Indicators of hemodynamic and structural heart parameters in patients with comorbid pathology

Currently, diabetes mellitus is a complex global problem, which is increasing every year. So in 2019, diabetes in the world was detected in 463 million adults (from 20 to 79 years old). And the main cause of death in patients with diabetes mellitus is cardiovascular complications. The features of functional and structural changes in the heart were studied in patients with type 2 diabetes mellitus and nephropathy. A total of 75 patients with type 2 diabetes mellitus were examined, of which 50 patients had diabetic nephropathy of varying severity. The control group consisted of 20 healthy individuals. The control group consisted of 20 practically healthy patients. After a clinical examination, depending on the state of renal function, all patients were divided into the following groups: group I consisted of 25 patients with type 2 diabetes mellitus without signs of nephropathy; group II consisted of 26 patients with type 2 diabetes mellitus with normal glomerular filtration rate and albuminuria; group III consisted of 24 patients with type 2 diabetes mellitus with decreased glomerular filtration rate and albuminuria. To study changes in hemodynamics and structural parameters of the heart, patients underwent transthoracic echocardiography on an ULTIMA PA ultrasound machine (Radmir, Ukraine) using a sectoral phased transducer with a frequency range of 2–3 MHz according to the standard technique according to the recommendations of the American Echocardiographic Society. Indicators the patients underwent anthropometric measurements. Patients with diabetic nephropathy and albuminuria and decreased glomerular filtration rate showed an increase in the linear dimensions of the heart in comparison with controls and patients without signs of nephropathy. With diabetic nephropathy patients have a significant increase in left ventricular myocardial mass and a significant increase in the detection rate of left ventricular hypertrophy up to 91.3 % in patients with albuminuria and preserved renal function and up to 100.0 % with a decrease in glomerular filtration rate. Keywords: diabetes mellitus, hypertonic disease, diabetic nephropathy, heart remodeling, chronic kidney disease.

Dynamics of biochemical indicators in the process of mucous-bone wound healing in cases of spontaneous periodontitis on the background of different organism reactivity

The dynamics of biochemical parameters (lipid peroxidation, medium molecular peptides, prostaglandins) blood levels after periodontal tissues surgery of 24 dogs with spontaneous periodontitis has been studied. Animals were divided into groups with normal, hyper- and hyporeactivity of the body. It has been revealed that the changes of the studied biochemical parameters during normoreactivity of the organism are mutually correlated, which provides synchronization of necrotic and reparative processes in the healing of mucosal wounds after patch surgery in cases of spontaneous periodontitis. When hyperreactivity of organism is observed, the changes of indicators of lipid peroxidation, medium molecular peptides and prostaglandins promote strengthening of necrotic processes, and in cases of hyporeactivity they boost their slowing down that in both cases leads to delay of reparation in healing of an artificial mucous-bone wound. Keywords: spontaneous periodontitis, reactivity of the organism, wound healing, biochemical parameters.

Biological and medical value of antioxidant protection system of the human body

The article is devoted to the antioxidant system of the human body in the context of biological and medical significance. The classification of antioxidants in terms of their physical and chemical properties, bioorganic compounds, biochemical effects, mechanisms of implementation of antioxidant protection is presented. The given processes of extreme radical oxidation and mechanisms of antioxidant defense in physiological and pathological conditions. The characteristics of the components of the glutathione system, namely glutathione and enzymes – glutathione peroxidase, glutathione reductase and glutathione transferase are presented. Much attention is paid to manganese superoxide dismutase, an antiradical defense enzyme, as a fundamental regulator of cell proliferation, a mediator of metabolism and apoptosis. Interpretation of changes in the antioxidant enzyme of mitochondrial origin from a prognostic point of view is interpreted on the basis of the results of clinical observations carried out by scientists in various human diseases. The expediency of determining manganese superoxide dismutase in clinical practice for the diagnostic search for the direction of the pathological process, the timely detection of complications and the appointment of adequate therapy is emphasized. Keywords: antioxidant system, classification, glutathione system, manganese superoxide dismutase.

Improvement of qualification of management staff authorities and medical protection specialists in civil protection

Modern sources of danger make new demands on the system of advanced training of managerial staff of government agencies and medical professionals whose activities are related to the organization and implementation of measures for civil protection. Improving their skills is aimed at forming readiness to perform complex tasks in a single state system of civil and its component – medical protection and involves the development of new general theoretical and special-technological and medical knowledge, expanding the range of skills and practical skills. The paper, based on logical analysis, reveals the features of professional development of government officials and medical professionals on civil protection in modern conditions, substantiated proposals to improve the process of their training. As a result of the study, the state of affairs was studied and it was argued that the optimization of improvement and professional development of government and medical specialists of the system of emergency care and disaster medicine on civil and medical protection as a functional subsystem in a single state civil protection system provides an organic combination different forms, methods and content of education, depending on the capabilities of the educational institution and the needs of the person. The above is not possible without the introduction of a rational construction of universal design during the educational process in a higher education institution, a civil defense institution. The urgency of these issues is confirmed by the course of our country for integration into the European Union, and this requires, in modern conditions, systematic improvement of the educational process and optimization of the level of professional development of these categories of personnel using the experience of developed countries. that meet world standards and requirements of today. Keywords: advanced training, managerial staff of government bodies, medical specialists, civil protection, emergency situation.

Differential-diagnostic criteria of active ulcerative colitis and irritable bowel syndrome

The authors conducted a comparative analysis of clinical, laboratory and endoscopic data of 80 patients with ulcerative colitis (UC) of the 1st, 2nd, 3rd degrees of activity and 82 patients with irritable bowel syndrome (IBS) to determine the possible differential-diagnostic criteria of these diseases. It has been found that UC of the 1st, 2nd, 3rd degrees of activity develops with equal frequency among men and women, but IBS develops more often in women. The average age of patients with UC [the 1st degree of activity – (49.1±1.8) years, the 2nd degree of activity – (49.2±1.9) years, the 3rd degree of activity – (49.4±2.5) years] is higher compared to the average age of patients with IBS [(38.4±1.2) years]. UC of the 1st, 2nd, 3rd degrees of activity more often develops in patients after 40 years, while IBS in patients at the age of 18 till 40 years. Pain along the intestine occurs with equal frequency in patients with UC of the 2nd and 3rd degrees of activity. Stool disorders occur with equal frequency in patients with UC of the 1st, 2nd, 3rd degrees of activity and IBS. In a clinical blood test with the same frequency diagnose anemia and increased erythrocyte sedimentation rate in patients with UC of the 2nd and 3rd degrees of activity. Increased level of fecal calprotectin is documented with equal frequency in patients with UC of the 1st, 2nd, 3rd degrees of activity. Bleeding in the large intestine is a characteristic endoscopic finding for patients with UC of the 3rd degree of activity. Erosive-ulcerative changes in the large intestine on endoscopic examination are found with equal frequency in patients with UC of the 1st, 2nd, 3rd degrees of activity. The comparative analysis of clinical, laboratory and endoscopic data in most cases did not allow to identify the clear differential-diagnostic criteria for different degrees of activity of UC, UC and IBS. The data obtained by the authors update the conduct of a comprehensive morphological study, which would identify the specific and clear differential-diagnostic criteria of UC and IBS, which will certainly improve the treatment and diagnostic process among this category of patients and also diseases prognosis. Keywords: differential-diagnostic criteria, active ulcerative colitis, irritable bowel syndrome.

Features of pathomorphosis of gunshot wounds of the lungs

The article analyzes the results of pathomorphological changes of the lungs in the period from 1 day to 1.5 years after receiving a gunshot wound after a gunshot wound to the lungs. The features of the pathomorphosis of modern gunshot wounds of the lungs were determined in the dynamics to identify the optimal surgical tactics. It is found that impaired hemodynamics under the influence of firearms leads to the development of intoxication as a result of necrotic changes in the areola and to thrombosis with obstruction and vascular stenosis, and entails a cascade of local disorders of lung structure and function and as a consequence of pulmonary heart failure. The obtained morphological results of healing of gunshot wounds in the dynamics necessitate the search for new and optimization of existing methods of treatment of persons with gunshot wounds of the lungs in order to primarily optimize the preserved tissues. Keywords: morphological examinations, lungs, gunshot wound.

Evaluation of the effectiveness of the method of prevention and treatment of complications after the tooth removal surgery according to orthodontic indications

The study was performed on 59 orthodontic patients who underwent tooth extraction surgery. In 30 of them (the main group) the drug complex was used, and in 29 (comparison group) the tooth extraction operation was performed without any additional actions. Pharmacological correction included vitamin-mineral complex, immunomodulator, probiotic chewing pills "BioGaya ProDentis" for 1 month. Examinations of children took place before the start of medication and after tooth extraction surgery for 3–4 and 6–7 days. The level of lysozyme activity in the oral fluid of children was determined according to the method of G. Gorin in the modification of A.P. Levitsky and O.O. Zhigina, the content of sIgA, IgA, IgG – by simple radial immunodiffusion, the concentration of IL-1β and IL-4 – by enzyme-linked immunosorbent assay. A microbiological study was also performed. The use of pharmacological complex for the prevention and treatment of post-extraction complications in orthodontic patients for microbial, immune and antioxidant background correction showed a pronounced clinical effect, manifested by the absence of any complications from maxillofacial tissues and probably lower intensity of such clinical signs, redness and swelling. The microbiocenosis of the oral cavity of children who used our proposed means during the surgical stage of orthodontic treatment, showed quantitative and qualitative changes, which was a prerequisite for the normal course of the wound process. Examination of the oral fluid of children who underwent orthodontic surgery on the background of pharmacological correction, showed the restoration of its protective functions (increased lysozyme activity, sIgA levels, IL-4 concentration), which resulted in a postoperative period without complications. Keywords: tooth extraction surgery, complications, microbiocenosis, protective mechanisms of the oral cavity.

Features of affective disorders correction in patients with epilepsy (therapy, rehabilitation, prevention)

For many decades, epilepsy has remained a serious medical and social problem that requires constant attention not only from neurologists, psychiatrists, but also from medical psychologists and social workers. The priority in the treatment of epilepsy is not only to prevent seizures, but also to help the patient maintain social functioning and restore quality of life. Achieving drug remission of epileptic seizures is only part of the management of the disease, it is necessary to help restore the patient's psychosocial adaptation and form a correct understanding of their disease and related limitations in daily functioning. A comprehensive examination which involved 65 patients with epilepsy of both sexes aged 18–40 years was conducted in compliance with the principles of bioethics and medical deontology. The mean age of the subjects ranged from (34.0±1.6) years, duration of the disease in patients did not exceed 10 years. All subjects had disorders of the emotional sphere of non-psychotic level, which were recorded in the interictal period of the disease. Selected comprehensive system of correction of affective disorders in patients with epilepsy helped to achieve following results, especially: reduction of anxiety and depressive disorders (73.5 %), reducing the level of motor and ideational inhibition (65.2 %), reducing the intensity and duration of depressive affect (72.5 %), restoration of interest in activities that previously interested patients (69.5 %), improvement of psychosocial adaptation (81.3 %), managed to achieve the transition of maladaptive types of attitudes to the disease to adaptive (66.5 %) and improve quality of life (83.2 %). A study of affective disorders in patients with epilepsy allowed us to make following conclusions: epilepsy is often combined with affective disorders. Depressive disorders are more common among all affective disorders. Epilepsy and affective disorders interact with each other and complicate clinical prognosis. Keywords: epilepsy, affective disorders, rehabilitation, psychoeducation.

Ultrasound characteristics of the internal genital organs in adolescent girls with gynecological and extragenital pathologies born with low or high body weight

We studied the effect of birth weight on ultrasound parameters of the uterus and ovaries in adolescent girls with gynecological pathology. 65 adolescent girls aged from 10 to 18 years old, who were treated at the surgical department № 4 of the Regional Child Clinical Department, were examined. Study groups were formed according to data relating to gestational weight in terms of low or overweight. The differences in ultrasound scanning of the pelvic organs between the studied groups were revealed. So, with the syndrome of intrauterine growth retardation of the fetus, a lag in ultrasound indicators develops in the postnatal period, and with macrosomia, on the contrary, a tendency to an increase in the size of the uterus and ovaries is revealed. The revealed changes can serve as prognostic criteria in diagnosing the risk of developing disorders of puberty during ultrasound scanning of the internal genital organs of adolescent girls, depending on the body weight at birth. Keywords: epilepsy, affective disorders, rehabilitation, psychoeducation.

Clinical-ultrasound and clinical-morphological characteristics of adnexal torsion in girls and adolescents

Clinical-ultrasound and clinical-morphological characteristics of adnexal torsion to the improvement of early diagnosis and development of optimal ways of organ-preserving surgical tactics of treatment have been determined. An analysis was carried out of 71 patients with adnexal torsion (group 1– 30 girls of 2–12 years, group 2 – 41 adolescents of 13–17 years). The main clinical signs of adnexal torsion were nonspecific and similar to the well-known clinic of acute abdomen. Ultrasound examination with color doppler mapping (CDM) allowed to suspect adnexal torsion in 44 (62 %) patients. The main echographic features of adnexal torsion were: ovarian enlargement, non-typical location and a change in the structure of ovary, the presence of a free liquid in the cavity of a small pelvis or in the abdominal cavity, «a symptom of springs» (a twisted vascular leg), a decrease or absence of blood flow in CDM. The torsion of intact uterine appendages is installed in 29 patients (twice as often in group 1). In 42 cases were detected the torsion of the uterine appendages, compromised by the presence of tumors and tumor-like formations (twice as often in group 2). In both groups, 36 (50.7 %) organ-preserving and 35 (49.3 %) radical operations were carried out. According to the results of morphological examination of the removed tissues, the following data were obtained: follicular cysts – 15, paratubal cysts – 8, corpus luteum cysts – 8, teratomas – 5, serous cystadenomas – 2, mucinous cystadenoma – 1, paraovarian cysts – 3. Differential diagnosis of adnexal torsion in girls and adolescents should include a thorough collection of anamnestic data, taking into account the features of the clinical course of the disease, the results of a comprehensive examination with an assessment of ultrasound data from CDM, computer and magnetic resonance imaging, which will contribute to the advanced adequate selection of tactics of urgent gynecological intervention. The method of choice for the treatment of adnexal torsion is a minimally invasive surgical intervention – a laparoscopy with organ-preserving operations. Keywords: adnexal torsion, girls, ultrasound and morphological characteristics.