosphorus in patients with stage II hypertension and generalized periodontitis of II degree of severity, depending on the method of treatment.
Materials and methods. The main group consisted of 70 patients with generalized periodontitis of II degree of severity and stage II hypertension who were divided into 4 groups. The comparison group consisted of 30 patients suffering from generalized periodontitis of II degree of severity without hypertension who were divided into similar 4 groups depending on age and type of treatment. The control group included 17 patients of corresponding age with healthy periodontium and without somatic pathology.
Results. Twelve months after starting treatment, in younger patients of the main group receiving basic therapy, serum phosphorus level increased by 0.03 mmol /l, and in the older ones, it increased by 0.04 mmol/l. In younger and older patients of the comparison group, serum phosphorus level increased by 0.05 mmol/l. The patients who received basic therapy in combination with the proposed scheme of treatment had higher level of phosphorus than those who received basic therapy only. Twelve months after starting treatment, serum level of total calcium decreased in young and older patients of the main group and comparison group receiving basic therapy. An obvious improvement of treatment 12 months after its starting was observed in all the patients of the main group and comparison group who received basic therapy in combination with the proposed scheme of treatment.
Conclusions. The improved treatment scheme was more effective for treatment of generalized periodontitis of II degree of severity in patients with stage II hypertension
Course of HBV-infection in HIV-infected and HIV-non-infected Pregnant women
Get PDFThe objective of the work – is to study the course of HBV-infection in pregnant women, infected and uninfected with HIV, based on the analysis of clinical-laboratory parameters.
Materials and methods. HBV-infection was diagnosed in 5.6% of women with negative HIV-status and in 9.4% positive with HIV.
To verify the diagnosis of HBV-infection, the data of anamnesis, clinical examination, laboratory tests: general clinical, biochemical, EIA, PCR, and VL in each trimester of pregnancy were used.
Research. In HIV-negative pregnant women, 71.6% of the patients were diagnosed with HBsAg carrier status and 28.4% – the replication stages. Replication stages were only in HIV-positive patients.
The frequency of clinical manifestations of CHB is higher in HIV-positive women – it is 33.33% vs 10.00% in HIV-negative (p<0.05), in a significantly lower rate of cytolysis – 11.11% vs 45.00% (p< 0.001), which did not increase up to the childbirth.
The rate of VL of HBV increased before the childbirth in 63.3% of pregnant women without HIV-infection, and in 36.7% it did not change. Thus, in 83.3% of HIV-infected, it decreased to the threshold, and in 16.7% it hasn’t changed (p<0.01).
During pregnancy, the immunotolerant phase of CHB in women of both groups was not transformed into immunoactive, and in HIV-negative pregnant women – the carrier status of HBsAg to the replicative form.
Conclusion. In pregnant women with HIV-infection the incidence of replicative forms of HBV-infection is 3.5 times than in pregnant women without HIV-infection, the HBsAg carrier status is not determined. HIV-immunosuppression is accompanied by the prevalence of the immunotolerant phase of CHB (88.9%) with subclinical course without disturbance of pigmentary metabolism and cytolysis increase against the background of a decrease of VL HBV up to the threshold in 83.3% (p<0.01). The inverse weak correlation between the level of CD4 + T-lymphocytes and VL HBV was determined.
In HIV-negative pregnancies, latent forms of HBV-infection prevail (71.6%). Replicative forms are characterized by a low degree (80.0%) of HBV viremia (p<0.05) with minimal cytolysis in 43.3% of women (p<0.001), which did not change during pregnancy
Quality Assessment of Prosthetic Rehabilitation Using Aesthetic Fixed Restorations
Get PDFThe objective of the research was to study and assess the quality of prosthetic treatment using aesthetic fixed restorations.Materials and methods. The study included 79 patients without a comorbidity who underwent prosthetic rehabilitation. All the patients were divided into 3 groups: Group I included 25 patients with metal-plastic restorations; Group II comprised 34 patients with porcelain-fused-to-metal restorations; Group III consisted of 20 patients with a combined occlusal surface of prosthetic restorations. The patients were observed 6 months after prosthetic repair. Only patients with single molar and premolar crowns were examined. Bridge prostheses were not taken into account in order to eliminate the effect of masticatory force redistribution on the abutment crowns.Results. In Group I, 11 (44%) patients were satisfied with the results of prosthetic treatment. In Group II, 25 (78.12%) patients reported that they were satisfied with their treatment. In Group III, there were 17 (85%) patients satisfied with their outcome. However, the patients’ complaints are often subjective and do not fully reflect the objective state of the dentoalveolar system. An objective examination revealed that in indirect restorations, marginal periodontium pathology is typical. Conclusions. Aesthetic fixed restorations with a combined occlusal surface have demonstrated good clinical results, even at long-term follow-up. Combining positive properties of two different construction materials, namely zirconium dioxide and ceramics, they reduce the risk of complications such as marginal periodontium pathology and chipping along the occlusal surface as well as contribute to minimal abrasion of the occlusal surfaces of the antagonistic teeth. We cannot recommend metal-plastic restorations due to their low clinical effectiveness, poor aesthetic qualities as well as a high level of marginal periodontium pathology
System of Educational Process Organization at the Department of Endocrinology and the Department of Internal Medicine No 1, Immunopathology and Allergology named after academician Neiko Ye.M. of Ivano-Frankivsk National Medical University
Get PDFThe The article highlights the system of educational process organization during module 1 of the subject “Internal Medicine” at the Department of Endocrinology and the Department of Internal Medicine No 1, Immunopathology and Allergology named after academician Neiko Ye.M. of Ivano-Frankivsk National Medical University. The possibilities of combining long-term experience and the traditions of national medical school with the principles of the credit-module system are described
Ultrastructural Changes in the Vessels of Hemomicrocirculatory Bed of the Iliac Lymph Nodes of White Rats in the Durable Action of the Opioid Nalbuphine
Get PDFThis article represents the electronic-microscopic examination of blood vessels of the hemomicrocirculatory bed of the iliac lymph nodes of white rats, males of reproductive age, who, during six weeks, received narcotic opioid analgesic – nalbuphine, increasing the weekly dose of the medicine to create a model of physical opioid dependence according to Ukraine Patent #76564 U.It was determined that opioid nalbuphine causes the reactive changes in the blood vessels of the hemomicrocirculatory bed of the iliac lymph nodes in the early stages of drug administration – within 1-2 weeks. A prolonged six-week administration of nalbuphine leads to profound destructive changes in the microvessels: the lumen of the hemocapillaries, which contains mainly the destructively altered erythrocytes, is expanding; the wall of microvessels, accompanied by hemorrhages into the vascular space, is violated; the structure of endotheliocytes nuclei changes, their cytoplasm swells, and organelles are damaged in it; the basement membrane thickens; the perivascular space swells and dilates. One week after the abolition of nalbuphine, the inverse changes in the blood vessels of hemomicrocirculatory bed do not occur
Comparative evaluation of the use of a chitosan-based multicomponent remedy in patients with acantholytic lesion of the tissues of the prosthetic bed to provide conditions for the use of removable dentures
Get PDFThe article describes the offered by us multicomponent remedy based on chitosan, to provide analgesic and wound-healing effect in patients with acantholytic lesions of the prosthetic bed tissues.
Objective of the study. To improve the conditions of removable dentures use for patients with acantholytic pemphigus.
Materials and methods. The study involved 56 patients with acantholytic pemphigus, aged from 45 to 63 years old, who were divided into 2 clinical groups. The main group used the proposed remedy; the comparative group received the standard local pemphigus treatment. Methods for determining the area of mucus lesion and the method for determining the intensity of pain syndrome were used to evaluate the final results.
Results of the study and their discussion. The average value of visual analogue scale (VAS) was 4.76±0.56 cm in patients of the main group during the first day. During the 7th and 14th day, the value decreased to 2.4±0.28 cm and 1.87±0.12 cm, respectively. In patients of the comparison group, the average value of VAS was 5.07±0.36 cm as for the first day and 4.45±0.45 and 2.36±0.17 cm during the 7th and 14th days, respectively. The ratio of the mean value of the affected area in patients of the main group and the comparison group was 1.04 during the first day, and during the 7th and 14th day the area of injury in patients of the main group was lower 1.29- and 1.84 -fold, respectively.
Conclusions The results of the study confirm the necessity of using a multicomponent remedy based on chitosan together with the removable dentures in patients with acantholytic pemphigus, due to its clearly expressed epithelial and analgesic action
The Use of Rentgenological Methods of Diagnostics in Surgical Treatment of Atrophy of the Alveolar Process of the Upper Jaw and Part of the Lower Jaw in Women of Postmenopausal Age
Get PDFThe objective of the study is to evaluate the condition of the alveolar part of the upper jaw and the part of the mandible according to X-ray studies in postmenopausal women before and after surgical treatment of the atrophy of jaw bone tissue using osteoplastic material and an ossein-hydroxyapatite compound.
Materials and methods: There were observed 24 women in the postmenopausal period, aged from 51 to 58 years, with atrophy of the alveolar process of the upper jaw and the part of the lower jaw who were surgically treated.
Results of the study. On the basis of the obtained results of the X-ray examination, we can assume that the developed by us technique of surgical treatment of atrophy of the alveolar process of the upper jaw and the part of the lower jaw by the use of bone material of animal origin in combination with the ossein-hydroxyapatite compound allows us to intensify bone tissue regeneration processes, which further will contribute to the increase of the volume of bone tissue.
Conclusions. The use of modern X-ray methods, in particular orthopantomography and cone-beam computerized tomography in the diagnosis and surgical treatment of atrophy of the alveolar process of the upper jaw and the part of the lower jaw, are highly informative, and also provide the possibility of work with a roentgenographic image in a digital format that allows a more detailed assessment of the area of surgical intervention before and after the treatment
Substantiation, Development and Implementation of Person-Centered Assessment of Psychosocial Significance of Chronic Dermatosis at the Stage of Primary Healthcare
Get PDFHigh prevalence and incidence of chronic dermatoses among different age groups of Ukrainian population in combination with their multifactorial etiology and the progredient clinical course determine the need for the provision of general family medicine physicians with simple and accessible at the stage of primary healthcare technologies of medical care delivery to such patients. Patients with chronic dermatoses are known to be characterized by certain metabolic features, clinicopathologic cutaneous manifestations, as well as the development of special mental state associated with psychological trauma due to chronic dermatoses.
The objective of the research was to substantiate, develop and implement person-centered assessment of psychosocial significance of chronic dermatoses at the stage of primary healthcare delivery by general family medicine physicians.
Materials and methods. The study was carried out according to a specially developed program for collecting, accumulating and analyzing the results and included 114 patients with chronic dermatoses at the age of 29-58 years. Patients were divided into 2 groups: Group I included patients with chronic dermatosis duration of <10 years and Group II comprised patients with chronic dermatosis duration of over 10 years. Medical and psychological examination of patients with chronic dermatoses was performed using the method of differentiated self-assessment of the functional state - the WAM (well-being, activity, mood), the Spielberger State Anxiety Scale modified by Khanin Yu.L., the personality questionnaire of the Bekhterev Institute (LOBI) etc.
Conclusions. The prognostic value of the decrease in strength and energy is an adverse effect on a relatively long clinical course of the disease. The diagnostic value of work/study limitations is 0.896 bit, and the prognostic value of this factor is a psychological limit of psychosocial functioning of an individual due to long-term clinical course of the disease. The presence of chronic skin disease was found to affect the patients’ daily lives; taking (physical, aesthetic, intellectual, etc.). The diagnostic value of work/study limitations is 0.896 bit, and the prognostic value of this factor is a psychological limit of psychosocial functioning of an individual due to long-term clinical course of the disease. The presence of chronic skin disease was found to affect the patients’ daily lives; taking (physical, aesthetic, intellectual, etc.). This indicated greater (p<0.050) psychosocial limitation in individuals with long-term clinical course of chronic dermatoses being an indicator of the need for psycho-educational activities at the stages of clinical manifestations of chronic dermatoses
SPECIAL ASPECTS OF MISCARRIAGE IN WOMEN WITH RECCURENT MISCARRIAGE
No full textMissing pregnancy is a consequence of the simultaneous or sequential action of several factors. The main causes of miscarriage and spontaneous interruption of pregnancy include: genetic factors, endocrine disorders, immune and infectious factors, congenital and acquired diseases of female genital organs. In almost 50% of women, it is not impossible to determine the reason of miscarriage, so the question of early diagnosis and prevention of this condition is quite acute.Materials and methods. In this study, we performed a pathohistological study of the deciduum in order to determine the etiological factor of the pathology of implantation of the embryo and placentation. The study included 88 women with a diagnosis of "recurrent miscarriage" that met the criteria for inclusion and exclusion.Results of research. In the study group, the age of women was from 19 to 35 years old (mean age was 27.6±4.1 years old). The abortion was observed at differentst ages of pregnancy, more often during the period of 4-9 weeks of gestation (67 cases – 76.14%). According to the results of the histopathological study of decidouum lymphohistiocytic infiltration was revealed in the stroma of villi in 62 cases (70.45%), other changes were less common.Conclusions and perspectives of further research. The obtained data indicate that the determination of the etiologic factor of miscarriage of the pregnancy, especially in women with a diagnosis "Reccurent miscarriage of obscure etiology", will allow to predict the development of the pathology of implantation and placentation in subsequent pregnancies.Prospects for further research are to develop adequate preparation before pregnancy and prevention of the pathology of implantation and placentation
Early and Remote Results of Surgical Treatment of Inferior Vena Cava Thrombosis
Get PDFThe objective of the research was to estimate the early and remote results of surgical treatment in patients with deep vein thrombosis of the inferior vena cava.Material and methods. The results of treating 790 patients with lower limb deep vein thrombosis and thrombosis of the inferior vena cava were analyzed. Depending on treatment, all the patients were divided into the following groups: Group IA consisted of 380 (68.5%) patients with deep vein thrombosis who underwent open complete or partial thrombectomy with or without surgical prevention of pulmonary thromboembolism; Group IB consisted of 50 (9.0%) patients with deep vein thrombosis who received combined treatment with surgical prevention of pulmonary thromboembolism; Group IC consisted of 125 (22.5%) patients with transfascial thrombosis who underwent thrombectomy of the apical thrombotic masses of deep veins followed by radical venectomy; Group II consisted of 235 (29.7%) patients with deep vein thrombosis who received conservative anticoagulant therapy only.For investigation of patients, there were used the following laboratory methods of examination: duplex ultrasound scanning, X-ray phlebography, computer tomography, echocardioscopy and radionuclide phleboscintigraphy.Results. The results of surgical and combined methods of treating deep vein thrombosis in clinical subgroups were evaluated using a three-point scale - good, satisfactory and unsatisfactory. The cumulative analysis of the results of the postoperative period during 3 years of follow-up showed that good and satisfactory results were observed in 89.3% of patients of Group IA, 81.7% of patients of Group IB, 88.4% of patients of Group IC, and 35.3% of patients of Group II. Three years after treatment, the signs of chronic venous insufficiency were found in 51.6% of patients who underwent conservative treatment, 36.4% of patients who received combined treatment, 10.2% of patients who underwent partial thrombectomy, 2.9% of patients who received surgical treatment of transfascial thrombosis; they were absent in patients who underwent radical thrombectomy.Conclusions. In quantitative evaluation of the early and remote results of treating deep vein thrombosis of the inferior vena cava, a significant improvement in the patients’ condition in all parameters was observed in the main group as compared to the control one