Osteoarthrosis and Combined Pathology: Features of Pathogenesis (Literature Review)

The purpose of the study. Identification of key links in the pathogenesis, which will improve the diagnostic and treatment approaches in such patients. Materials and methods. Analytical and bibliosemantic methods were used in the research. Results. Modern scientists are actively discussing the problems of providing medical care to patients who, in addition to the underlying disease, have an aggravating effect of concomitant, combined pathology. Interestingly, in the publications of domestic literature we find the terms "combined", "concomitant", "combined" pathology. The English-speaking scientific community uses the terms - "comorbidity" when it comes to damage to 2 organs or systems and "multimorbidity" when more than 3 diseases. The problem of combined pathologies is one of the key in modern medicine. Osteoarthritis is one of the most common diseases in Ukraine and around the world. Exhausting degenerative-dystrophic pathology, which is combined with high personal and socio-economic burden. According to the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) and the International Society for the Study of Osteoarthritis (OARSI), it is known that a middle-aged patient with osteoarthritis has 4 combined pathologies, including In addition to osteoarthritis, up to 8 other chronic diseases are diagnosed in old age. In clinical practice, a combination of this disease with hypertension and type 2 diabetes is often observed. However, there are still many differences in the opinion of scientists about the pathogenesis of osteoarthritis with combined pathologies. Conclusions. Scientific research in the modern world is aimed at studying the complex relationships between diseases that are often found in combination in the same patient. During the research the data of modern domestic and foreign literature were reviewed and analyzed and data on new ideas of common links in the pathogenesis of osteoarthritis, arterial hypertension and type 2 diabetes mellitus, which combines disorders in the system of oxidant-antioxidant, protease-antiprotease imbalance, proteolytic and fibrinolytic activities of blood plasma, changes in endothelial function, impaired mineral metabolism, the impact of vitamin D deficiency on the further development of chronic inflammation with the activation of cytokine synthesis. The information presented in the review is a reason to assume that the combined pathologies show the potential for complicating each other, complicating the diagnosis and treatment tactics

Possibilities of rehabilitation treatment of children with lymphoblastic leukemia (literary review)

According to nowaday protocols of acute lymphoblastic leukemia (ALL) treatment, the percentage of recovering patients has increased significantly. This determines the necessity for comlex long-term rehabilitation, as chemotherapeutic drugs are highly toxic and contribute to the development of comorbid diseases of the gastrointestinal tract, nervous and musculosceletal systems. The purpose of the study was to review and analyze data from foreign and domestic literature concerning possibilities for rehabilitative treatment of children with ALL and to reveal informative methods assessing the effectiveness of rehabilitation. Important elements of rehabilitation goals and assessment of its the effectiveness are the International Classification of Functioning, Disability and Health of Children and Adolescents, and the Quality of Childrens’ Life. Rehabilitation begins at the hospital and includes psychological support for the child with the involvement of psychotherapists and family, as well as the performance of certain physical exercises lasting for 15-30 minutes, which are selected individually, taking into account the functional capabilities and motivation of the child. After the acute period, physical activity is carried out in accordance with an individual plan, which takes into account the peculiarities of the disease and includes active video games, cycling and other activities. Rehabilitation treatment on the basis of sanatorium-resort institutions with the participation of a multidisciplinary team is actual. Such treatment, in addition to physical exercises, includes the use of natural and preformed physical factors in order to influence the manifestations of comorbid pathology, and also contributes to an increase of the social activity and independence of the child. However, the number of such studies is limited, which determines the necessity to develop clear practical recommendations regarding methods of exposure, their duration and intensity.

Additional risk factors for in-hospital ischemic stroke. Hypercoagulation syndrome

The risk of ischemic stroke in inpatients is higher than in the general population. This is due to both the greater comorbidity of inpatients and the presence of additional risk factors, the most studied of which are iatrogenic interventions. At the same time, the higher the probability of developing an ischemic stroke, the more risk factors the patient has. An important link in the pathogenesis of in-hospital ischemic stroke is the activation of the hemostasis system, which is an obligate consequence of a typical pathological process underlying diseases and injuries that led to hospitalization: blood loss, inflammation, mechanical tissue damage, dehydration, etc. In foreign literature, this condition is attributed to the group of acquired thrombophilia, in domestic literature the term hypercoagulation syndrome has become more widespread. Iatrogenic effects can also play an important role in the pathogenesis of hypercoagulation syndrome. It is characterized by increased readiness for thrombosis, clinical and laboratory signs of hypercoagulation, activation of various factors and components of coagulation, decreased fibrinolysis, but without the development of acute thrombosis. Hypercoagulation syndrome is rarely assessed in routine practice as a risk factor for ischemic stroke, however, it can act as an additional and main risk factor for the development of all subtypes of ischemic stroke (according to the TOAST classification), including the ESUS concept. In this regard, it is advisable to distinguish in its structure: chronic (existing before hospitalization: hereditary and/or acquired) and acute (situational, developed as a result of the underlying disease, its complications or iatrogenic effects) hypercoagulation syndromes. To designate a group of acute pathological conditions predisposing to the development of hypercoagulation syndrome, systemic and/or local thrombotic complications, including in-hospital ischemic stroke, and requiring increased preventive measures, it seems pathogenetically justified, understandable and convenient to use the term situational hypercoagulation conditions (1 table, bibliography: 19 refs)

Selected management concepts in supply chains

Supply chain management is considered a complex process that can lead to errors, conflicts, or a breakdown of cooperation. In chain creation, it is important to organize and rationalize the network of interconnections to which the assumptions of concepts, such as lean manufacturing, agile manufacturing, and resilient supply chains, can be applied. For this reason, the aim of the research presented in the study was to attempt to identify how selected management systems in supply chains can influence the improved functioning of enterprises in a vulnerable condition and in the contemporary challenging situation. The starting point for consideration was to define the concept of a supply chain, lean manufacturing, agile manufacturing, and resilient supply chains, and to indicate the benefits of using the selected concepts. For this purpose, foreign and domestic literature was used. The result is a description, analysis, and criticism of the different systems in relation to the supply chain.

A Review of Issues Concerning the Support for Fathers During Pregnancy: Research Trends in Japan

Objective: To identify future issues in the development and implementation of support programs for fathers with the aim of preventing child abuse, we reviewed the domestic literature to determine the characteristics of support for fathers during pregnancy and identify research trends.Methods: The domestic literature was searched on January 31, 2021, using the Central Journal of Medicine ver. 5.0. The search yielded 110 original articles and nursing literature using the keywords “pregnancy & father” and “pregnancy & husband,” wherein 100 articles with abstracts were found, excluding conference proceedings. The abstracts were then checked, and finally, 27 were included in this analysis.Results: In the articles collected, the following themes were extracted: “satisfaction from the experience of child-rearing skills from pregnancy,” “relationship between marital intimacy and relationship to mother and child from pregnancy,” “role adjustment between work and home from pregnancy,” and “vague imagination and anxiety from pregnancy.”Conclusion: During pregnancy, the deepening of the relationship between the mother and father, who is still adjusting to become a father, can affect the quality of the relationship between the mother and the child. Thus, the challenge is to develop support programs that will further strengthen the relationship between the husband and wife.

Hypomenstrual syndrome in adolescent girls as a result of reproductive dysfunction in their mothers

In recent years in Ukraine and in the world there has been a clear tendency towards deterioration in the indicators of the somatic health of children and adolescents, that is negatively affects the processes of reproductive health formation and it state in the future. Concern for adolescent girl's health, including their reproductive system, forms an enormous contribution to the society future. That's why big attention is paid to the formation and saving reproductive health of adolescent girls. The period of sexual development is defining in a woman's life and is considered a key moment on the path of reproductive maturity. Today it has been established that the reproductive health formation is influenced by environmental, socio-economic factors and the presence of somatic diseases. Despite the fact that the pathogenetic mechanisms of the reproductive system formation are extremely complex and sensitive to the effects of negative factors, the appearance of destructive factors at this time can disrupt the physiological chain of functioning of the hormonal mechanisms which regulate the reproductive system. Disorders of the menstrual cycle is one of the most common pathological conditions, combining pathogenetically different diseases, which are manifested by a violation of the menstrual duration and frequency, amount of menstrual flow. According to domestic literature, hypomenstrual syndrome (oligomenorrhea, amenorrhea) is in the first place among menstrual dysfunctions in adolescent girls in the structure of gynecological morbidity and is up to 45%. Menstrual irregularities that occur during adolescence often persist into the future, causing infertility, obstetric pathology, perinatal loss and other reproductive health problems during childbearing years. The problem of the menstrual cycle formation has been little studied, but it is socially significant, very relevant and requires further study.Thus, girls with menstrual disorders constitute a group of increased risk of gynecological diseases in women of reproductive age, since many chronic diseases of adults are a protracted pathology of adolescents. Therefore, adolescent girls should be examined and treated by a specialist in pediatric and adolescent gynecology, pediatric endocrinologist, pediatrician and family doctor.

International Migration of the Older Generation: Global and Russian Trends

The subject of this research is the international migration of the elderly (global and Russian trends). This topic is of particular relevance due to the fact that the elderly people make up 17% of international migrants (2019). In addition, older migration is at the intersection of four demographic “megatrends” - population aging, migration, population growth and urbanization. In addition, the international emigration of elderly Russians is practically not studied in the domestic literature. The hypothesis of the study is the assumption of the aging of international migration flows in accordance with the trend of demographic aging. Research method - secondary data analysis. The main empirical base is the data of the UN and Rosstat. Global statistics show that while the number of older migrants has increased, the proportion of older people has not changed. Thus, the hypothesis was not confirmed, which gives grounds to draw the following conclusion: migration lags behind aging. This is due to the weak mobilization and adaptive potential of the older generation. Russian statistics make it possible to single out 4 thousand people over the working age who moved abroad in 2019 (not including the CIS countries). The most popular destinations are Germany, Georgia. In conclusion, it examines the risks (negative impact on the labor potential of the country, etc.) and opportunities (rejuvenation of the age structure, reduction in age discrimination) for Russia in the context of the emigration of the elderly population. Analysis of the existing indices of active longevity showed the absence of migration as an indicator of activity, which significantly distorts this index. The direction of future research is to study the migration of Russian pensioners in the countries of Southeast Asia and China.

An Evaluation Model for the Teaching Reform of the Physical Education Industry

In order to promote the development of sports industry teaching and accurately evaluate the teaching reform of sports industry, this paper constructs an evaluation model based on the teaching reform of sports industry. In addition, the k-means method is used to classify the teaching effect and simplify the data collection process, so as to improve the accuracy of teaching reform evaluation. The sample data come from the data released by the sports department and the government from 2017 to 2020, as well as the actual survey. The 26 evaluation indexes were determined by expert survey, questionnaire interview, and relevant domestic literature. In addition, the Euclidean distance in K-means method is used to calculate the weight of each index, and the results of the evaluation model are analyzed. The results show that the evaluation accuracy of the sports industry teaching reform model proposed in this paper is 98.4% and the error is 1.3%. The evaluation result is better than the previous ant colony model and is suitable for the evaluation of sports teaching reform.

Effect of oral antihyperglycemic drugs on purine metabolism

Gout and diabetes mellitus are metabolic diseases, the pathogenesis of which is based on an excess of organic molecules in the body, in the first case — uric acid (UA), in the second — glucose. It is assumed that UA can also be involved in the pathogenesis of type 2 diabetes mellitus (T2DM), while insulin resistance and hyperglycemia affect purine metabolism. Both diseases are associated with an increased risk of cardiovascular events. In addition, chronic microcrystalline inflammation, which is absent in asymptomatic hyperuricemia, but is an obligatory component of gout, is probably an independent factor in T2DM, arterial hypertension, and cardiovascular events. The treatment of both diseases is strategically similar: in gout, the goal is to achieve a normal blood MC level, in T2DM — to normalize glycemia, and the frequent combination of these metabolic diseases requires taking into account the effect of drug therapy on concomitant diseases. Most modern antihyperglycemic drugs can affect purine metabolism, which is confirmed by the results of a number of foreign works. At the same time, the effect of T2DM therapy on purine metabolism and gout has not been adequately covered in the domestic literature, which was the purpose of this review.

Numerical simulation for increasing the sand mastic adaptation of repairing the breakwater

As a breakwater gradually becomes obsolete, it becomes vulnerable to loss of its original functions and finally occurs corruption due to cavitation, scours inside, etc. The mortar grouting method, which has been in general applied in many cases, would invoke serious issues such as coastal environmental pollutions because of spilled-out cement before curing on the near sea. Thus, the sand mastic that utilizes the mastic asphalt becomes focused on as a substitute. However, the related study is hard to find in the domestic literature. In this study, therefore, the workability of sand mastic when filling up the cavitation inside a breakwater was evaluated with a 3-D numerical model, FLOW-3D. It was intended to propose the workability index (WI) of sand mastic based on the diffusion diameter. It has been shown that the temperature and the composition ratio of the asphalt are the most significant parameters on the rheologic characteristics of the sand mastic. As a result, it is recommended that the asphalt composition above 16% and the initial temperature above 150℃ when applying with a breakwater with inside cavitation.