RISK PREDICTION FOR ARRHYTHMIA IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

The aim: To evaluate P-wave dispersion (PwD), as an independent predictor of atrial fibrillation, corrected QT interval dispersion (cQTD), the noninvasive marker of ventricular arrhythmia and sudden cardiac death, investigate the atrial electromechanical delay in patients with COPD and assess their relation with the severity of the disease. Materials and methods: We prospectively enrolled consecutive patients with newly diagnosed COPD (n = 53, age 41.2 ± 6.8 years), compared with an age-matched healthy control group (n = 51, age 40.9 ± 6.5 years). A standard 12-lead electrocardiogram of each patient was analyzed for PwD and сQTD. Atrial electromechanical delay was analyzed by echocardiographic tissue Doppler imaging. The difference between PAs-PAl, PAs-PAt, and PAl-PAt were defined as left intra-atrial, right intra-atrial, and interatrial electromechanical delays (EMD), respectively. Results: PwD was higher in COPD patients than in control subjects (39.47 ± 3.12 ms vs. 30.29 ± 3.17 ms, p < 0.05). In comparison between control group and COPD subgroups (mild, moderate and severe), there was a statistically significant difference among these free groups in terms of PwD. Subgroup analyses showed that this difference was mainly due to patients with severe COPD. Regarding cQTD, there was a statistically significant increase in COPD patients 57.92 ± 3.43 ms vs 41.03 ± 5.21 ms, p < 0.05 respectively. PAs, PAl and PAt durations, right intra-atrial and interatrial EMD were also significantly longer in COPD patients (p < 0.05). Furthermore, there were significant negative correlations between FEV1 and PwD (r = – 0.46, p < 0.05), right intra-atrial (r = – 0.39 ms, p < 0.05), interatrial EMD ( r = – 0.35 ms, p < 0.05) and cQTD (r = – 0.32, p < 0.05). Conclusions: Atrial conduction time, such as inter- and intra-atrial EMD intervals, PwD and cQTD were longer than in healthy controls and correlated with the severity of COPD. These parameters offer a non-invasive and cost-effective assessment method for detecting patients at high risk of arrhythmia. Nevertheless, further prospective investigations on this issue are required.

EOSINOPHILIC GASTRITIS IN CHILDREN: MORPHOLOGICAL AND IMMUNOHISTOCHEMICAL DIAGNOSTIC CRITERIA

The aim: To study peculiarities of morphological and immunohistochemical changes of stomach’s mucosa in eosinophilic gastritis in children Materials and methods: 64.1±6.0% patients with eosinophilic gastritis and 35.9±6.0% patients with lymphocytic gastritis participated in our investigation. In order to verify the diagnosis morphological and immunohistochemical diagnostics of the stomach’s mucosa was performed in all children. To assess morphological changes in tissues the specimens were colored with hematoxylin, eosin and picrofuchsin by van Gieson’s. Indirect streptavidin-peroxydase staining method was used for immunohistochemical investigation and the following indexes were assessed: proliferating cell nuclear antigen – PCNA, Bcl – 2, Вax, Collagen Type ІV, TGFβ and NF-κβ. Results: Comparative analysis of morphologic investigation has demonstrated that eosinophilic gastritis is characterized by fibrosis and fibroblasts proliferation into basal and superficial parts of mucosa’s lamina propria, multiple hemorrhages, thrombosis and erosions on the background of eosinophilic infiltration. Immunohistochemical indexes of cellular restoration in eosinophilic gastritis are characterized by increased proliferative activity and decreased indexes of proapoptotic and antiapoptotic activity. Prevalence of the reaction with the use of monoclonal antibodies to Collagen Type IV in majority of children with eosinophilic gastritis was characterized by separate fragmented foci in basal membranes of superficial epithelium. Remarkable TGFβ immune coloration was detected in majority of children on the background of fibrosis and eosinophilic infiltration of lamina propria. NF-κβ expression in epitheliocytes’ cytoplasm and nuclei was uneven. Homogenous remarkable coloration was detected in majority of patients with lymphocytic infiltration of mucosa. Conclusions: Eosinophilic gastritis course in children is characterized by remarkable inflammation, decreased regeneration of the mucosa, impairment of cellular restoration which is prognostic index of fibrous remodeling development.

THE ROLE OF CIRCADIAN REGULATION OF GHRELIN LEVELS IN PARKINSON’S DISEASE (LITERATURE REVIEW)

The paper is aimed at the analysis of the role of the circadian regulation of ghrelin levels in patients with Parkinson’s disease. Based on the literature data, patients with Parkinson’s disease have clinical fluctuations in the symptoms of the disease, manifested by the diurnal changes in motor activity, autonomic functions, sleep-wake cycle, visual function, and the efficacy of dopaminergic therapy. Biological rhythms are controlled by central and peripheral oscillators which links with dopaminergic neurotransmission – core of the pathogenesis of Parkinson`s disease. Circadian system is altered in Parkinson`s disease due to that ghrelin fluctuations may be changed. Ghrelin is potential food-entrainable oscillator because it is linked with clock genes expression. In Parkinson`s disease this hormone may induce eating behavior changing and as a result metabolic disorder. The “hunger hormone” ghrelin can be a biomarker of the Parkinson’s disease, and the study of its role in the pathogenesis, as well as its dependence on the period of the day, intake of levodopa medications to improve the effectiveness of treatment is promising.

FUNCTIONAL DISORDERSOF THE SALIVARY GLANDS IN PATIENTS WITH COMPRESSION AND DISLOCATION DYSFUNCTION OF THE TEMPOROMANDIBULAR JOINT AND THEIR CORRECTION

The aim: Is to assess the functional state of parotid glands and general secretion in patients with compression, dislocation dysfunction of TMJ, to correct the revealed disorders. Materials and methods: We examined 46 patients with dysfunction of TMJ. Examination included TMJ zonography and salivary glands sonography. We studied the general and parotid secretion, transparency, viscosity, pH of the oral fluid and the secretions of the parotid glands before and after treatment. The treatment of dysfunction and hyposialosis included the repositioning of the articular heads of the lower jaw in the correct anatomical position, the use of a repositioning plate on the posterior teeth at the compression side of the articular head, bougienage of the duct of the parotid gland, administration of 10% magnesium-mineral solution of bischofite into the gland. Results: In patients with TMJ dysfunction, a significant decrease in the oral fluid content was noted before treatment. The saliva transparency was reduced, the viscosity was increased, the pH was slightly acidic. A study, which was carried out a month after completion of the course of treatment showed that all the studied parameters corresponded to those in healthy individuals. Conclusions: The study confirmed that in compression and dislocation dysfunction of TMJ, there are disorders of the functional state of the salivary glands.

DEVELOPMENT OF CONTINUOUS ANTI-SOLVENT RECRYSTALLIZATION METHOD TO PRODUCE CEFTRIAXONE SODIUM NANO CRYSTALS INJECTION USING CERAMIC FILTRATION

The aim: In this work we developed a method of continuous recrystallization to meet industrial requirements. Materials and methods: Continuous recrystallization method was investigated using porous ceramic filter for water purification with pour size less than 1 μm, that ensures high mixing rate of ethanol and water. Results and conclusions: The results of experiments using crystallization through ceramic filter, gives superior products in particle size, and produced needle shaped ceftriaxone crystals form, that showed significant improvement in dissolution time and obtained ceftriaxone sodium powder to be reconstituted in injectable formula that give clear solution without insoluble microparticles.

EXACT LASER FLUENCE FOR SUCCESSFUL TREATMENT OF FACE AND LEG TELANGIECTASIA

The aim: Facial and leg telangiectasia are usual cosmetic concern for females who have different skin phototypes and ages. Until now, the various treatments for these problem have frequently failed or led to unwanted side-effects. Based on approved pre-calculated doses, the present study highlights the clinical effects and safety of treatment after using the exact laser parameters from 1064-nm Nd: YAG laser. Materials and methods: Twenty people with facial and leg telangiectasia underwent a single laser treatment, based on pre-calculated laser parameters for each case. Results: All subjects showed visible improvement, with 95–100% clearance of face telangiectasia directly after the first treatment, and 50–100% clearance of the lower extremity vessels after one to three days; with minimal side-effects. Conclusions: Treatment of facial and leg telangiectasia by using true, exact, and mathematically pre-calculated parameters of long pulse 1064 nm Nd: YAG laser was an effective and safe procedure of clearing face and leg telangiectasia.

PECULIARITY OF ADAPTATION OF BABIES ARE BORN PREMATURELY FROM MOTHERS WITH UNDIFFERENTIATED CONNECTIVE TISSUE DYSPLASIA

The aim: To evaluate the peculiarity of clinical manifestations of neonatal respiratory distress syndrome (NRDS) in deeply premature infants from mothers with phenotypic markers of undifferentiated connective tissue dysplasia (UCTD). Materials and methods: The study represent the results of a retrospective clinical and statistical analysis of 268 premature birth report card and newborn report sheet. .The main (1 group) included 50 pregnants with obvious phenotypic markers of UCTD, the comparison group (group 2) consisted of 50 pregnant women without phenotypic markers of UDCTD. Results: According to the study, in 12 (24%) pregnant women of the main group at the time of admission to the clinic had contractions,which required specific therapy. Cervical cerclage was performed in 38 (76%) patients of the main group due to the presence of cervical insufficiency (CI). In these cases, the severity of the CI on the Steinber scale was 7.2 &#177; 0.4 points in the main group against 4.4 &#177; 0.2 points in the comparison group (p &#60;0.05). Group I patients were more likely to have complications of labor such as:premature rupture of membranes, uterine contraction abnormalities and fetal distress, which required in most cases cesarean delivery (7% and 2%), respectively (p &#60;0.05). The incidence of neonatal complications requiring respiratory support was 67% in group I and 48% in group II. According to our observations, the clinical manifestations of bronchopulmonary dysplasia were twice as high in infants of the main group (66%) against (44%) of the comparison group (p &#60;0.05). Conclusions:1.Neonatal respiratory distress syndrome in premature infants is more often associated from mothers with UDCTD. 2. The high importance of steroid prophylaxis of NRDS and antioxidant therapy in reducing the frequency of mechanical ventilation and the development of bronchopulmonary pathology, especially in infants from mothers with UDCTD syndrome, has been proven. 3. The possibility of diagnosing disorders of functional maturation of the lungs in the fetal period using a non-invasive method of ultrasonography has been confirmed.

THE EFFECTIVENESS OF COMPLEX THERAPY WITH THE INCLUSION OF THE URSODEOXYCHOLIC ACID IN PATIENTS WITH NON-ALCOHOLIC FATTY LIVER DISEASE IN COMBINATION WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

The aim: Was increase the effectiveness of treatment in patients with non-alcoholic fatty liver disease (NAFLD) comorbid with chronic obstructive pulmonary disease (COPD) by using ursodeoxycholic acid (UDCA) in combination with ademethionine. Materials and methods: Under observation was 98 patients with a diagnosis of NAFLD and COPD group II or their combination. Patients were divided into 3 groups: 1 (n = 36) – COPD + NASH – in addition to standard COPD therapy received UDCA 15 mg / kg / day – 6 months and ademethionine 1000 mg IV once a day for 10 days, followed by oral administration of 500 mg 2 times per day – 20 days, and group 2 (n = 32) – COPD + hepatic steatosis – in addition to standard therapy – UDCA 15 mg / kg / day – 6 months. Group 3 (n = 30) – COPD received standard therapy for COPD. Results: UDCA with ademethionine on the background of standard COPD therapy reduces the clinical manifestations of NAFLD and normalizes liver function. The combination of UDCA with ademethionine not only has a positive effect on the course of NAFLD, but also reduces the intensity of dyspnea, systemic inflammation, improves the external respiration function and reduces anxiety and depression. Patients receiving UDCA + ademethionine for 6 months of follow-up had no exacerbations of COPD. Conclusions: UDCA in combination with ademethionine in COPD courses have a positive effect on the course of NAFLD, and also reduces the intensity of dyspnea, improves the external respiratory function and reduces the frequency of COPD hospitalization.

PERINATAL ASPECTS OF PREGNANCY AND CHILDBIRTH ON THE BACKGROUND OF VITAMIN D LACK IN PREGNANT WOMEN

The aim: To study the features of the course of gestation and perinatal outcomes of delivery in women with vitamin D lack. Materials and methods: The article presents the results of studies of the characteristics of the course of pregnancy and delivery outcomes in 50 patients with vitamin D lack compared with a group of 50 somatically healthy pregnant women with normal level of 25 (OH) D. In order to establish a lack of vitamin D in pregnant women in the 10-12, 20-22, 30-32 weeks of gestation electrochemiluminiscence method by using a test system EURIMMUN (Germany) in the blood serum level of 25-hydroxycalciferol (25 (OH) D) in pregnant women. Results: When analyzing the structure of complications in women with vitamin D lack during pregnancy and childbirth we found out that risk of premature birth and premature births dominated among all the complications, respectively (58.0% and 36.0%) against (12.0% and 16.0%), p <0.05. Vitamin D lack in pregnant women is often associated with a wide range of obstetric and perinatal complications, namely: preeclampsia, gestational diabetes, bacterial vaginosis , premature rupture of membranes, placental abruption, abnormal labor activity, fetal distress that required delivery by Caesarean section. Conclusions: An analysis of the course of pregnancy and childbirth in women of thematic groups proved the expediency of an individual approach to the therapy of obstetric pathology among women with vitamin D lack. Despite the level of 25 (OH) D in the blood serum of a pregnant woman of 30 ng / ml and below, it is advisable to prescribe vitamin D for prophylaxes and treatment of Vitamin D deficiency in mother and fetus.

MINERALIZATION OF TEETH ENAMEL AFTER ERUPTION

The aim: The paper was aimed at the study of the processes of mineralization of the enamel of the permanent tooth after its eruption. Materials and methods: To study the structure of the enamel of permanent teeth has been carried out using light and electron microscopy. The study of the process of the development of the primordia of the permanent teeth involved 10 culled puppies of 30-40 days of age. Microscopic, electron microscopic, immunohistochemical methods of research have been used to study the processes of histogenesis. Results: The studies show that in the postnatal period, the formation of the crown, externally covered with cuticular epithelium, marks the formation of the primordium of the permanent tooth at the follicle stage. After eruption of a tooth, different parts of its crown have three individual structural and functional barriers to enamel biomineralization. The first one is provided by the cuticular epithelium of the pitted areas of the crown, which ensures filtering of the salivary fluid from the protein deposit in the form of a pellicle. The second barrier is defined on the lateral and cuspidate surfaces of the enamel, where the cuticle is erased or poorly expressed. The third structural and functional barrier of enamel biomineralization is located in the cervical portion of teeth of different classes. Conclusions: Different areas of the enamel in the tooth crown have specific filtration barriers, which can be distinguished as follows: pit-and-fissure-and-groove, cuspidateand-approximal, and cervical barriers. The cuticle is poorly expressed or totally absent on the cusps of the tooth crowns in contrast to pitted areas.