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Special peculiarities of clinical course of osteoarthrosis of knee joints depending on 6-hydroxymelatonin-sulfate urinary excretion profile
Get PDFThe study objective was to define the special features of the clinical course of knee joint osteoarthrosis depending on 6-sulfatoxymelatonin urinaryexcretion profile.Materials and methods.We surveyed 141 patients with radiological Stage II-III osteoarthrosis (OA) of the knee joints (18 female subjects). Diagnosis of OA was established on the basis of ACR criteria (1991) and EULAR (2010) recommendations. We determined the AO clinical indexes (Lequesne, WOMAC, KOOS), HAQ functional index, sleep quality and psycho-emotional state indicators. ELISA was used to assess 6-sulfatoxymelatonin urinary excretion profile.Results. It was established that 66% of patients with OA of knee joints had a reduced 6-sulfatoxymelatonin urinary excretion compared to this of practically healthy individuals. AO patients with low 6-SMT urinary excretion profiles had higher incidence of severe insomnia and depressive disorders. Reduction in 6-SMT excretion was associated with a moderate increase in pain syndrome and deterioration of physical functions by Lequesne, WOMAC, KOOS, and HAQ indexes.Conclusion.The reducedmelatonin production in ОА patients is a factor of more severe clinical course of the disease due to deterioration of the psycho-emotional state, the development of pain syndrome, and functional disorders
Thyroid Volume and Doppler Indices of the Inferior Thyroid Artery in Clinically Euthyroid Adults in Kashmir
Get PDFThe objective of the research was to evaluate thyroid volume and spectral indices (the resistivity index, the pulsatility index and the peak systolic velocity) in normal euthyroid adults in Kashmir.
Materials and methods. There was carried out a prospective observational study at a tertiary care hospital; 182 normal euthyroid adults (102 males and 80 females) were included in the study. Thyroid gland volume was calculated from grey-scale ultrasound images followed by spectral Doppler evaluation of the bilateral inferior thyroid arteries; the resistivity index, the pulsatility index and the peak systolic velocity were calculated for the bilateral inferior thyroid arteries with calculation of the mean values.
Results. The mean thyroid volume was 7.8±1.9 ml with no significant difference in males and females. The mean peak systolic velocity obtained was 15.65±6.5 cm/s. The mean pulsatility index and resistivity index were 0.95±0.29 and 0.58±0.13, respectively. There was no significant difference in the values obtained among both genders, and no significant difference was seen in values of the right and left inferior thyroid arteries.
Conclusions. The study showed no significant difference in the indices of thyroid volume and the inferior thyroid arteries measured by Doppler ultrasonography in euthyroid adult males and females. As thyroid vascularity is altered in many thyroid pathologies, the study will serve as the baseline for the evaluation of thyroid volume and Doppler parameters in patients with altered thyroid function. 
Diagnostic and Treatment Approach in Case of Aorta Mesenteric Clamp
Get PDFThe article presents anatomical and physiological features of the aorta mesenteric clamp. Diagnostic and treatment features of the pathology were analyzed in order to improve operating procedures. Unfortunately, few published literature data are not the result of multicenter randomized research and indicate the fact that consensus on diagnostic algorithms and therapeutic approach is absent
The Analysis of Some Indicators of Oxidative Student’s Stress with An Initial-i Stage of Generalized Periodontitis
Get PDFPeriodontal tissue disease is one of the most widespread human diseases. The development of periodontal tissue diseases (generalized periodontitis) depends on many local and systemic risk factors. An important place is the emergence of diseases of periodontal tissues against the background of a violation of the normal functioning of antioxidant defense systems, which leads to the development of oxidative stress and dysfunction of cells and tissues of the oral cavity. The aim of the study was to determine some indicators of oxidative stress in 2-year students of a medical university with an initial-I degree of generalized periodontitis. To assess the level of oxidative stress, indicators such as malonic aldehyde (MDA), SOD (superoxide dismutase) and glutathione peroxidase were used. The results of the study showed that oxidative stress plays an important role in the pathogenesis of periodontal tissue diseases
Alexithymia and Quality of Life in Adult Patients with Juvenile Idiopathic Arthritis
Get PDFPatients with chronic pain disturb not only quality of life (QL) but also develop difficulties in describing their feelings. Prolonged pain, stress, pathological conditions and related emotions can alter the perceived sensation of pain. The aim of our study was to study the QL and the level of alexithymia in adult patients with different types of juvenile idiopathic arthritis (JIA).Materials and methods. 173 young people aged 18-40 years old were examined: 118 adult patients with different ILAR variants of JIA, 30 patients with ankylosing spondylitis (AS) and 25 healthy young people. The QL was assessed using the Short-Form-36 questionnaire (SF36) with further assessing the level of alexithymia by Toronto alexithymia scale (TAS-20).Results. The analysis of QL shows that PCS (44.8±9.9) was significantly lower (p=0.001) in patients with JIA than in healthy subjects (55.7±6.9) of the corresponding age and sex, but did not differ from patients with AS (42.3±7.5). Patients with JIA had lower physical (p=0.001), role functioning (p=0.001) and bodily pain (p=0.001) compared with healthy, with no difference from patients with AS. In the distribution of patients with JIA in groups by the level of alexithymia, differences in QL were not revealed by MCS or PCS and scales related with them. The relationship analysis between the alexithymia and QL in patients with JIA shows, that elevated and high levels of alexithymia were related with low levels of MCS (p<0.05), role functioning (p<0.05), mental health (p<0.05). PCS and physical functioning did not affect the level of alexithymia in adult patients with JIA. PCS, role functioning, bodily pain, and general health were the lowest in patients with poly-articular JIA. However patients with oligo-, poly-articular, enthesyte-related JIA had no differences on scales related to PCS. Patients with poly-JIA with elevated and high levels of alexithymia revealed significantly lower social (p<0.05) and role (p<0.05) functioning, mental health (p<0.05) compared to patients without alexithymia. The presence of low bodily pain in alexithymic patients was found. Signs of alexithymia were found in 90% and 85% of adult patients with the oligo-arthritis and enthesyte-related JIA, respectively. The comparison of the QL in patients with oligo-arthritis and enthesitis-related JIA with different levels of the alexithymia shows no significant differences.Conclusions. 85.2% of adult patients with different variants of JIA have elevated and high levels of alexithymia. Adult patients with JIA have lower physical functioning than healthy individuals of the same age and sex, although they do not differ from the control group and AS group on psychological functioning and related vitality, social and role functioning, and mental health. The presence of alexithymia is related with a low level of psychological functioning, role functioning, mental health. However, physical functioning did not affect the level of alexithymia in adult patients with JIA. Patients with poly-JIA have the lowest physical, role function, bodily pain and general health, but according to the psychological functioning there were no differences between different variants of JIA in adulthood. Patients with poly-JIA with elevated and high levels of alexithymia have significantly lower social (p<0.05), role (p<0.05) functioning and mental health (p<0.05) compared to patients without signs of alexithymia.
The Prevalence of Caries of First Molars and Its Role in the Occurrence of Occlusal Disorders
Get PDFTo study the caries lesion of the first molars we used the results of our research about the prevalence of tooth decay in young people, who live in the districts with low level of fluoride. 300 students of first 3 years of study at Ivano-Frankivsk National Medical University at the age of 17 to 20 were examined for the research of prevalence of tooth decay. They were the citizens of Ivano-Frankivsk city, Nadvirna districrt, Verhovyna district and Rivne region. Clinical examination included medical history and oral cavity examination with the help of dental probe and detection device diagnodent (Kavo). We found that, regardless of the place of residence, the prevalence of acute and chronic tooth decay of the first molars was the highest. Occlusal decay was observed most commonly (38,3%). The established regularities of the prevalence of caries lesions in the first molars point to the necessity of development and realization of treatment measures for the prevention of occlusal disorders
Study of Macro- and Microelement Status in Patients with Nodular Goiter Residing in Kyiv Region
Get PDFSixty-one residents of Kiev region (16 individuals with nodular goiter and 45 individuals without thyroid pathology – the control group) were examined. When studying urinary iodine excretion, median urinary iodine concentration in the control group was 65.0 μg/l, while in patients with nodular goiter, it was 72.15 μg/l indicating mild iodine deficiency. In patients with nodular goiter, there were observed decreased serum levels of calcium - 74.17 mg/l (p<0.05), magnesium - 17.67 mg/l, zinc - 0.73 mg/l (p<0.05) and selenium - 0.03 mg/l (p<0.05) as compared to those in the control group. The relative risk of developing nodular goiter in decreased serum calcium concentration was 1.66 (95% confidence interval 1.07-2.09), (p<0.05); in decreased serum concentration of both calcium and selenium, it was 2.30 (95% confidence interval 1.147–4.085), (p<0.05); in low serum magnesium concentration, the relative risk was 2.6 (95% confidence interval 1.11-6.09) (p<0.05).
Sensorineural Hearing Loss in the Structure of Occupational Morbidity in Ukraine: the Problem of Disease Detection
Get PDFThe objective of the research was to compare Ukrainian statistics in occupational morbidity with data of other countries, to analyze the trend of the occupational hearing loss formation in Ukraine over a six-year period (2011 – 2016), to consider a modern state of sensorineural hearing loss detection and prophylaxis.Materials and methods. A comparative analysis of occupational morbidity in Ukraine and other counties within 2011-2016 years was based on the data obtained from the reports of the Social Insurance Fund of Ukraine, Statistical Collector, Eurostat, the International Labour Office, the Bureau of Labor Statistic, etc.Results. The difference in Ukrainian and international statistics in occupational morbidity can be explained by the diversity in the surveillance systems. The sharp decline in occupational morbidity in Ukraine within 2014-2016 is connected neither with the improvement of prophylactic measures nor with creating better work conditions. Sensorineural hearing loss has been ranked fourth in occupational morbidity accounting for 2.5%-4% of professional pathology and is underestimated.Conclusions. The underestimation of occupational hearing loss in Ukraine is determined by economic and organizational reasons, scarce diagnostics during medical examinations, peculiarities of the national surveillance system. A possible solution to this problem includes but is not limited to the reduction in countless pathologies caused by a high level of unreported employment, the establishment of unified sensorineural hearing loss classification, the increase in an accuracy of noise zone determination (noise-map construction), the performance of pure-tone audiometry in extended range (9 – 16 kHz)
The Experience of Studying the State of Occlusal Relations in Patients with Generalized Periodontitis Who Require Orthopedic Treatment with Non-Removable Structures Using the “T-Scan system”
Get PDFDetermining the state of occlusal relations in orthopedic dentistry is an important step both for diagnosis and for treatment. For the purpose of their study, 65 patients with chronic GP of theІst and ІІnd degree of the development who needed an orthopedic treatment, were used the device “T-Scan III”. Patients had a partial (1-3) loss of teeth of III and IV classes according toKennedy; they were divided into two groups. Group I included 35 patients who had included defects and were not previously prosthetic, group II – 30 patients who had poor-quality bridges of different materials that needed replacement. Control was provided by 20 dentally healthy patients with normal occlusal ratios of dentitions.We have determined that patients with GP with included defects in the dentition have significant deviations from the even distribution of occlusalloading on the dental rows in both of the studied classes according to Kennedy, especially those who had not previously been prosthetic. It is necessary to use a computerized analysis of occlusion with the help of the apparatus “T-Scan III” to all of these patients at every orthopedic stage of complex treatment. The precise definition of supra-contacts reduces the possibility of errors and allows achievement of the ideal – 50% to 50% –relationship between the left and right parts of the tooth-jaw system during fitting and fixing of orthopedic structures and keeping it in the process of their exploitation
Acute Appendicitis: Approaches to Complex Surgical Treatment in Accordance with the Principles of Multimodal Surgical Strategy (Fast-Track Surgery)
Get PDFThe objective of the research was to develop approaches to complex surgical treatment of patients with acute appendicitis taking into consideration the type of surgical approach, perioperative antibiotic therapy, adequate pain relief, duration of inpatient treatment. Materials and methods. The analysis of complex surgical treatment of the group of patients (31) with acute appendicitis, treated in the surgical departments of Lviv Emergency Hospital during 2017 was performed. The age of patients ranged from 18 to 77 years. There were 13 (41.9%) males and 18 (58.1%) females. Duration of hospital stay from the moment of hospitalization varied from 2 to 13 days. The level of pain sensation in patients was assessed on a 10-point visual analog scale of pain 6, 12 and 24 hours after surgery (with four-step stratification of the received data - absent (0-2), weak (3-4), moderate (5-8), strong (9-10 points). All the patients were divided into two groups using blind envelope technique: Group A included 18 patients, who underwent conventional appendectomy, and Group B comprised 13 patients who underwent diagnostic laparoscopy with the transition to laparoscopic appendectomy if the diagnosis of acute appendicitis was confirmed, or laparoscopic appendectomy was initially performed. The analysis of treatment efficacy was performed taking into account the dynamics of pain relief and the duration of inpatient treatment. Results and discussion. As a result of the conducted research it was stated that among all the patients examined, catarrhal acute appendicitis was found in 1 (3.2%) case, acute phlegmonous appendicitis was detected in 20 (64.5%) cases, acute gangrenous appendicitis was seen in 7 (22.6%) cases, acute gangrenous appendicitis with perforation and local peritonitis was diagnosed in 3 (9.7%) cases. Conventional appendectomy was performed in 18 cases; laparoscopic appendectomy was used in 13 cases. All the patients received anti-bacterial treatment in the early perioperative period. According to the prospective analysis, pain syndrome at the site of postoperative wounds was found to be present in patients of both groups. The intensity of pain syndrome was significantly lower in patients who underwent laparoscopic appendectomy. The analysis of treating patients with acute appendicitis allows confirming that the introduction of laparoscopic appendectomy into the complex of surgical treatment of patients with acute appendicitis can significantly reduce the body’s response to stress from surgical trauma and pain, speed up recovery due to early activation of the patient and maximally reduce the duration of hospital stay, which definitely corresponds to the modern principles of fast-track surgery. Conclusions. The use of laparoscopic appendectomy makes it possible to significantly reduce the body’s response to stress from pain and surgical trauma and is an important part of the formation of the patient’s general condition. Complex surgical treatment of patients with acute appendicitis using non-invasive techniques allows shortening the duration of hospital stay (4.62 ± 0.77 days) and reducing the period of disablement. The method of minimally invasive surgical interventions can be considered a “gold standard” for providing medical care to the patients with urgent surgical diseases of the abdominal cavity, which provides an optimal approach to surgical treatment