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СТРАТЕГІЯ ХІРУРГІЧНОЇ КОРЕКЦІЇ ЕСТЕТИЧНИХ ДЕФЕКТІВ ПЕРЕДНЬОЇ ЧЕРЕВНОЇ СТІНКИ У ПАЦІЄНТІВ З ОЖИРІННЯМ
No full textThe aim. According to forecasts, by 2035, 50% of the world's population will suffer from obesity, and we aimed to develop an effective strategy for the surgical correction of its consequences, in the form of aesthetic defects of the anterior abdominal wall.
Materials and methods. For its implementation, from 2020 to 2024, a prospective study was conducted on the basis of the Postgraduate Surgery Department of IFNMU, which included 93 patients, divided into three homogeneous groups, depending on the surgical interventions performed: №1 – liposuction of the anterior abdominal wall, performed according to principles of the SAFE technique, №2 – traditional abdominoplasty, №3 – a combination of both techniques. The expression of pain syndrome was measured in the postoperative period on the first and seventh days using the Visual Analog scale. Treatment results were evaluated after 1, 6, and 12 months by determining patients' satisfaction with the aesthetic consequences of surgical interventions using the Global Aesthetic Improvement Scale, and the dynamics of psycho-emotional changes using the Ukrainian version of the Body Shape Questionnaire-34. The presence of postoperative complications was recorded.
Results. During analyzing the Visual analog scale, a statistically significant difference was observed between the results of groups 1 and 2 and groups 1 and 3. At the same time, it was absent between groups 2 and 3. The obtained results of patient satisfaction according to the GAIS showed a positive trend, as all study participants noted an improvement in the aesthetic parameters of the anterior abdominal wall, and this indicator was the most pronounced ("very significant improvement" in 45.2% of patients) was in group 3 for the 6th month from the moment of the surgical intervention. The treatment had a significant impact on the psycho-emotional state of the patients, since, according to the results of the questionnaire, 100% of the study participants demonstrated a positive trend in the perception of their own appearance. Already 1 month after the surgical intervention, a statistically significant difference with the data obtained before the start of treatment is observed in all studied groups. The development of postoperative complications was observed in 5.4% of patients. Among the most significant: seroma, infection of the postoperative wound and deformation of the postoperative scar.Згідно прогнозів, до 2035 року 50 % населення світу страждатиме ожирінням, розробку ефективної стратегії хірургічної корекції наслідків якого, у вигляді естетичних дефектів передньої черевної стінки, ми взяли за мету. Для її реалізації, з 2020 р по 2024 р на базі кафедри хірургії післядипломної освіти ІФНМУ було проведено проспективне дослідження, до якого включено 93 пацієнти, розподілені на три однорідні групи, залежно від проведених оперативних втручань: №1 – ліпосакція передньої черевної стінки, виконана згідно принципів SAFE-техніки, №2 – традиційна абдомінопластика, №3 – поєднання обох методик. Вираженість больового сидрому вимірювали у післяопераційному періоді на першу й сьому добу за допомогою Visual Analog scale. Результати лікування оцінювали через 1, 6, та 12 місяців шляхом визначення задоволеності пацієнтів естетичними наслідками оперативних втручань за допомогою анкетування Global Aesthetic Improvement Scale, динаміку психоемоційних змін – за допомогою української версії BSQ-34. Фіксували наявність післяопераційних ускладнень. При аналізі VAS спостерігалась наявна статистично достовірна різниця між результатами 1 та 2 й 1 та 3 групи. Водночас, вона була відсутня між групами 2 та 3.Отримані результати задоволеності пацієнтів за шкалою GAIS продемонстрували позитивну тенденцію, оскільки всі учасники дослідження відзначили покращення естетичних показників передньої черевної стінки, а найбільш вираженим цей показник («дуже значне покращення» у 45,2% пацієнтів) був у групі 3 на 6-ий місяць від моменту проведеного оперативного втручання. Лікування суттєво вплинуло на психоемоційний стан пацієнтів, оскільки, за результатами анкетування 100% учасників дослідження продемонстрували позитивну тенденцію у сприйнятті власної зовнішності. Вже через 1 місяць після оперативного втручання в усіх досліджуваних групах спостерігається статистично достовірна різниця з даними, отриманими до початку лікування. У 5,4% пацієнтів спостерігався розвиток післяопераційних ускладнень. Серед найбільш вагомих: серома, інфікування післяопераційної рани та деформація післяопераційного рубця.
Ключові слова: ліпосакція, абдомінопластика, ожиріння, передня черевна стінка, естетичні дефект
ВПЛИВ ІНОЗИТОЛУ НА ПРОЦЕСИ ПЕРОКСИДНОГО ОКИСНЕННЯ ТА МОРФОЛОГІЧНІ ЗМІНИ В ОЧАХ ТВАРИН РІЗНОЇ СТАТІ З МЕТАБОЛІЧНО АСОЦІЙОВАНОЮ ЖИРОВОЮ ХВОРОБОЮ ПЕЧІНКИ
Full text linkIntroduction. Steatotic liver disease associated with metabolic dysfunction is characterized by hepatic steatosis and at least one cardiometabolic risk factor without any other identifiable cause. Their prevalence is increasing year by year. Changes associated with hepatocyte damage, inflammation, and fibrosis are observed in the liver. These diseases are often complicated by concomitant metabolic diseases, including obesity, type 2 diabetes and hypertension, metabolic disorders in various organs, including the eye. At the same time, the integrity of cells is violated, the processes of free radical oxidation of lipids and proteins are activated. There is data in the literature that inositols are used to treat steatotic liver disease associated with metabolic dysfunction.
The aim of the research: determine the features of changes in the content of lipid peroxidation products in the homogenates of the eyes of rats with experimentally simulated metabolically associated steatotic liver disease (MASLC) and the influence of inositol isoforms on their content and to evaluate the morphological changes in the eyes under these conditions.
Research methods. Experiments were performed on 216 white rats of different sexes, at the time of withdrawal from the experiment they were 7.5-8 months old. The animals were divided into 9 groups: 1 – control, 2 – myo-inositol (MI), 3 – D-chiro inositol (DI), 4 – MASLP 2 months, 5 – MASLP 2 months + MI 2 months, 6 – MASLP 2 months + DI 2 months, 7 – MASLP 4 months, 8 – MASLP 4 months+ MI 2 last months, 9 – MASLP 4 months+DI 2 last months. MASLP was induced by giving 20% fructose solution (Fr) instead of drinking for 2 months in groups 4. 5 and 6, for 4 months in groups 7, 8 and 9. Inositols were administered intragastrically (MI – 400 mg/kg of weight, DI – 30 mg/kg of weight) after 2 months from the beginning of the simulation of MASHP. The content of diene and triene conjugates (DC, TC), Schiff's bases (SB), TBA-active products (TBA-ap), superoxide dismutase (SOD) and catalase activity (CAT) was determined in eye homogenates. A morphological study of the eyes was carried out.
Results and discussion. An increase in DC, TC, SB, TBA-ap, SOD, and CAT was revealed in males and females with MASLP, which were higher in group 7, compared to group 4. excluding CAT in females. MI and DI had a corrective effect, and males had a greater effect in group 7 (there were also significantly higher SOD and CAT), and females - in group 4.
Conclusions. 1. With experimentally modeled MASLP in the eyes, the processes of lipid peroxidation are activated, DC, TC, SB, TBA-ap, as well as SOD and CAT increase. Longer consumption of Fr causes more damage. With 2-month use of Fr, the changes are greater in males. 2. Correction of the simulated MASLP MI and DI with 2 and 4 monthes use of Fr causes a decrease in the products of lipid peroxidation and antioxidants in eye homogenates, which is more pronounced with 4 monthes use of Fr in males, and with 2 monthes use in females. 3. The morphological study showed a significant violation of the retina of the eyes with experimentally simulated MASLP, which is more pronounced with longer use of Fr. MI and DI have a corrective effect on the structure of the retina.Стеатотична хвороба печінки, пов’язана з метаболічною дисфункцією характеризується стеатозом печінки та хоча б одним кардіометаболічним фактором ризику без будь-якої іншої ідентифікованої причини. Поширеність їх зростає з року в рік. У печінці спостерігаються зміни, пов’язані з пошкодженням гепатоцитів, запаленням, фіброзом. Ці хвороби часто ускладнюється супутніми метаболічними захворюваннями, включаючи ожиріння, цукровий діабет 2 типу та гіпертензію, порушенням обмінних процесів у різних органах, у тому числі й оці. При цьому порушується цілісність клітин, активуються процеси вільнорадикального окиснення ліпідів і білків. У літературі є дані, що для лікування стеатотичної хвороби печінки, асоційованої з метаболічною дисфункцією використовують інозитоли. Мета. Визначити особливості змін вмісту продуктів пероксидного окиснення ліпідів у гомогенатах очей щурів із експериментально змодельованою метаболічно асоційованою стеатотичною хворобою печінки (МАСХП) та вплив ізоформ інозитолу на їх вміст і оцінити морфологічні зміни в очах за цих умов. Методи. Досліди виконано на 216 білих щурах різної статі, на час виведення з експерименту їм було 7,5-8 місяців. Тварин розділено на 9 груп: 1 – контроль, 2 – міо-інозитол (МІ), 3 – D-chiro інозитом (DІ), 4 – МАСХП 2 місяці, 5 – МАСХП 2 місяці+ МІ 2 місяці, 6 – МАСХП 2 місяці+ DІ 2 місяці, 7 – МАСХП 4 місяці, 8 – МАСХП 4 місяці+ МІ 2 останні місяці, 9 – МАСХП 4 місяці+DІ 2 останні місяці. МАСХП викликали даванням 20% розчину фруктози (Фр) замість пиття протягом 2 місяці у 4. 5 і 6 групах, протягом 4 місяці – у групах 7, 8 і 9. Інозитоли вводили інтрагастрально (МІ – 400 мг/кг маси, DI – 30 мг/кг маси) через 2 місяці з початку моделювання МАСХП. У гомогенатах очей визначали вміст дієнових і трієнових кон’югатів (ДК, ТК), основ Шиффа (ОШ), ТБК-активних продуктів (ТБК-ап), супероксиддисмутазну (СОД) і каталазну активність (КАТ). Проводили морфологічне дослідження очей. Результати. Виявлено зростання ДК, ТК, ОШ, ТБК-ап, СОД, КАТ у самців і самиць із МАЖХП, які були вищі у 7 групі, порівняно з 4. за виключенням КАТ у самиць. МІ і DІ виявляли коригуючу дію, причому у самців більший вплив був у 7 групі (також були достовірно більші СОД і КАТ), а у самиць – у 4. Висновки. 1. При експериментально змодельованій МАСХП у очах активуються процеси пероксидного окиснення ліпідів, зростають ДК, ТК, ОШ, ТБК-ап, а також СОД і КАТ. Триваліше споживання Фр спричинює більше пошкодження. При 2-місячному вживанні Фр зміни більші у самців. 2. Корегування змодельованої МАСХП МІ і DІ при 2- і 4-місячному вживанні Фр викликає у гомогенатах очей зменшення продуктів пероксидного окиснення ліпідів і антиоксидантів, що більше виражено при 4-місячному вживанні Фр у самців, а при 2-місячному вживанні – у самиць. 3. Морфологічне дослідження показало значне порушення сітківки очей при експериментально змодельованій МАСХП, яке вираженіше при довшому вживанні Фр. МІ і DІ виявляють коригуючий вплив на структуру сітківки
Therapeutic natural factors of the Morshyn resort
Full text linkThe mild climate of Morshyn can be attributed to the factors that have a positive effect on the body of patients, this is facilitated by the absence of sharp temperature fluctuations, a picturesque area surrounded by heights completely covered with forests, clean, fresh air, silence and many other healing power of the Carpathians.
The aim of our work was to make the medical public more familiar with the natural therapeutic factors of the Morshin resort, which will contribute to the optimization of complex treatment and rehabilitation of patients with diseases of internal organs and, especially, the digestive system after exacerbations have faded out, and as a result – to popularize the use of natural resources of our region regarding the use of rich natural physical factors in such patients.
The main therapeutic agents of the resort – are the unique sulfate-magnesium-sodium chloride, potassium-magnesium-sodium chloride-sulfate and sodium chloride mineral waters – brines, the formation of which occurs at the outcrops of salt-bearing strata in the foothills of the Carpathian bend. In addition to drinking treatment, therapeutic drainage of the biliary tract and duodenal “drainage”, the internal use of mineral waters in the treatment of diseases of the hepatobiliary system includes washing-irrigation and underwater washing of the intestines, which are performed at the Morshyn resort with Morshyn mineral water. In the pathology of hepatobiliary system, in combination with other medical procedures, different showers (circular, ascending, underwater shower-massage) are used at the Morshyn resort.
Among other natural therapeutic factors, ozokerite from the Boryslav deposit of the Lviv region and peat mud from the Rozhnativ deposit of the Ivano-Frankivsk region are used in the treatment of diseases of the liver and biliary tract at the Morshyn resort. Extremely effective use of mud thermal procedures in the complex treatment of patients with chronic diseases of the liver and biliary tract.
Other therapeutic and rehabilitative factors in the treatment of patients with diseases of the liver and biliary tract at the Morshyn resort include therapeutic nutrition, various electrophysiotherapeutic procedures, physical therapy, climate therapy, and psychotherapy.
The use of physical therapy (PT) is especially indicated in those diseases of the hepatobiliary system, which are accompanied by disorders of the general metabolism, indigestion, congestion in the liver and disorders of the motor function of the gallbladder (chronic hepatitis, chronic cholecystitis, gallstone disease that passes without frequent attacks). The use of physical therapy adheres to the principle of gradualness and individuality of the load, systematicity, impact and efficiency accounting, and the necessity of positive emotions.
Conclusions. The use of non-medicinal methods of treating diseases of the gastrointestinal tract is an important component of successful complex treatment, which aims to fully restore the structure and functions of the digestive system. The therapeutic factors of the Morshyn resort are an invaluable natural resource that should be more actively used not only for treatment, but especially for the rehabilitation of patients with diseases of internal organs and, especially, the digestive system after exacerbations have subsided. Wider familiarization of the medical community will contribute to the popularization of treatment and rehabilitation with the use of natural physical factors in such patients
The Power of Social Media in University Life – a Survey-Based Analysis
Full text linkBackground. Social media has become essential for universities, both in recruiting students and enhancing their experience. Platforms like Instagram and Facebook influence student perceptions, foster community, and impact satisfaction, yet the effectiveness of these strategies remains under-explored.
Aim. This study examines the role of social media in shaping students' decisions to apply to Ivano-Frankivsk National Medical University (IFNMU) and their satisfaction with their university experience.
Methods. A survey was conducted with first- and second-year IFNMU students from multiple faculties, using closed- and open-ended questions to gather quantitative and qualitative feedback on academic, social, and infrastructural aspects. Data were analyzed to identify key trends in student perceptions.
Results. The study found that personal networks (64%) and social media (25.3%) are significant sources of information for prospective students, with Instagram as the most influential platform. Positive aspects cited included faculty support (35%) and social engagement (20%), while workload (30%) and infrastructure (15%) were identified as areas for improvement.
Conclusion. Social media is a vital tool for engaging IFNMU students, with Instagram and personal networks playing a prominent role. Addressing concerns around workload and infrastructure, alongside strategic social media content, could enhance student satisfaction and attract prospective applicants. Future research should investigate the impact of specific social media content on recruitment and retention
Морфологічна характеристика кісткового регенерату при акселерації кісткової репарації в умовах краніо-скелетної політравми
No full textBackground. The phenomenon of accelerated fracture healing in patients with cranio-skeletal polytrauma was first described qualitatively in 2005 by Morley. Already existing morphological studies allowed to form a clear hypothesis about the mechanism of formation of heterotopic ossifications after traumatic brain and spinal cord injuries. Morphological analysis of fracture healing is one of the leading methods for identifying the underlying mechanism.
Materials and methods. Adult white rats (n=90) were divided into two same size groups: TBI-related polytrauma group and sham group. Harvesting was performed on day 7, 14, and 21. In both groups closed femur fracture was modelled. Modeling of polytrauma in animals of group 1 was achieved by modelling closed TBI followed by fracture of the femur, contralateral to the side of the brain lesion, by method described above. Animals were euthanized on days 7, 14, and 21 after surgery collecting of bone callus in the fracture area and the brain tissue which were examined by both light and electron microscopy.
Results. The study of histological sections of the callus in animals with an isolated fracture on the seventh day showed its connective tissue organization. Ultrastructural analysis reveals activated fibroblasts with well-developed membrane organelles in the cytoplasm. Examination of section series from polytrauma group on day 7 demonstrates the presence of skeletal tissue components, such as cartilage and bone, in addition to connective tissue elements. The light-microscopy of the connective tissue components of the callus reveals its vascularization and grouping of collagen fibers into bundles. In animals with polytrauma on the day 14, the callus has cartilaginous and bone structures, while cytoplasm is characterized by pronounced granularity. On the day 21, the callus of animals with an isolated fracture contains islands of cartilage tissue, which is represented by a few isogenic groups of chondrocytes surrounded by a connective tissue framework. The callus of animals with polytrauma on day 21 has elements of calcified bone matrix, which makes it difficult to make sections. Further examination reveals numerous trabeculae with osteocytes in the unligated bone matrix with islands of multinucleated osteoclasts.
Conclusions. In animals with polytrauma, the dynamics of transformation is accelerated in time, when cartilage tissue elements and activated osteoblasts are observed on the seventh day, and loci of calcified bone matrix are already detected on the twenty-first day. This dynamics confirms the existing theory of acceleration of fusion in the cranial component of the injury. Further studies of the intermediate bone repair terms are needed.Вступ. Феномен прискореного зрощення переломів у пацієнтів з краніо-скелетною політравмою вперше був описаний у 2005 році Morley. Вже існуючі морфологічні дослідження дозволили сформувати чітку гіпотезу про механізм формування гетеротопічних осифікацій після травматичних ушкоджень головного та спинного мозку. Морфологічний аналіз загоєння переломів є одним з провідних методів виявлення цього механізму. Матеріали та методи. Дорослі білі щури (n=90) були розділені на дві однакові за розміром групи: групу з політравмою, пов'язаною з ЧМТ, та групу з ізольованою травмою. Забір матеріалу проводили на 7, 14 та 21 добу. В обох групах моделювали закритий перелом стегнової кістки. Політравму у тварин 1-ї групи моделювали шляхом створення закритої ЧМТ з подальшим переломом стегнової кістки, контралатеральної до сторони ураження головного мозку. Тварин евтаназували на 7, 14 та 21 добу після операції з забором кісткової мозолі в ділянці перелому та тканини головного мозку, які досліджували методами світлової та електронної мікроскопії. Результати. Вивчення гістологічних зрізів кісткової мозолі у тварин з ізольованим переломом на сьому добу показало її сполучнотканинну організацію. Ультраструктурний аналіз виявляє в цитоплазмі активовані фібробласти з добре розвиненими мембранними органелами. Вивчення серії зрізів з групи політравми на 7-му добу демонструє наявність, окрім сполучнотканинних елементів, компонентів скелетної тканини, таких як хрящ і кістка. При світловій мікроскопії сполучнотканинних компонентів мозолі виявляється їх васкуляризація та групування колагенових волокон у пучки. У тварин з політравмою на 14-ту добу каллус має хрящову та кісткову структури, а цитоплазма характеризується вираженою зернистістю. На 21-шу добу мозоль тварин з ізольованим переломом містить острівці хрящової тканини, яка представлена кількома ізогенними групами хондроцитів, оточеними сполучнотканинним каркасом. У мозолі тварин з політравмою на 21-шу добу є елементи кальцинованого кісткового матриксу, що ускладнює проведення зрізів. При подальшому дослідженні виявляються численні трабекули з остеоцитами в незміцнілому кістковому матриксі з острівцями багатоядерних остеокластів. Висновки. У тварин з політравмою динаміка трансформації прискорюється в часі, коли на сьому добу спостерігаються елементи хрящової тканини та активовані остеобласти, а на двадцять першу добу вже виявляються локуси кальцинованого кісткового матриксу. Така динаміка підтверджує існуючу теорію про прискорення зрощення при краніальному компоненті травми. Необхідні подальші дослідження проміжних термінів репарації кісткової тканини
Three-Dimensional Modeling of Firearm Injuries in Forensic Medicine
Full text linkIntroduction. Forensic medical investigations, including illustration, evidence collection, and expert conclusion preparation, have faced significant challenges in recent years. One of the primary challenges for Ukraine’s forensic medical service today is the examination of firearm-related injuries, necessitating substantial improvements to traditional methodologies.
The study aimed to develop a methodology for the three-dimensional spatial reconstruction of firearm injuries.
Methods. An automatic pistol CZ83 of medium caliber, manufactured in the Czech Republic and chambered for 7.65x17 mm ammunition, was used in the study. Roma Plastilina No. 1 ballistic gelatin, produced in the USA, served as the target and reproducing material for controlled ballistics tests. The experiments included 15 shots, during which the main morphological elements of skin injury, the subcutaneous adipose tissue, and the wound channel at the entry, middle, and exit points were studied. These were photographed, analyzed using photogrammetry, and converted into a three-dimensional format with the graphic editors Agisoft PhotoScan and 3Ds Max.
Results. Measurements of all parameters obtained through classical methods differed significantly (p<0.05) from those obtained using 3D modeling. However, Cohen’s d values indicated that the differences were very small for defect size measurements, small for the abrasion ring and wound channel diameter across all sections, and medium for the entry wound diameter.
Conclusions. The developed methodology for three-dimensional modeling allows for the accurate recording of the main morphometric parameters of firearm injuries, making it a viable alternative to traditional measurement methods
Multiple Myeloma Patient with Secondary Liver and Tongue Involvement, Complicated by COVID-19-Induced ARDS: An Autopsy Case Report and Literature Review
Full text linkBackground. Liver involvement secondary to multiple myeloma is a rare and uncommon radiologic finding. Such extraosseous secondary lesions as well as tongue involvement require pathohistological confirmation to prevent misdiagnosis. Clinical and laboratory diagnostics are challenging in patients with COVID-19 and underlying multiple myeloma and its secondary lesions, leading to difficulties in treatment and outcomes.
Case Report. A 64-year-old male patient, not vaccinated against COVID-19, with a history of multiple myeloma presented with symptoms of headache, fatigue, dyspnea, cough, and fever. The patient’s medical history was intricate, involving cholecystectomy and a diagnosis of multiple myeloma, which was subsequently treated with chemotherapy and radiation therapy. Additionally, uncommon liver and tongue involvement secondary to multiple myeloma was found. Upon admission, the patient’s peripheral oxygen saturation was 90%, accompanied by increasing shortness of breath and a respiratory rate of 26 breaths per minute. A positive COVID-19 test was recorded. A lung computed tomography revealed bilateral multifocal areas of ground-glass opacity and consolidation, encompassing the entire pulmonary regions, corresponding to CO-RADS 6. The patient was admitted to the intensive care unit. Despite initiating oxygen support and symptomatic therapy, the patient’s death occurred. Autopsy confirmed the development of severe acute respiratory distress syndrome and bilateral hemorrhagic pneumonia, with multiple myeloma as a contributing factor.
Conclusions. This case report highlighted the rare occurrence of secondary liver involvement in multiple myeloma, characterized by nodules with distinct imaging features. It underscored the importance of identifying coexisting lesions, such as tongue involvement, and the diagnostic challenges they pose. Additionally, the case emphasized the need for comprehensive clinical assessment in patients with concurrent COVID-19 and underlying multiple myeloma, as it may lead to the development of acute respiratory distress syndrome
Antioxidant Properties of Oral Fluid, Clinical Assessment of the Dental Status of Patients Depending on Age and the Presence of the Dentition Defects with a View to Replacing them
Full text linkIt is evident that the violation of the oral fluid redox balance constitutes a very important element in the progression of various dental diseases, including caries, gingivitis, and periodontitis; as well as in the recovery processes following dental interventions.
Aim of the study is to evaluate the antioxidant properties of the oral fluid in patients, taking into account age and depending on the condition of the dentition and replacement of their defects with various types of dental structures.
Materials and methods. A total of 103 patients, ranging in age from 18 to 89 years, were included into the study. The groups were divided according to the following dental status: preservation of the integrity of the dentition (n=25); partial loss of teeth without replacement of the defect (n=18), and under the following conditions of replacement of the defect: with bridge-like prostheses (n=22) and partial removable plate dentures (n=17); complete loss of teeth without replacement of the dentition defects (n=8) and under the following conditions of replacement of the defect with complete removable plate dentures (n=13). The formation of age-based groups was performed according to the following categories: young age (18–24 years, n=25), young-adult (25–44 years, n=21), middle age (45–59 years, n=22), elderly (60–74 years, n=19) and senile (75–89 years, n=16).
Results. A number of significant changes in antioxidant processes were identified in patients with partial and complete tooth loss, as well as in cases involving the replacement of dentition defects. The lowest level of antioxidant protection in oral fluid was observed in patients with the complete tooth loss: suppression of superoxide dismutase (SOD) activity at 61.06% (p<0.001), glutathione peroxidase (GPR) – at 76.60% (p<0.01) and glutathione reductase (GR) – at 54.29% (p<0.05), compared to values in subjects with intact dentition. The study revealed a significant decline in the antioxidant properties of the oral fluid among individuals aged 45-59 years: SOD and GR activity was found to be suppressed at 36.06-52.27% (p<0.05) compared to young and young-adult age, GPR – at 42.77% (р<0,05) only in comparison to the values of young age. In the senile age, the activity of antioxidant enzymes is observed to be 61.11-81.81% (р<0.05) lower than in the young age, and 33.33-61.90% (р<0.05) lower compared to the middle age. The depletion of antioxidant potential may be due to age-related changes in physiological processes (more pronounced in elderly and senile individuals). Additionally, the activation of protein and lipid peroxidation may contribute to this depletion, particularly in middle-aged subjects in response to changes in dental status.
Conclusions. The decline in oral fluid antioxidant protection is most pronounced in patients of advanced age and in those with total tooth loss, which is not significantly dependent on the type of defect replacement. Such data correlate with deterioration of oral hygiene, increased intensity of caries and inflammatory periodontal diseases. The results of the study emphasize the necessity for a comprehensive approach to the prevention and treatment of dental diseases, taking into account age characteristics and the condition of the dentition in order to maintain an optimal pro/antioxidant balance in the oral fluid
Incidence of Skin Melanoma in the Precarpathian Region. Overview of Trends of the Last Decade and Demonstration of Clinical Cases
Full text linkIntroduction. Melanoma is a malignant tumour that develops from melanocytes and in most cases affects the skin. Although melanomas are usually highly pigmented, they can also be amelanotic. In the structure of mortality from skin cancers, melanoma takes the leading place with a rate of 90%.
Even small tumours can metastasise. Under such conditions, early diagnosis is of paramount importance, as its main task is to detect and eliminate the primary lesion before it becomes deeply invasive.
However, naked eye examination is limited to a sensitivity of about 75%, and is more effective when the tumour size is more than 5 mm. Among the additional examination methods, dermoscopy has become widespread. The technique has been introduced into the world dermatological practice for a long time and is actively used in Ukraine, demonstrating high efficiency at a relatively low cost of equipment.
Materials and methods. Statistical data on 901 cases of newly diagnosed skin melanoma in the Ivano-Frankivsk region were obtained from the bulletins of the National Cancer Registry of Ukraine for the period 2012-2022.
Results and discussion. There has been a gradual decline in the number of undetermined melanoma cases according to the TNM classification. The indicator has changed by more than 50 percentage points, with the lowest values at the turn of 2017-2018, and a subsequent increase of 10 percentage points until 2022.
The number of reported cases of skin melanoma where the primary tumour distribution corresponds to the TI-TII category has increased, with a peak value of 92.7% as of 2017. However, in the period 2019-2022, the trend changed dramatically. Since 2019, cases of skin melanoma diagnosed in the state of spread, which corresponds to category TIII, have prevailed – 51.1%, while cases of TI-TII accounted for 32.2%
The global COVID pandemic that began in 2019 led to negative trends, contributed to the isolation of patients, and complicated their access to specialists. russia’s full-scale invasion of Ukraine in 2022 exacerbated this impact, which was reflected in the indicators of 2019-2022.
The clinical cases from our practice in 2018 and 2021 were presented in the article.
Conclusions. Melanoma is a malignant tumour with a high metastatic potential, with a better prognosis for recovery if diagnosed early. The increase in the number of registered cases of skin melanoma with primary tumour distribution in category TI-TII in 2013-2017 may indicate the effectiveness of measures aimed at promoting self-examination and timely treatment of patients for specialised care. The global COVID-19 pandemic and the full-scale russian invasion of Ukraine led to an increase in the proportion of melanomas diagnosed at the stage when the prevalence of the primary tumour corresponds to category TIII. It is necessary to resume measures that have had a positive impact on the health of residents of the Precarpathian region
Acute Lung Injury Associated with Blood Transfusion in a Hysterectomy Patient: A Case Report
Full text linkThis case report presents a case of transfusion-related acute lung injury (TRALI) in a 50-year-old female patient who underwent total hysterectomy due to multiple fibromyomas. The patient developed dyspnea, heart palpitations, and fatigue postoperatively, with SpO2 dropping to 61%. Despite initially suspecting pulmonary embolism, the normal D-dimer level and characteristic changes observed on X-ray facilitated the diagnosis of TRALI. The patient was successfully treated with oxygen supplementation, intravenous corticosteroids, and thromboembolism prophylaxis, resulting in complete recovery. This case underscores the importance of considering TRALI in the differential diagnosis when patients exhibit respiratory distress following transfusion