Publishing House of Ivano-Frankivsk National Medical University
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Clinicopathologic Aspects of Endometrial Proliferous Processes in Women of Reproductive Age
Get PDFThe peculiarities of benign proliferative pathology of endometrium including their combination in women of reproductive age are reviewed in the article.Materials and methods. The results of pathohistological research of benign proliferative pathology of endometrium (without atypia) were analyzed. Statistical data processing was performed by means of MedStat software package.Results. The obtained results revealed that benign proliferative pathology of endometrium is one of the most frequent gynaecological malignancies among female patients of reproductive age accounting for 52.2 % cases. Endometrial polyps were found to be accompanied by morphological peculiarities indicating chronic inflammatory process in endometrium in 56.5% cases (р<0.05) in comparison with endometrial hyperplasia in 38.2% cases, proving the presence of long-term inflammation in endometrial tissue and its trigger role in the development of the proliferative processes. Among patients with chronic salpingo-oophoritis, infertility was revealed in almost half of cases (44.5% of patients with endometrial polyps, 40.5% of patients with endometrial hyperplasia and 48.3% of women with combined proliferative pathology of endometrium) clinically confirming the data of morphological research. Peculiar signs of proliferative processes in genitals were determined, namely coexistence of uterine and endometrial pathology: endometrial hyperplasia was found in 40.4% of patients with uterine leiomyoma and 30.3% of patients with adenomyosis. The same combinations were peculiar for patients with endometrial polyps: endometrial hyperplasia was found in 30.1% of patients with uterine leiomyoma and 36.3% of patients with adenomyosis. Menstrual disorders were revealed in every third woman with endometrial hyperplasia (30.3%) and co-existent polyposis (30.2%)
A Case of Arteriovenous Malformation Involving the Hand
Get PDFArteriovenous malformations of the hand and wrist are uncommon and may involve any anatomic structure of the body. They may often lead to chronic pain and dysfunction. Treatment ranges from conservative measures to amputation with a high risk of complications and recurrence. We hereby report a rare case of an arteriovenous malformation in a 47-year-old woman who presented with a painless swelling of the dorsum of her left hand, which was treated successfully by surgical excisio
Peculiarities of Teaching Problems of Metabolic Syndrome in Children to Interns
Get PDFObesity has become one of the most urgent social problems worldwide. Continuous and rapid increase in obesity rates is considered by the World Health Organization as a global epidemic. Obesity affects children as well; the World Health Organization recognized childhood obesity as an acute public health crisis. Childhood obesity is often accompanied by arterial hypertension, hyperlipidemia and disorders of carbohydrate metabolism resulting in symptom complex – metabolic syndrome. While teaching the problems of metabolic syndrome in children to interns, a significant attention is paid to risk factors, diagnosis, treatment and prevention of syndrome. Such approach will allow future pediatricians to diagnose and prevent the development of early complications of metabolic syndrome in children timely
Evaluation of Arterial Stiffness in Patients with Bronchial Asthma and Co-Existent Chronic Obstructive Pulmonary Disease
Get PDFThe objective of the research was to determine the characteristics of arterial stiffness and cardiovascular risk in patients with co-existence of asthma and chronic obstructive pulmonary disease.Materials and methods. The study included patients with symptoms of chronic obstructive pulmonary disease, those with asthma and chronic obstructive pulmonary disease and the group of apparently healthy individuals.Results. In patients with obstructive lung disease, the parameters of vascular stiffness and central blood pressure reflecting the degree of cardiovascular risk were significantly higher as compared to those in apparently healthy individuals. They were significantly elevated in patients with chronic obstructive pulmonary disease and asthma-chronic obstructive pulmonary disease overlap. The indicators of central blood pressure were significantly higher in patients with asthma-chronic obstructive pulmonary disease overlap and more pronounced bronchial obstruction, and in patients with more obvious symptoms of obstructive pathology. Excess body weight or obesity had a strong and pronounced effect on the parameters of central blood pressure in patients with asthma-chronic obstructive pulmonary disease overlap. In patients with a comorbidity, a reliable correlation between the indicator of the presence of pulmonary hyperinflation and the degree of arterial stiffness was revealed.
Effect of Metformin on Parameters of Insulin Resistance in Patients with Primary Hypothyroidism
Get PDFThe research examined the frequency and nature of carbohydrate metabolism disorders in patients with primary hypothyroidism. In 25.8% of patients increased glycemic indexes responding to a prediabetes stage were found. In patients with thyroid hypofunction (TG) the presence of insulin resistance (IR) by defined HOMA IR and Caro indexes has been proved. The dependence of IR severity on heaviness of hypothyroidism and BMI has been determined.Differentiated treatment of patients with primary hypothyroidism, obesity and initial carbohydrate metabolism disorders has demonstrated the priority of efficiency of combination therapy with appointed metformin and levothyroxine in comparison with the basic substitution therapy. Appointment of metformin for the treatment of the patients with proven IR contributed to the rapid compensation of hypothyroidism, normalization of carbohydrate metabolism indexes, and it is also preventing the possible development of metabolic syndrome
Combined treatment of acute deep vein thrombosis of the lower limbs
Get PDFThe article represents the combined treatment results analysis of 50 patients with deep vein thromboses of inferior vena cava system. The complex clinical and instrumental examination of patients included duplex ultrasound scan, X-ray phlebography, multislice computed tomography with intravenous contrast and radionuclide fleboscintigrahpy. All patients were performed the regional thrombolytic therapy, combined with an open palliative thrombectomy in 19 (38%) patients and endovascular implantation of a temporary or constant cava-filter in 31 (62%) patients. In postoperative period for 12 months’ monitoring the local and general complications after combined treatment were found in 4 (8.0%) out of 50 patients, who were performed the combined treatment
The modern approach to the correction of menopausal disorders in women with physiological menopause and after ovariectomy
Get PDFThe problem of menopause attracts attention for many decades of not only gynecologists, but urologists, cardiologists, psychiatrists and other doctors. This is related to systemic complications of estrogen deficiency. The objective of our work is to establish clinical and hormonal changes in women of menopausal age with physiological menopause and after ovariectomy and also assess the effectiveness of the offered treatment. During the examination and treatment the women were divided as follows: I – main group – 48 women with physiological menopause: Ia (n=27) – within three months received a complex of non-hormonal treatment, Ib (n=21) – hormone replacement therapy (HRT); II group – 34 women after total ovariectomy: IIa (16) with therapeutic purpose received a complex of non-hormonal treatment for three months, IIb (18) – HRT. The offered complex of non-hormonal treatment included Cimicifuga, Menopace, Noophen. This treatment was used in women with early menopause who have contraindications to HRT or refused to take hormones. The degree of severity of menopausal syndrome was judged according to the menopausal index of Kuperman. In the study of hormonal status the determination of a set of hormones by immunochemical method was performed. During study we obtained results that indicate the inverse dynamics of menopausal disorders in both study groups. For the prevention and treatment of individual selection of treatment of climax manifestations it is appropriate the dynamic definition of hormonal mirrors of the patients.
Aeromonas Sobria: a Rare Cause of Continuous Ambulatory Peritoneal Dialysis-Related Peritonitis
Get PDFPeritonitis is a very common complication in patients treated with continuous ambulatory peritoneal dialysis. The most common causes are gram positive cocci (part of the normal skin flora), and then gram negative bacteria, while fungi are listed as a rare cause of peritonitis. Aeromonas species are identified as a rare cause of continuous ambulatory peritoneal dialysis-related peritonitis. Among them, Aeromonas hydrophila is somewhat more common, followed by Aeromonas caviae.Case presentation. We reported a case of continuous ambulatory peritoneal dialysis peritonitis caused by Aeromonas sobria that is extremely rare cause of this type of peritonitis. In our patient, pseudomembranous colitis occured as a complication and, reinfection – another episode of peritonitis with Klebsiella pneumoniae. Treatment with third-episode cephalosporins was successful and patient continued treatment with continuous ambulatory peritoneal dialysis. Conclusions. The rare causes of peritonitis should not be ignored, especially those which lead to increased morbidity and mortality of patients
Ethiopathogenetic Peculiarities of Diagnosis, Clinical Course and Treatment of Chronic Abacterial Prostatitis
Get PDFChronic abacterial prostatitis or chronic pelvic pain syndrome remains an urgent problem due to its high prevalence among young men of reproductive age. Chronic abacterial prostatitis or chronic pelvic pain syndrome, especially its etiology, diagnosis and treatment, is the most discussible issue in the literature and among healthcare professionals. Many modern authors increasingly associate the etiology of this disease with viruses. However, viral etiology of chronic abacterial prostatitis has not been clearly confirmed yet
Dynamics of Heart Failure Markers in Patients after Past Myocardial Infarction with the Use of Potassium and Magnesium Salts of Gluconic Acid, Eplerenone and Rivaroxaban
Get PDFThe objective of the research was to increase the efficiency of treatment of patients with chronic heart failure (CHF) and post-infarction cardiosclerosis by adding potassium and magnesium salts of gluconic acid, eplerenone and rivaroxaban to the background therapy taking into account the indices of growth differentiation factor 15 (GDF-15), aldosterone and galectin-3. Materials and methods of the research. Emmunoenzymometric determination of the galectin-3, GDF-15 and aldosterone levels concentration in blood serum was conducted to achieve the stated objective. 42 patients with CHF and post-infarction cardiosclerosis after coronary artery stenting in the acute period of myocardial infarction (MI) were examined. The patients were randomized into four groups according to the peculiarities of treatment. Group I included patients with CHF and post-infarction cardiosclerosis treated with the background therapy (BT). Group II consisted of patients with CHF who were treated with BT and addition of potassium and magnesium salts of gluconic acid. Group III included patients with CHF who were prescribed eplerenone secondary to BT. Group IV consisted of patients who were treated with BT and rivaroxaban. Results. The proposed treatment regimens were proved to be effective in reduction of GDF-15, aldosterone and galectin-3 indices in 12 months of treatment. Conducted therapy with the use of rivaroxaban secondary to BT led to more intensive decrease in GDF-15 concentration in comparison with the use of potassium and magnesium salts of gluconic acid or eplerenone on the background of BT. This index constituted (2110.21±107.4) pg/ml before the treatment in these patients and significantly decreased to (1286.75±109.6) pg/ml being significantly before the therapy. The performed treatment with the use of eplerenone secondary to BT was proved to be more effective for normalization of aldosterone and galectin-3 levels in blood serum compared to other studied treatment regimens. The average value of aldosterone changed in the treatment process by 67.24%. Thus, the average level of this index constituted (139.8±7.63) pg/ml before the treatment and was equal to (45.8±5.52) pg/ml at the end of the treatment course. The average value of galectin-3 in patients with CHF and post-infarction cardiosclerosis was noted to be (34.69±1.67) ng/ml before the treatment. It constituted (22.53±0.98) ng/ml after the end of treatment being significantly lower compared to the value before the treatment. The average value of this index changed in the course of twelve-month treatment by 35.05%. Lower risk of sudden cardiac arrest (SCA), acute coronary syndrome (ACS) and stroke was observed in the patients with CHF and post-infarction cardiosclerosis with the use of rivaroxaban secondary to BT.Conclusions. Thus, the use of rivaroxaban combination therapy secondary to BT led to more intensive decrease in GDF-15 concentration in comparison with the use of potassium and magnesium salts of gluconic acid or eplerenone. Conducted therapy with the use of eplerenone on the background of BT was more effective for the normalization of galectin-3 and aldosterone levels in the blood compared to other studied treatment regimens