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The Modern Concept of the Problem of Short Clinical Crowns
Full text linkShort clinical crowns of teeth significantly complicate the qualitative restoration of functional and aesthetic indicators of the dentofacial system. Often, therapeutic, orthopedic treatment of patients with low clinical crowns becomes impossible without prior surgical correction.
This study was aimed to analyze domestic and foreign literary sources to identify the main problems associated with low clinical crowns of teeth and modern approaches to solving them.
Results. It was analyzed that the causes of short clinical crowns include eruption anomalies, occlusal disorders, diseases of hard dental tissues (caries and its complications, especially in the case of subgingival defects of the tooth crown, non-carious lesions), injuries (tooth fracture, abrasion), iatrogenic effects during dental interventions (reduction of a superfluous tooth, creation of wide endodontic access). A short clinical crown makes it impossible to have a high-quality fixation of the orthopedic structure and causes a violation of the occlusal curve and aesthetic parameters - the relief of the gum line. Preserving the dental crown, a fundamental aspect of prosthetics, depends on tooth preparation, choice of cement, and crown-tooth contact. For high-quality dental restoration, the placement of the tooth in the dental arch, its strategic importance, the state of the periodontium, the ratio of the crown to the root, the state of occlusion, the feasibility of endodontic treatment, and aesthetics are assessed. A thorough examination includes a clinical examination, assessment of the periodontal biotype, radiographic examination, and analysis of the diagnostic impression with the condition of further visualization of the desired treatment result. In each case, the problem of apical displacement of the gingival margin arises, which can be both within the soft tissues and with the capture of hard ones - removal/alignment of the edge of the bone walls or simultaneous interventions. Important factors are the "biological width" of the dentogingival junction, the level of gingival keratinization, and the height of the clinical crown when deciding on the type and depth of intervention. Today, surgical lengthening of the tooth crown is used as a guided preparation of soft and hard tissues to expose a greater height of the tooth structure. Among modern techniques, a diode laser and piezosurgery are considered, characterized by minimally traumatic surgical interventions and rapid healing.
Conclusions. The literature review demonstrates the relevance of the issues and possibilities of modern methods of surgical correction in the case of a short clinical crown of the tooth. Scientists focus on the prevalence of such clinical conditions of the teeth and consider the anatomical, functional, and aesthetic characteristics of dental treatment. However, the issues of a differentiated approach in the case of choosing a method of implementation - gingivectomy/resection of soft and hard tissues around the tooth, as well as individualized methods of their implementation, taking into account effective methods of postoperative healing in order to prevent soft tissue recession, remain insufficiently studied
Features of Inflammatory Syndrome in Patients with COVID-19-Associated Pneumonia and Concomitant Chronic Coronary Syndrome
Full text linkIntroduction. The COVID-19 coronavirus disease caused by the SARS-CoV-2 virus has become an unprecedented challenge for the healthcare system and has taken a leading position among infectious diseases due to its rapid spread and development of complications in various body systems. COVID-19 has been shown to increase the long-term risk of both ischemic and nonischemic cardiovascular diseases. This underscores the need for primary prevention through measures such as vaccination and a deeper understanding of the pathophysiology linking COVID-19 to endothelial dysfunction and systemic inflammation. Patients hospitalized for coronavirus disease often have concomitant cardiometabolic disease. Cardiovascular complications are common in these patients, emphasizing the need for ongoing research to better understand these effects. The role of integral inflammatory indices in patients with coronavirus disease in the setting of chronic coronary syndromes (CCS) is unexplored.
Aim. To identify the features of the course of chronic coronary syndromes in patients with pneumonia caused by coronavirus infection COVID-19, as well as to assess the relationship between the level of inflammatory indices and the severity of the disease.
Materials and methods. 124 patients with COVID-19 were enrolled upon admission to the cardiology department of the Central City Clinical Hospital in Ivano-Frankivsk, the therapeutic department of the Kolomyia Central District Hospital and the therapeutic department of the Verkhovyna Hospital, 124 patients with COVID-19-associated pneumonia were selected, including 92 patients with a history of chronic coronary syndromes (CCS), including 49 patients with a history of acute myocardial infarction, 43 patients with stable angina pectoris and 32 patients without a history of CCS.
Results of the study. The mean age of the examined patients was (66,2±7,8) years in the CCS group and (59,9±8,9) years in the non-CCS group.Among the patients with severe course, there were 36 patients (39,1%) in the CCS group and 10 patients (31,2%) in the non-CCS group. In the CCS group, 4 patients (4,3%) died, and in the non-CCS group, 2 patients (6,2%) died. The BMI in patients with CCS was (28,3 [26,2; 30,9]) kg/m2, in the group without CCS (26,66±3,59) kg/m2 and was higher in the CCS group (p=0,03). The mean number of days from the onset of symptoms to hospitalization in the CCS group was (7 [5;7] days, in the non-CCS group (7 [5;7] days). There was significant difference in the levels of inflammatory indices in the study groups after treatment, lower levels of SIRI 1,12 [0,58; 1,98] vs. 1,71 [0,74; 3,98] (p=0,04), NLR 4,22 [2,79; 5,40] vs. 5,3 [3,8; 9,56] (p=0,03), SII 936,75 [571,30; 1263,16] vs. 1198,75 [784,0; 2627,78] (p=0,008), PLR 154,75 [115,27; 208,09] vs. [124,23; 307,83] (p=0,04), AISI 253,61 [96,18; 437,47] vs.345,28 [229,48; 1040,13] (p=0,01). In the CCS group, a significant increase in the level of the LMR index (p=0,01) and a decrease in the level of CRP/L (p<0,0001) were observed after treatment. According to the results of the ROC analysis, there is a significant prognostic value of the CRP/L marker for mortality in patients with COVID-19 pneumonia and concomitant CVD (AUC = 0,901; 95% CI 0,820 – 0,953; p<0,0001) during hospitalization. The markers NMR, SIRI, NLR, SII, PLR, AISI, dNLR, CRP/L had a significant prognostic value for mortality when observed in the dynamics.
Conclusions. Increased levels of inflammatory indices showed a significant value in predicting hospital mortality from COVID-19 with concomitant CCS in the dynamics but had no prognostic value during hospitalization. Patients who were discharged with recovery or improvement had lower levels of inflammatory indices in the presence of concomitant CCS in the anamnesis.Вступ. Коронавірусна хвороба COVID-19, спричинена вірусом SARS-CoV-2, стала безпрецедентним викликом для системи охорони здоров'я та посіла провідне місце серед інфекційних захворювань через швидке поширення та розвиток ускладнень у різних системах організму. Доведено, що COVID-19 збільшує довгостроковий ризик як ішемічних, так і неішемічних серцево-судинних захворювань. Це підкреслює необхідність первинної профілактики за допомогою таких заходів, як вакцинація та глибше розуміння патофізіології, що пов'язує COVID-19 з ендотеліальною дисфункцією та системним запаленням. Пацієнти, госпіталізовані з приводу коронавірусної хвороби, часто мають супутні кардіометаболічні захворювання. Серцево-судинні ускладнення є поширеними у цих пацієнтів, що підкреслює необхідність постійних досліджень для кращого розуміння цих ефектів. Роль інтегральних показників запалення у пацієнтів з коронавірусною хворобою на тлі хронічних коронарних синдромів (ХКС) є невивченою.
Мета. Виявити особливості перебігу хронічних коронарних синдромів у хворих на пневмонію, спричинену коронавірусною інфекцією COVID-19, а також оцінити взаємозв'язок між рівнем показників запалення та тяжкістю перебігу захворювання.Матеріали та методи. З метою проведення дослідження в міру поступлення у кардіологічне відділення КНП «Центральна міська клінічна лікарня» м. Івано-Франківськ, терапевтичне відділення КНП «Коломийська ЦРЛ» та терапевтичне відділення КНП «Верховинська БЛ» відібрано 124 пацієнти, хворі на COVID-19-асоційовану пневмонію, із яких 92 пацієнтів з анамнезом хронічних коронарних синдромів (ХКС), серед яких 49 пацієнтів мають в анамнезі перенесений гострий інфаркт міокарда, 43 пацієнти зі стабільною стенокардією напруги та 32 без анамнезу ХКС.
Результати дослідження. Середній вік обстежених пацієнтів становив (66,2±7,8) років у групі ГКС та (59,9±8,9) років у групі без ХКС. Серед пацієнтів з тяжким перебігом було 36 пацієнтів (39,1%) у групі ХКС та 10 пацієнтів (31,2%) у групі без ХКС. У групі з ХКС померли 4 пацієнти (4,3%), а в групі без ХКС - 2 пацієнти (6,2%). ІМТ у пацієнтів з ХКС становив (28,3 [26,2; 30,9]) кг/м2, у групі без ХКС - (26,66±3,59) кг/м2 і був вищим у групі з ХКС (р=0,03). Середня кількість днів від появи симптомів до госпіталізації в групі з ХКС становила (7 [5;7] днів, у групі без ХКС (7 [5;7] днів). Спостерігалася достовірна різниця в рівнях показників запалення в досліджуваних групах після лікування: нижчі рівні SIRI 1,12 [0,58; 1,98] проти 1,71 [0,74; 3,98] (р=0,04), NLR 4,22 [2,79; 5,40] проти 5,3 [3,8; 3,9] (р=0,05). 5,3 [3,8; 9,56] (p=0,03), SII 936,75 [571,30; 1263,16] проти 1198,75 [784,0; 2627,78] (p=0,008), PLR 154,75 [115,27; 208,09] проти [124,23; 307,83] (p=0,04), AISI 253,61 [96,18; 437,47] проти.345,28 [229,48; 1040,13] (p=0,01). У групі ХКС після лікування спостерігалося достовірне підвищення рівня індексу LMR (p=0,01) та зниження рівня CRP/L (p<0,0001).
Висновки. Підвищення рівня запальних індексів показали достовірну значення у прогнозуванні госпітальної смертності від COVID-19 з супутніми ХКС в динаміці, проте не мали прогностичної цінності при госпіталізації. У пацієнтів, що виписалися з одужанням чи покращенням виявилися нижчі рівні запальних індексів при наявності супутніх ХКС в анамнезі.
Ключові слова: COVID-19, пневмонія, запалення, ішемічна хвороба серця, хронічний коронарний синдро
Comparative Evaluation of Soft Tissue Reaction to Titanium and Polyetheretherketone Customized Healing Abutments: a Split-Mouth Randomised Clinical Trial
Full text linkAim. This study aimed to evaluate the peri-implant soft tissue response to customized healing abutments (CHAs) made of titanium and polyetheretherketone (PEEK).
Methods. Titanium and PEEK CHAs were mounted on bone-level dental implants in bilateral edentulous patients in a randomized split-mouth study design. After a three-week healing period, the clinical parameters of the peri-implant soft tissues were assessed. The value of marginal bone resorption was measured by cone-beam computed tomography. In addition, peri-implant crevicular fluid samples were obtained to identify periodontal pathogenic bacteria, cytokine levels, and active neutrophil collagenase (aMMP-8) concentration. Microcirculation and oxygenation parameters were assessed using laser Doppler flowmetry and optical tissue oximetry. In addition, wavelet analysis was conducted to study blood flow control mechanisms.
Results. Out of the 23 participants initially recruited, 20 were assessed after titanium and PEEK CHA installation due to losses to follow-up. The peri-implant soft tissue around 27 titanium and 25 PEEK CHAs was evaluated during follow-ups. No differences were found in the values of marginal bone resorption, cytokine levels, or total bacterial load (p>0.05). PEEK CHAs demonstrated lower bleeding on probing values, less plaque accumulation, and faster relief of ischemia and hypoxia. Although aMMP-8 concentration was higher in the PEEK group, the values were within normal limits.
Conclusions. The results of this comparative study showed a positive soft tissue response to PEEK CHAs. However, further studies comparing the effectiveness of different materials for CHAs should be carried out, considering their specific physical properties and processing protocols
КОМПЛЕКСНИЙ ПІДХІД ДО ІДЕНТИФІКАЦІЇ ОСОБИ З ВИКОРИСТАННЯМ ДЕРМАТОГЛІФІВ ТА ШТУЧНИХ НЕЙРОННИХ МЕРЕЖ
No full textIntroduction. Due to the full-scale military invasion of Ukraine by the aggressor state, the tendency to aggravate local armed conflicts in the world, which causes a large number of depersonalised, fragmented corpses, the problem of identifying the bodies of two or more persons arises
The aim of the study to develop expert criteria for the informativeness of dermatoglyphic fingerprints in the system of forensic medical identification of a person.
Materials and methods. The object of the study was fingerprint cards obtained from 460 people (200 women and 260 men) aged 18-59 years living in Ukraine. We used statistical analysis and neural network programming.
Results. Using neural network prediction, we have developed a methodology for reproducing unknown (lost) phenotypic traits based on the available ones (dermatoglyphs). Given the fact that many different neural networks can be built even on the same variables, depending on their combination, we managed to achieve a prediction accuracy of 73-90%, which suggests that a combination of different neural networks and an integrated approach show better results.
Conclusions. Based on the above, it can be concluded that the reliability of the results obtained ranged from 73-90% (automatically calculated by the Dermatoglyphics For Prediction (DFP) software), which is significantly higher than the results of previous fingerprint examinations. The use of our proposed software in combination with other basic methods will improve the quality of forensic identification examinations.У зв’язку з повномасштабним воєнним вторгненням держави-агресора на територію України, тенденцією до загострення локальних збройних конфліктів у світі, що є причиною появи великої кількості знеособлених, фрагментованих трупів, виникає проблема ідентифікації тіл двох і більше осіб
Мета дослідження - розробити експертні критерії інформативності дерматогліфічних відбитків пальців рук у системі судово-медичної ідентифікації особи.
Матеріали та методи. Об'єктом дослідження були дактилоскопічні картки, отримані від 460 осіб (200 жінок і 260 чоловіків) віком 18-59 років, які проживають в Україні. Використано дерматогліфічний метод та метод статистичного аналізу. Результати. Використавши нейромережеве прогнозування, ми розробили методику відтворення невідомих (втрачених) фенотипових ознак на основі наявних (дерматогліфів). Враховуючи ту особливість, що можна побудувати багато різних нейромереж навіть на одних і тих же змінних залежно від їх комбінації, нам вдалось досягнути точності у прогнозуванні 73-90%, що дозволяє стверджувати, що комбінація з різних нейромереж і комплексний підхід показують кращі результати.
Висновки. Виходячи з наведеного вище можна зробити висновок, що використання програмного забезпечення Dermatoglyphics For Prediction (DFP) значно перевищує отримувані раніше результати дактилоскопічних експертиз. Використання запропонованої нами програми у комплексі з іншими базовими методами дозволить підвищити якість проведення судово-медичних ідентифікаційних експертиз.
Ключові слова. Ідентифікація особи, дерматогліфічний статус, фенотип, криміналістика, дактилоскопія, штучна нейронна мережа
Historical Landmarks of Congresses of All-Ukrainian Public Organization “Scientific Society of Anatomists, Histologists, Embryologists and Topographic Anatomists of Ukraine”
Full text linkThe Scientific Society of Anatomists, Histologists, Embryologists and Topographic Anatomists of Ukraine - is a public organization whose activity is aimed at the formation of conditions for revealing the scientific and creative potential of morphologists in Ukraine; at the development of the research work; at the development of innovative activity; and at the creation of a society website. This article aims to highlight the historical aspects of the formation and development of the society since Ukraine gained independence and up to nowadays, to focus attention on the famous Ukrainian scientists having managed the society and made significant efforts to develop morphology in Ukraine and in the whole world
Changes in Endogenous Intoxication and Antioxidant Defense System Markers in Patients with Tumor-Induced Acute Colonic Obstruction
Full text linkA comprehensive evaluation of clinical and biochemical markers defining the status of endotoxemia in patients diagnosed with acute colonic obstruction (ACO) was conducted. The findings revealed that advancing stages of ACO corresponded to an increase in serum levels of endogenous intoxication markers and a simultaneous decrease in antioxidant defense system (ADS) markers.
The aim of the study was to analyze changes in endogenous intoxication and ADS markers in patients with tumor-induced ACO throughout the disease progression and evaluate the outcomes.
Materials and Methods. The study is based on examining serum levels of endogenous intoxication markers, including middle weight molecules (MWM), products of lipid peroxidation (LPO) - conjugated dienes (CD), malonaldehyde (MA), protein oxidative modification (POM), and key ADS markers, specifically superoxide dismutase (SOD), catalase (CAT), and ceruloplasmin (CP), in 155 patients with ACO throughout the disease progression and 20 apparently healthy individuals.
Results. Upon patient admission to the hospital, the duration of ACO was found to correlate with an increase in endogenous intoxication markers and a decrease in antioxidant defense markers. Depending on ACO stage, MWM levels were 0.42 (0.38; 0.43) IU, 0.56 (0.51; 0.58) IU, and 0.72 (0.69; 0.73) IU, respectively (р1<0.01, р2<0.01, р3<0.01), with a normal range of 0.23 (0.18; 0.25) IU. In the compensated stage of ACO, MA levels significantly increased compared to the control group, reaching 6.39 (6.25; 6.42) nmol/mL (р1<0.001, р2<0.01, р3<0.05). Additionally, with the progression of the disease, a gradual increase in MA levels up to 6.39 (6.25; 6.42) nmol/mL, 7.88 (7.62; 7.92) nmol/mL, and 8.11 (8.05; 8.15) nmol/mL, respectively, was noted (р1<0.001, р2<0.01, р3<0.05), with a normal range of 3.14 (2.58; 3.17) nmol/mL. Similar trend was observed in serum CD levels - 3.11 (3.02; 3.18) IU, 3.69 (3.52; 3.72) IU, and 4.69 (4.53; 4.82) IU, respectively, with a normal range of 1.41 (1.32; 1.46) IU (р1<0.01, р2<0.01, р3<0.01). The study of LPO intensity via the optical density of aldehyde and ketone derivatives of neutral and basic dinitrophenylhydrazones (POM 356, POM 370, POM 430, POM 530) revealed an increase in POM product levels with the disease progression compared to the control group (р1<0.001, р2<0.01, р3<0.01). The analysis of the ADS showed an opposite trend, characterized by a significant decrease in marker levels. In patients with different ACO stages, serum CAT levels were 8.08 (7.95; 8.12) Н2О2/mL, 6.32 (6.25;6.41) Н2О2/mL, and 5.67 (5.59; 5.75) Н2О2/mL, respectively, with a normal range of 12.36 (12.21; 12.55) Н2О2/ml (р1<0.001, р2<0.01, р3<0.01), while SOD concentration decreased with the disease progression as well - 42.43 (31.75; 51.84) IU, 35.65 (24.72; 45.53) IU, and 32.18 (18.72; 41.15) IU, respectively, with a normal range of 63.60 (54.41; 74.56) IU (р1<0.001, р2<0.01, р3<0.01). In the compensated stage of ACO, CP level exceeded the normal value - 39.21 (38.92; 39.41) IU, with a normal range of 28.9 (28.4; 29.1) IU, indicating a compensatory defensive response of the body to a dramatic increase in LPO products. CP reserves, however, were depleted with the disease progression and a consistent decrease in this marker was subsequently observed: 19.10 (18.91; 19.23) IU in the subcompensated stage and 16.12 (16.01; 16.15) IU in the decompensated stage (р1<0.001, р2<0.01, р3<0.01).
Conclusions. As a systemic process that induces various metabolic homeostasis disorders, endogenous intoxication serves as the pathogenetic foundation for the development of multiple organ failure in ACO patients. With ACO progression, endogenous intoxication caused an increase in LPO and POM activity, resulting in elevation of highly toxic middle-molecular weight substances, concurrently accompanied by a decline in the AOS activity
Cortex and White Matter of the Cerebral Hemispheres: Anatomical Correlations and Age-Related Changes Measured with Fractal Analysis
Full text linkAim. The aim of the present study was to determine the fractal dimension (FD) values of the cortex and white matter of the cerebral hemispheres using fractal analysis of two-dimensional magnetic resonance images, explore the anatomical correlations of the cortex and white matter FD, and study age-associated changes in the cortex and white matter.
Methods. Two-dimensional brain magnetic resonance images of 100 apparently healthy individuals of both genders (44 males and 56 females) aged 18-86 years were studied. Five sections of each participant’s brain were selected (4 coronal and 1 axial). After image segmentation, the FD values and sectional areas of the cortex and white matter were determined. Fractal analysis was conducted using a two-dimensional variant of the box-counting method.
Results. The FD values of the cortex and white matter varied across the five brain sections analyzed. Specifically, the cortex exhibited a decrease in the FD, whereas the white matter showed an increase in the FD in the coronal sections along the rostro-caudal direction. The FD values obtained from different sections displayed weak to moderate correlations. Additionally, no significant differences were observed in the FD values of the cortex and white matter between males and females. However, the sectional area values of the cortex and white matter were slightly higher in males as compared to females. Furthermore, a negative correlation was identified between the FD values of the cortex and white matter of the cerebral hemispheres, while sectional areas did not exhibit significant correlations. The cortex FD positively correlated with the gyrification index, whereas the white matter FD showed a negative correlation with this parameter. Additionally, both the FD and sectional area values of the cortex displayed strong and moderate negative correlations with age, respectively. In contrast, the FD and sectional area values of the white matter demonstrated weak negative correlations with age. Males showed stronger correlations of the studied parameters with age across the majority of the analyzed sections compared to females, although these differences were not statistically significant.
Conclusions. In this study, a negative correlation was found between the cortex and white matter FD values, influenced by anatomical factors such as the degree of gyrification. While the cortex FD values significantly decreased with age, age-related changes in the white matter FD values were relatively weak
Особливості Ремоделювання Надниркових Залоз за Умов Впливу Ендо- та Екзопатогенних Чинників
No full textOne of the main links of the body's adaptation system, sensitive to the action of various types of exo- and endogenous factors, is the adrenal glands. The body's response to acute stress is mediated by the effects of the sympatho-adrenal system, while the most important component of the endocrine response to chronic stress is the hypothalamic-pituitary-adrenocortical system. An analysis of sources of scientific literature has been done, the results of which indicate that under the influence of factors of different genesis, including other endocrine diseases, significant structural and functional changes occur in the adrenal glands of rats, which is a confirmation of their adaptation-compensatory mechanisms in response to stress.Однією з основних ланок системи адаптації організму, чутливої до дії різних видів екзо- та ендогенних факторів, є надниркові залози. Реакція організму на гострий стрес опосередкована ефектами симпато-адреналової системи, у той час як найбільш важливою складовою ендокринної реакції на хронічний стрес є гіпоталамо-гіпофізарно-адренокортикальна система. Проведений аналіз джерел наукової літератури, результати якого свідчать про те, що під впливом чинників різного генезу, в тому числі інших ендокринних захворювань, в надниркових залозах щурів відбуваються значні структурно-функціональні зміни, що є підтвердженням їх адаптаційно-компенсаторних механізмів у відповідь на стрес
Methodology for Occlusal-Articulation Relationships through the T-SCAN System in Treatment with Complete Denture
Full text linkBackground: The exact physiological restoration of the occlusal-articulation balance is a challenge for every dentist. Any tooth restoration, extraction, or prosthetic treatment creates a prerequisite for a change in occlusion
Objectives: To approve a methodology that uses the capabilities of the T-SCAN system to evaluate the occlusal-articulation relationships in the treatment of patients with complete dentures.
Material and methods: The study included 47 patients for prosthetic treatment. The subjects were aged 56 to 81 years (18 men and 24 women). On each one, control of the occlusal-articulation relationship was performed after the treatment with a complete denture. Examination of the occlusal contacts was performed with two-step articulation paper and the T-SCAN system. The minimum sample size of patients was determined based on power analysis for sample-size calculation. Descriptive statistics was used. Statistical significance was assumed at P< 0.05. SPSS version 20.0 was applied for data processing.
Results: More women 51.06 ± 7.29 % and 38.29 ± 7.09 % men were included in the study. The study participants were divided into 4 age groups: under 60 years, 61-70 years, 71-80 years, and over 81 years. It shows that the largest number are patients in the age group 61-70 years (46.81 ± 7.28 %), followed by patients up to 60 years (31.91 ± 6.80 %) and patients 71-80 years (12.77 ± 4.87 %), and the smallest number were patients over 81 years old (8.51 ± 4.07 %). The achieved results give us reason to consider that the articulation of the complete dentures with our proposed methodology ensures the achievement of optimal, harmonious occlusal relationships.
Conclusion: A methodology has been developed to control the occlusion-articulation relationships through the T-SCAN system in treatment with complete denture, which can be used as the method of choice in the presence of technical possibility since optimal, harmonious occlusal relationships can be achieved with it
Prevalence of Diastasis Recti Abdominis Among Women in the Postpartum Period
Full text linkObjective. Determination of the prevalence of diastasis recti after vaginal delivery and assessment of correlations between major physiological parameters of pregnancy and the postpartum period from patients with diastasis recti.
Materials. We’ve analysed 49 patients diagnosed with diastasis recti abdominis during pregnancy. There were 22 primiparous and 27 were repeat births. The average age of primiparous women was 22.8±4.9 years, multipara – 28.8±6.8%. Thirty patients (61.2%) were married, 10 (20.4%) were single, and 9 (18.4%) were divorced. Nineteen women (38.8%) were employed, 19 (38.8%) were housewives, and 2 (4.1%) were students. Three pregnant women (14.3%) were smokers, and two (4.1%) drank alcohol regularly.
Results. The prevalence of diastasis above the navel was observed in 31 patients (63.3%), below the navel – in 18 (36.7%). This value did not depend on the number of births. When analysing the width of the diastasis above the navel among primiparous women, a weak probability was noted (0.105), and when analysing the width below the navel, the difference was unlikely (0.250). When comparing the width of the white line of multipara whose diastasis was above the navel, the difference was improbable (0.241), while in localisation below the navel, a probable (0.014) difference was observed – prevailed in patients whose width of diastasis was less than 2 cm.
Conclusion. Among patients with diastasis recti, there is no probable difference between primiparous women and multipara, between primiparous women and postpartum women, and between multipara and postpartum women whose diastasis was above/below the navel and its size was less/more than 2 cm.Мета. Визначення поширеності діастазу прямих м’язів живота після вагінальних пологів та оцінка кореляційних зв’язків між основними фізіологічними параметрами вагітності і післяпологового періоду.
Матеріали. Ми проаналізували 49 пацієнток, у яких під час вагітності було встановлено діагноз діастазу прямих м’язів живота. Серед них було 22 були першороділлями і 27 – повторнонароджуючими (табл. 1). Середній вік першороділь становив 22.8±4.9 років, повторнонароджуючих – 28.8±6.8 %. Тридцять пацієнток (61.2 %) були одружені, 10 (20.4 %) – неодружені та 9 (18.4 %) – розлучені. Дев’ятнадцять жінок (38.8 %) були працюючими, 19 (38.8 %) – домогосподарками та 2 (4.1 %) – студентами. Курцями були троє вагітних (14.3 %), регулярно вживали алкоголь двоє (4.1 %).
Результати. Поширеність діастазу над пупком була у 31 пацієнтки (63.3 %) під пупком – у 18 (36.7 %). Це значення не залежало від кількості пологів. При аналізі ширини діастазу вище пупка серед першороділь відмічалася слабка вірогідність (0.105), а при аналізі ширини нижче пупка різниця була невірогідною (0.250). При порівнянні ширини білої лінії повторнонароджуючих, у яких діастаз був вище пупка різниця була невірогідною (0.241), тоді як при локалізації нижче пупка спостерігалася вірогідна (0.014) відмінність – переважали пацієнтки, у яких ширина діастазу була меншою 2 см.
Висновок. Серед пацієнток з діастазом прямих м’язів живота немає вірогідної різниці між першороділлями і повторнонароджуючими, між першороділлями і жінками після пологів та між повторнонароджуючими і жінками після пологів у яких діастаз був вище /нижче пупка та його розміри складали менше/більше 2 см.
Ключові слова: діастаз прямих м’язів живота, локалізація, першороділлі, повторнонароджуючі