Publishing House of Ivano-Frankivsk National Medical University
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Results of the Ultrasound Study of Intracardial Hemodynamics in Patients with Ischemic Heart Disease in Combination with Arterial Hypertension and Complicated by Chronic Heart Failure 2A and 2B
Get PDFObjective. To conduct a comprehensive study of patients with ischemic heart disease (IHD) in combination with arterial hypertension (AH) complicated by chronic heart failure (HF) 2A and 2B, by studying parameters of intracardiac hemodynamics considering the pressure in the pulmonary artery.Research results. We examined 120 patients with coronary heart disease in combination with hypertension aged 44 to 90 years old (mean age 72.29 ± 1.66), the majority were men (86.7%). All patients were divided into two groups according to the degree of heart failure: HF 2A - 54 persons, with HF 2B - 66 people. The groups were compared in age, gender, functional class of IHD, severity of AH and HF.Analysis of heart ultrasound showed the following. In IHD in combination with hypertension, complicated by HF 2A, the pressure in the pulmonary artery rises in an average to 46.46 ± 3.64 mm Hg and it increases in HF 2B to 57.00 ± 5.19 mm Hg., that corresponding to the average level of pulmonary hypertension (p<0.01); at the same time, the fraction of ejection of left ventricle in the first patients decreases moderately up to 45.96 ± 2.01%, in others - to 39.93 ± 1.99% (p ˂0.01).In patients with IHD in combination with hypertension complicated by chronic heart failure the structural and functional changes are formed on the side of the left heart, accompanied by an increase in their size due to hypertrophy, formation of stagnant phenomena, regurgitation, functional state disorders by the restrictive type, progressive systolic and diastolic dysfunction, increased pressure in the pulmonary artery.Conclusions. Consideration of pulmonary hypertension, along with other parameters of intracardiac hemodynamics, is an important component in determining the degree and nature of heart failure, which requires the selection of adequate and timely therapeutic tactics
Endothelial Dysfunction in the Pathogenesis of Chronic Inflammatory Processes of the Internal Genital Organs in Women
Get PDFThe objective of the work: to study the changes of the functional activity of the endothelium and the plasma-coagulation link of hemostasis in women with chronic inflammatory processes of the internal genital organs (CIPIGO) with and without varicose veins of the small pelvis (VVSP).Materials and methods: 68 women with chronic inflammatory processes of the internal genital organs against the background of varicose veins of the small pelvis (group 1); 52 women with chronic inflammatory processes of the pelvic organs without varicose veins of the small pelvis (group 2); 30 practically healthy women (control group) were examined before and after the treatment. The age of women was between 18 and 45 years old. All the patients of the study groups received the treatment offered by us, which included a diosmine-containing phlebotropic preparation normoven, 500 mg twice a day in continuous mode and a donor of nitric oxide tivortin aspartatum, 5 ml 3 times per os for 14 days each month during six months.Determination of concentration of endothelin-1, prostacyclin was performed by immunoassay using a set of reagents from the firm “Biomediсa” (Austria); the determination of D-dimers in blood plasma was performed by latex-test of the firm “Organon-Tekhnika”.Results of workIn women with CIPIGO with and without VVSP, the increased production of endothelin-1, which has a pro-aggregate and pro-inflammatory effect, was determined. At the same time, the decrease of the synthesis of prostacyclin, which has anti-aggregant properties, was noted. In evaluating the indicators of coagulograms in patients of the studied groups, the propensity for hypercoagulation was revealed, as evidenced by an increase in the level of fibrinogen and a rise of index of the phospholipid-dependent coagulation tests. The decrease of the percentage of fibrinolytic blood activity and the increase in plasma concentration of the molecular marker of thrombophilia D-dimer can be considered as activation of intravascular coagulopathy and the presence of endothelial dysfunction.Conclusions: 1. Our studies found endothelial dysfunction and violations of the plasma-coagulation linkage of hemostasis in both studied groups. 2. After the performed treatment, the improvement of the functional activity of the endothelium and normalization of the main parameters of the plasma-coagulation linkage of hemostasis were observed
Teaching Diagnosis and Treatment of Acute Viral Hepatitis in Children to Interns
Get PDFThe objective of the research was to improve interns’ knowledge of the etiopathogenesis, clinical and paraclinical diagnosis, current methods of treatment and prevention of viral hepatitis in children. Infectious diseases are unfortunately very dangerous due to their severe clinical course, often unpredictable clinical symptoms and treatment results. This pathology remains one of the most common causes of death among children. Pathology of the liver and biliary tract in childhood is quite common; it is characterized by prolonged clinical course continuing into adulthood. The article describes the experience of teaching problems of diagnosis, treatment and prevention of viral hepatitis in children to pediatric interns during the cycle of lectures “Children’s Infectious Diseases”. During practical training of interns special attention is paid to etiology, clinical and laboratory diagnosis, treatment and prevention of various types of viral hepatitis. In particular, significant attention is given to the prevention of viral hepatitis in childhood. For this purpose educational learning material was developed at the Department.
Motivation for Learning as an Integral Part of the Educational Process in Higher Educational Establishment
Get PDFThe article presents the main ways of increasing professional motivation for learning in students of higher medical educational institutions. Training of professionally competent specialists is one of the most urgent problems of modern medical education. It requires particularly high demands on teaching clinical disciplines. With the growth of information load on students and a simultaneous reduction in the number of hours for studying these disciplines the problem of motivation formation is the primary one
Analysis of the Impact of Doctors’ and Health Care System Credibility on Patients’ Satisfaction with Health Care
Get PDFForming a patient-oriented health care system, patients’ participation in health care quality assessment has become the imperative of our time.The objective of the research was to analyze the impact of doctors’ and health care system credibility on satisfaction with health care.Materials and methods. Sociological survey of 530 patients was conducted. The patients completed their treatment in the surgical departments of inpatient facilities in Ivano-Frankivsk region. According to its results the patients were divided into two groups: satisfied (372 people) and not satisfied (158 people) with the level of health care services in the department and the hospital as a whole.Results of the research. Nearly 60% of the surveyed patients were determined not to trust their doctors and one third of respondents did not know their primary care physician. This significantly increased the chances of dissatisfaction with health care (OR= 4.11; 95% CI: 1.67–10.14, p<0.001 and OR=1.96; 95% CI: 1.33–2.90 respectively; p<0.001) and promoted inefficient use of the health care system resources as a result of unreasonable hospitalization (in 18.8% cases). Conclusions. Patients who do not trust doctors in general and do not know their general practitioner remain dissatisfied with inpatient care by 1.5-10 times more often
Quality of Life as an Integrative Indicator of Health Status in Patients with Chronic Hepatitis C and Concomitant Diabetes Mellitus Type II
Get PDFThe main indicators of quality of life in patients with chronic hepatitis C with concomitant diabetes mellitus type II were studied on the basis of SF-36. A sharp decrease in physical and mental health was observed in patients with combined comorbidity in comparison with the group of patients without concomitant diabetes mellitus type II. Improvement of the patients’ quality of life by all parameters was detected under the influence of alpha-lipoic acid and lactulose use in addition to antiviral therapy
Optimization of Therapeutic Measurements in Rotavirus Infection in Infants with Perinatal Exposure to HIV
Get PDFThe features of the clinical course of rotavirus infection in infants with perinatal exposure to HIV were studied. Serum level of procalcitonin as a marker of inflammatory activity and the need for antimicrobial therapy was determined. The efficiency of the proposed additions to basic treatment (low-lactose mixture for two months, antibiotic therapy in case of elevated procalcitonin level) was demonstrated
Ethiopathogenetic Factors of Precancerous Gynecological Diseases in Patients with Breast Cancer
Get PDFThe objective of the research was to assess risk factors for precancerous gynecological disease (PGD) in patients with breast cancer (BC) after comprehensive and combination treatment.Materials and methods. The study was based on the results of examination and treatment of 40 patients suffering from BC with PGD which developed at different times after treatment. In patients with breast cancer PGD included precancerous uterine body disease in 26 (65.0 %) patients, the precancerous ovariopathies in 9 (22.5 %) individuals and precancerous cervical disease in 5 (12.5%) cases.Results of the research. Precancerous uterine body disease occurred most often in most patients with BC after treatment. It included atypical endometrial hyperplasia in 19 (73.0%) patients and proliferating nodular leiomyoma of uterine body in 7 (27.0%) cases. Precancerous ovariopathies detected in patients with BC included allied papillary mucinous cystadenoma of ovaries in 6 (66.7%) patients and endometrioid cystadenoma in 3 (33.3%) cases. Precancerous cervical disease detected in patients with BC included severe cervical intraepithelial neoplasia (CIN III). CIN III was found in 5 (12.5%) cases. Conclusions. According to the results of the analysis and literature data, PGD occurred in patients with BC. The results indicated that hormonal factors, burdened oncology case history and results of immunohistochemical and molecular genetic diagnosis of breast tumors are important in PGD development in patients with BC
Efficacy of Clinical Application of Phosphatidylcholine Liposomes: Comparative Ultrastructural Analysis of Gingival Epithelium at Different Stages of Treatment of Patients with Generalized Periodontitis
Get PDFOn the basis of comparative ultrastructural analysis of the gingival mucosa (GM) before and during the stages of clinical application of phosphatidylcholine liposome there was revealed that the basal layer of the epithelium was relatively expanded and represented by cells that preserved the structure typical for normal mucous membrane. It indicated an increase in reparative potential of this layer filled with cambial cells to restore epithelial integrity. In the stratum spinosum cells were more distinctly joined to each other with desmosomes that provided the integrity of the connections between cells and maintenance of barrier properties of the epithelium; in the stratum granulosum complete recovery of cells was not observed, however, the structure of most keratinocytes resembled the normal one. The efficacy of using advanced therapeutic dental complex (TDC) (deposition of egg phosphatidylcholine liposomes (EPCL) by means of infiltrative injections and periodontal bandage) was also indicated by an increase in functional activity of gingival epithelial cells: the presence of large functional nucleoli in the nuclei of euchromatin which predominates over heterochromatin reflecting the activation of the RNA and protein biosynthesis on the background of the expansion of the nuclear pores as morphological equivalent of the intensification of the nuclear-cytoplasmic transport process.
Multispiral Computed Tomography as a Universal Screening Method for Stable Coronary Artery Disease and Non-Coronarogenic Heart Diseases
Get PDFCoronary bed condition in patients with different clinical forms of ischemic heart disease and painless myocardial ischemia was investigated in order to visualize atherosclerotic changes in coronary vessels during screenings.The results of multispiral computed tomography in 29 patients with different forms of coronary arteries disorders (stable coronary artery disease, unstable angina, painless myocardial ischemia) and in patients without severe coronary symptoms were analyzed in order to determine “calcium score” as a marker of atherosclerotic coronary vascular disease. Relation between the degree of increase in the coronary calcium score (CCS) (particularly in patients with hypertensive crisis in case history) and basic cardiodynamic characteristics was observed in patients with increased CCS. Reliable correlation between CCS and aortic stiffness index (r=0.82; p≤0.01), between CCS and pulse pressure (r=0.63; p< 0.05)