Features of the formation of certain bones of the skull at the early stages of human ontogenesis

The study of morphogenesis and embryotopography of skull bones is important not only in understanding the normal development of the human embryo but also will improve existing methods of invasive treatment and visualization of various pathologies of the central nervous system in children.The aim was to investigate the peculiarities of morphogenesis and topography of some skull bones during the early stages of human ontogenesis.Material and methods. We have studied 14 series of consecutive histological sections of human embryos and pre-fetuses aged 6 to 11 weeks of intrauterine development by using a set of topical morphological methods (anthropometry, morphometry, histology, three-dimensional reconstruction).Results. The frontal and parietal bones appear at the end of the embryonic period as mesenchymal rudiments that gradually expand upwards from primary points of ossification (starting from the basolateral parts of the head). During 8th week of IUD, the germ of the ectomeningeal capsule is detected in the form of a thin plate, close to the brain. At the beginning of the pre-fetal period, histological signs of membranous ossification are revealed; frontal and parietal bones develop from paired rudiments, which gradually fuse, which was accompanied by active angiogenesis.Conclusions. The primary ossification centers in frontal and parietal bones of the human embryo appear at the beginning of embryological period and develop by membranous type. Two ossification centers appear in frontal and parietal bones and they gradually merge. At the beginning of the prenatal period, the rudiment of a small wing of the sphenoid, spheno-ethmoidal cartilage and signs of merging of both ossification centers in the parietal bone are detected.

Analysis of factors influencing the formation of neurotic disorders in sudents of higher education institutions

The article analyzes the factors influencing the formation of non-psychotic mental disorders (NPD) in students of higher education institutions.The purpose of the study is to analyze the factors influencing the formation of non psychotic mental disorders in students of higher education.Material and methods. We analyzed the results of a survey of 1235 students. Methods applied: clinical, clinical, psychopathological, clinical, epidemiological, clinical and medical history, experimental psychological and statistical methods. Results. It has been found that living alone much increases the risk of NPD, namely 2.21 times. Notably, more married students have an NPD of 15.46% versus 3.53% of healthy students (p <0.05). Significantly more students with NPD rated family relationships as "calm, cold" 19.87% versus 4.14% of healthy students (p<0.05). So we can say that cold relationships in the family are factors in the formation of NPD. Significantly more students with NPD recognized interpersonal conflicts in the team as an urgent problem - 96 (30.28%), while only 165 (17.97%) healthy students noted this problem (p <0.05).Conclusions. The identified patterns must be taken into account when building programs for early diagnosis of NPD, as well as when planning individually targeted psychotherapeutic care.

Pharmaco-economic features of hospital treatment of acute community-acquired pneumonia in children

The goal. Тo analyze the features of treatment and medical expenses in children hospitalized for acute community-acquired pneumonia. Materials and methods. The study analyzed medical records and examined 51 children aged 2 to 17 months hospitalized for pneumonia. In patients studied clinical symptoms, severity, structure and duration of basic treatment measures, their cost. Results. The duration of inpatient treatment was 13.3±0.62 days with subsequent outpatient treatment and rehabilitation. Antibiotics, antipyretics, antihistamines, mucolytics and corticosteroid hormones were used in the treatment. The total cost of treatment for one case averaged 2346.9±145.7 hryvnias. The most expensive were the costs of antibiotics, and the cheapest - the antipyretics. Given the community-acquired nature of the process, the initial use of third- and fourth-generation cephalosporins was irrational and significantly increased the cost of treatment. Conclusions. The introduction of a new model of medicine focuses on the optimization of treatment tactics and the rational choice of antibiotics for acute community-acquired pneumonia. In antibacterial therapy is still inadequate, from a clinical and economic point of view, the choice of drugs. In the treatment of this disease, the role of pathogenetic therapy to restore the processes of mucociliary clearance and prevention of dysbiosis on the background of the use of antibiotics has increased.

Assessment of the state of the oxidant-antioxidant system and lipid peroxidation in patients with chronic pancreatitis combined with hypothyroidism

Changes in oxidative-antioxidant homeostasis is one of the pathogenetic links in the onset and progression of many nosologies, including chronic pancreatitis (CP) and hypothyroidism (HТ), however, data on the development of oxidative stress (OS) with a combination of CP and HP are insufficient, therefore, determining the role of these systems with a comorbid course of these pathologies is an urgent issue of our time.The aim of the work is to study the state of the oxidative and antioxidant system in patients with CP and CP combined with HT.Material and methods. 96 people were examined, including 26 patients with chronic pancreatitis (group 1), 24 patients with hypothyroidism (group 2), 26 patients with chronic pancreatitis on the background of hypothyroidism (group 3), 20 almost healthy individuals (group 4). Evaluation of the oxidative-antioxidant system and lipid peroxidation was assessed by determining the content of malonic aldehyde in blood plasma (MA pl.) And erythrocytes (MA er.), The level of reduced glutathione, glutathione peroxidase (GP) and glutathione-S-trans-ion (GT). Enzyme activity was calculated per 1 g of hemoglobin (HB).Research results. The analysis of the obtained results revealed clear patterns of changes in the state of the oxidative-antioxidant system and lipid peroxidation in patients with chronic pancreatitis on the background of hypothyroidism. Namely, violation of lipid peroxidation in patients with comorbid pathology, accompanied by an increase in the content of MA er. by 44.87% and the content of MA in blood plasma by 46.42%; oxidative-antioxidant system: decrease in HF in the blood by 51,61%, combined of a compensatory increase in BP - by 48.03% and HT - by 34.76%.Conclusion. Under the conditions of comorbidity of CP and HT, there is a violation of the oxidative-antioxidant system and the state of lipid peroxidation, which is characterized by a significant increase in MA in erythrocytes and MA in plasma against a decrease in glutathione and which complicates the course of the underlying disease, its diagnosis and treatment.

Disorders of lipid metabolism and lipid transport system in women with unstable angina in the dependence on smoking: pathogenetic connections and development risks

The aim of the study. To study the effect of smoking on lipid metabolism, lipid transport system and systemic inflammation, to find out their correlations and the risks of unstable angina in women, depending on the habit of smoking.Material and methods. 225 women were examined: 150 women - patients with unstable angina and 75 healthy women. The level of total cholesterol, low and high-density lipoprotein cholesterol, triglycerides, apolipoproteins A1 (ApoA1) and B (ApoB), C-reactive protein, fibrinogen were determined in all subjects. Multifactor correlation-regression analysis was performed using Fisher's test. Statistical processing of the results was performed using the applications "Microsoft Office Excel 2016" and "Statistics ver. 10.Results. The relative risk of developing unstable angina in patients with a smoking habit is most often associated with atherogenic dyslipidemia (total cholesterol > 4 mmol, OR = 12.02, SI = 8.12-16.32; low-density lipoprotein cholesterol > 1.8 mmol / l, OR = 9,32, SI = 6,13-12,56, high-density lipoprotein cholesterol <1,2 mmol / l, OR = 3,91, SI = 2,12-5,45, the ratio of apolipoproteins ApoV / ApoA1> 0.85, OR = 2.69, SI = 1.15-4.21) and the highest activity of systemic inflammation (C-reactive protein >3 mg / l, OR = 3.62, SI = 2.15- 4.56). The risk of developing unstable angina associated with these indicators is 1.5-2 times higher in women with a smoking habit than in women who have never smoked. Significant direct correlations of high and medium strength between the severity of systemic inflammation, disorders of the lipid transport system (increase in the ratio of ApoB / ApoA1 and decrease in the level of ApoA1), in patients with unstable angina in women smokers.Conclusions. Smoking is one of the most aggressive factors of unstable angina in women, which contributes to the emergence and progression of other important risk factors and leads to disorders of lipid metabolism, lipid transport system, systemic inflammation and increased chances of unstable angina.

Immunosupressive activity of opportunist pathogens of the infectious-inflammatory process in the urinary tract of men with calculous pyelonephritis

Objective - identification of pathogens of the infectious-inflammatory process of the urinary tract in men with calculous pyelonephritis, antilysozyme, anticomplementary, anti-immunoglobulin activity and inhibitory effect on the phagocytic activity of peripheral blood neutrophils.Material and methods. 34 strains of opportunistic taxa were isolated and identified by bacteriological method from 30 sick men aged 31 to 65 years (mean age 48.8 ± 4.27 years). These bacteria have antilysozyme, anti-complementary and anti-immunoglobulin activity, as well as the suppressive effect of supernatants of cultures of calculous pyelonephritis pathogens on the phagocytic activity of neutrophils in the peripheral blood of patients. The determination of the anti-complementary activity of bacteria was carried out using the principle, which includes testing the protective action of bacteria and their metabolic products against the growth of an indicator strain in the presence of a bactericidal substance (complement of blood serum). The antilysozyme activity of pathogens was investigated by a photometric method. Anti-immunoglobulin activity was studied by the method described in the work of I.S. Gaidash et al. Results. The majority of 27 (79.41%) isolated strains of Enterobacteriaceae (84%) and facultative anaerobic and aerobic gram-positive cocci (E. faecalis, S.saprophyticus) (66.67%) exhibit antilysozyme activity of varying degrees. The highest antilysozyme activity was found in the isolated strains of K. pneumoniae, 8.14% lower – in E. coli. Most (64.71%) of isolated strains of Enterobacteriaceae (68%) and gram-positive cocci (55.56%) from the urinary tract of men with calculous pyelonephritis exhibit anti-complementary activity. All isolated and identified taxa exhibit inhibitory activity against immunoglobulins of the main classes: Ig M, Ig G, and Ig A. K.pneumoniae inhibits immunoglobulins of all major classes, the concentration of Ig M decreases under the influence of this taxon by 22.36%, Ig G - by 26.88% and Ig A - by 19.61%.Conclusions. Opportunistic pathogens (E. coli, K. pneumoniae, P. mirabilis, E. cloaceae, S. marcescens, E. faecalis, S. saprophyticus) of the infectious-inflammatory process of the urinary tract in men with calculous pyelonephritis exhibit different levels of antilysozyme, anti-complementary activity; reduce the function of immunoglobulins Ig G (by 21.60%), Ig A (by 21.49%) and Ig M (by 14.30%), inhibit the phagocytic activity of neutrophilsby 15.74%, their capturing ability- by 22.59%.

Optimized treatment of patients with alcoholic steatohepatitis taking into account comorbid anaemic conditions and H.pylori contamination

The prospective study of patients with alcoholic steatohepatitis (ASH) showed that 40 % of patients with ASH were diagnosed with anaemic conditions (AC), among which vitamin B12-deficiency anaemia was registered - in 17.5% of cases, anaemia of chronic disease (ACD) – in 10.0% of cases and hemolytic anemia (HA) - in 12.5% of cases. In patients with SH of mixed (including alcoholic) etiology AC was found in 32.0%: vitamin B12 - deficient - in 16.0%, ACD - in 8.0% and hemolytic - in 8.0 % of patients. In patients with ASH, H. pylori contamination was present in 32 (80.0%) individuals, including 100% of patients with B12-deficient anaemia. Among patients with SH of mixed (including alcoholic) etiology, H. pylori was detected in 100.0% of people with AS. The use of Hepadif in the complex therapy of ASH contributed to the elimination or reduction of the intensity of the main clinical syndromes (astheno-vegetative, dyspeptic, cholestatic, hepato-, splenomegaly, hepatic steatosis) and biochemical syndromes (mesenchymal-inflammatory cholestasis, hepatocellular insufficiency), in the range of 1.3-4.3 times (p <0.05), as well as higher efficiency of treatment of patients with ASH with anaemic syndrome in 6.0 times (p <0.05). The efficiency of eradication of H. pylori in the main and control groups accompanied by the use of the 3-component programme of the first line according to the stool test was the same (85.7% and 84.2% (p> 0.05), respectively), but in 57.9 % of patients in the control group, the symptoms of dyspepsia increased or appeared on the background of antibacterial therapy, while no side effects of the drug were found during the study in the main group.

Prevention of pregnancy complications and delivery at low placentation

Objective is to evaluate the effectiveness of the developed method of preventing pregnancy complications with low placentation from early gestation.Material and methods. We have examined 119 pregnant women with low placentation. This diagnosis was made at 6-7 weeks of gestation on the basis of echographic research. The main group consisted of 64 pregnant women with low chorionic location who underwent prevention from pregnancy complications in early gestation by the complex of medicines developed by us and a control group -55 women with low placentation who had not undergone complications prophylaxis from early gestational periods. The prophylactic complex included Luteina, ginkgo biloba extract, folio and biolectra. To assess the effectiveness of the therapy in the study groups, we analyzed the course of pregnancy in early and late gestation, as well as complications of pregnancy and delivery.Results. The frequency of pregnancy pathologies in the main group, where the prevention of pregnancy complications from early gestation with low placentation, was significantly lower than in the control group. According to the study, the risk of abortion with bleeding and without bleeding in the first and second trimesters significantly decreased in the main group of pregnant women (p<0.05). In the third trimester of gestation in the group where the prevention of pregnancy complications was significantly reduced, the incidence of preterm birth, premature detachment of the low-lying placenta, fetoplacental dysfunction, fetal developmental delay syndrome and fetal distress during pregnancy (p<0.05). Also, in the main group there was a lower percentage of premature births and births that ended by cesarean section.Conclusions. 1. The place of attachment of the placenta in the uterine cavity is closely related to its function, the development of placental dysfunction, pregnancy and delivery. 2. Studies have shown the effectiveness of our proposed comprehensive drug prevention of complications of pregnancy with low placentation, which in turn has led to improved pregnancy and delivery and has become an effective means of preventing placental dysfunction.

The influence of melatonin on stress-induced ultramicroscopic changes of the neurons of the supraoptic nuclei of the rat hypothalamus

The aim: to study the effect of melatonin on the ultrastructural state of the supraoptic nuclei of the hypothalamus of rats under immobilization stress.Materials and methods. The experiments were performed on non-linear male white rats weighing 200-220 g. The animals were divided into 3 study series, in each of which the biomaterial was collected at 2 p.m. and at 2 a.m. using electron microscopic method. Long immobilization stress was simulated by keeping rats in special plastic penal cages for 6 hours daily for 7 consecutive days. Melatonin (Sigma, USA, 99.5% purification degree) at a dose of 0.5 mg/kg, in 1.0 ml of solvent (0.9% ethanol solution on physiologic saline) was injected daily, intraperitoneally.Results. When the animals were kept under the standard light regime, the ultrastructural organization of the hypothalamic nuclei at 2 p.m. indicated their low functional activity in comparison with the studies carried out at 2 a.m. Prolonged exposure of rats to immobilization stress was reflected in a significant rearrangement of the ultrastructural organization of supraoptic nuclei of the hypothalamus. The established changes can be considered as a manifestation of neurosecretory activity suppression, a decrease in neurosecretase production by hypothalamic neurons. Melatonin injections against the background of immobilization stress resulted in relative normalization of ultrastructural state of neurons of supraoptic nuclei of the hypothalamus of animals. In particular, studies at 2 a.m. revealed light neurosecretory cells containing a large nucleus, it was pyknotically altered. Karyolema invaginations, euchromatin dominance in the nucleus were observed. Heterogeneous changes were observed on the part of mitochondria. Enlarged tubules of granular endoplasmic reticulum were seen. At the same time, a small number of ribosomes and few hormonal granules were noticeable in neuroplasm. The mentioned picture of neurosecretory cells reflects a relative improvement in their electron microscopic state, which is evidenced by the appearance of neurosecretory granules. However, the ultrastructure of other organelles of the studied neurons indicates a depleted state caused by prolonged immobilization.Conclusions. 1. In animals under standard photoperiod conditions, the structural organization of supraoptic neurons of the hypothalamic nuclei during the nighttime of the experiment reflects the intensity of intracellular synthesizing processes (at 2 a.m.). A decrease in the activity of the structures under study is noted during the daytime. 2. Under immobilization stress, the ultrastructural organization of the above neurons indicates a pronounced disturbance of reactive nature with the signs of decreased functional ability of the structures and the phenomena of edema and destruction during the period of observation. 3. Melatonin injections against the background of immobilization stress led to a relative improvement in the ultrastructural state of the animals’ hypothalamic nuclei neurons, which is evidenced by the appearance of neurosecretory granules. However, the ultrastructure of other organelles of the studied neurons indicated a depleted state caused by prolonged immobilization.

Dual antiplatelet therapy of patients with acute myocardial infarction after coronary artery stenting

Objective: to study the effectiveness of dual antiplatelet therapy (DAPT) in patients with myocardial infarction (MI) after emergency percutaneous coronary intervention (PCI).Material and methods. The study involved 20 patients who underwent PCI at the Department of Interventional Cardiology in Khust district hospital, Zakarpattia region. After PCI and coronary artery stenting during 12 months in addition to the complex therapy (Metoprolol, Rosuvastatin, Ramipril, Pantoprazole) the patients received dual antiplatelet therapy (DAPT) with acetylsalicylic acid and Ticagrelor (Brilinta). A clinical course of the disease was analyzed. Prothrombin time, prothrombin index, international normalized ratio (INR), activity of the liver transaminases, and total bilirubin concentration in the blood serum were determined. Results. During the period of 12 months after PCI for acute transmural MI and coronary artery stenting, re-admissions for exacerbation of the underlying disease were not registered. One patient developed a side effect after DAPT in the form of mild gastrointestinal bleeding. 12 months after DAPT, a reliable increase of prothrombin time from 12,77±0,18 sec. to 13,45±0,34 sec. (р<0,05) and international normalized ratio (INR) from 0,95±0,008 Un to 1,0±0,026 Un were registered. (р<0,05). Inconsiderable but reliable increase of alanine aminotransferase (ALT) activity from 14,4±1,11 Un/L to 16,67±1,25 Un/L was found (р<0,05).Conclusions1. Patients after percutaneous coronary intervention (PCI) and coronary artery stenting for acute transmural myocardial infarction (MI) are well tolerant to dual antiplatelet therapy (DAPT) with acetylsalicylic acid and Ticagrelor. For 12 months re-admissions for exacerbation of the underlying disease were not registered.2. Increase of prothrombin time values and international normalized ratio in patients with MI after PCI and DAPT is indicative of a decrease in blood coagulation activity.