IN VITRO STUDY OF PHYSICO-CHEMICAL PROPERTIES OF THE «BALANCED SALT SOLUTION − H2O» SYSTEM WITH THE PURPOSE OF DEVELOPMENT OF TREATMENT, REHABILITATION AND PREVENTIVE MEASURES IN OPHTHALMOLOGY

The research is devoted to the in vitro study of the behavior of the model system «irrigation balanced salt solution BSS − H2O» in order to further develop treatment, rehabilitation and prevention measures for patients with ophthalmic diseases. The aim of the investigation is the experimental determination and analysis of physico-chemical properties of irrigated balanced salt solution, the study of its behavior in the aquatic environment to model changes in the characteristics of intraocular fluid and further development of rehabilitation and preventive measures for ophthalmic patients. Materials and Methods. The study used methods of physico-chemical analysis, in particular, densimetry and viscosimetry of model systems containing BSS for intraocular use and double-distilled water in different volume ratios. The density of the system was determined pycnometrically (20.00 0С ± 0.05 0С; 101.3 kPa); the correction for weight loss of bodies in the air has been taken into account. Viscosity was measured under the same conditions with an Ostwald viscometer. Statistical analysis and evaluation of the reliability of the results were performed using such software products as MS Excel 2007, Google Spreadsheets, SPSS Statistics. Results. Approximate mathematical models of the dependences of density and kinematic and dynamic viscosity on the composition of the multicomponent system «BSS – H2O» were obtained with quite high coefficients of determination. Statistical significance and adequacy of model selection were tested by Student's criterion at a significance level of 5 %. To develop therapeutic, prophylactic and rehabilitation measures, mathematical models of kinematic and dynamic viscosity dependences on the density of the «BSS – H2O» system, measured under the same conditions, were built. The models also have high coefficients of determination. Conclusion. The in vitro physico-chemical analysis of the system «BSS – H2O», as well as the obtained approximate mathematical models can be used to predict possible changes in the characteristics of irrigated balanced salt solution during its long stay in the patient's eye.

CLINICAL AND ECONOMIC ASPECTS OF HORMONOTHERAPY ER (+) HER2 (–) BREAST CANCER (BC): FOCUS ON AROMATASE INHIBITORS (AI)

Aim. Analysis of clinical efficacy of AI for therapy ER (+) HER2 (–) BC, assortment and volume of their consumption in Ukraine in 2017–2020. Materials and methods. Analysis of the assortment and prices and consumption of AI for hormone therapy ER (+) HER2 (–) BC, available on the pharmaceutical market of Ukraine in 2017–2020. Results. A retrospective analysis of the assortment, prices and consumption of AI used for therapy ER (+) HER2 (–) BC, presented on the Ukrainian pharmaceutical market in 2017–2020, was carried out. AI were represented by 3 INNs: anastrozole (L02B G03), letrozole (L02B G04) and exemestane (L02B G06). Market prices in 2017 range from 460.5 to 4163.8; in 2018 – from 486.3 to 1849.0; in 2019 – from 308.7 to 1677.0; and in 2020 – from UAH 449.6 to UAH 2545.3. IA implemented in 2017 – 55,943, in 2018 – 81,284, in 2019 – 126,628, and in 2020 – 160,858.4 thousand packages. Conclusion. There is a clear tendency towards stabilization and even a decrease in prices for AI, if we compare the indicators of 2017 and 2020. There is a clear upward trend in consumption AI are implemented mainly of import production. The price picture for AI has changed somewhat due to the registration of drugs from the letrozole group in 2019-2020, and in 2020 – from the exemestane group.

The duration and specificity of the humoral immune response to SARS-CoV-2

Background. Our assumption that immunity after COVID-19 will persist has been fully confirmed in the researches already conducted. Our work is a continuation of research that demonstrates the results obtained 12 months of determining the humoral response in patients after COVID-19. Materials and methods. The research involved 42 individuals. All subjects had a positive PCR test for COVID-19. At certain intervals, from 40 to 240 days, individuals in the group were tested for IgG SARS-CoV-2. The last step was to check the level of IgG to the COVID-19 nucleocapsid and spike protein in the research group for 360 days from the onset of the disease. A private certified laboratory in Kyiv, the “DNA Laboratory”, was involved. Patients were tested for antibodies to COVID-19 by ELISA using serology COVID-19 test systems VitroTest (Ukraine). The immunological laboratory of the Institute of Pediatrics, Obstetrics and Gynecology was used in parallel for interlaboratory quality control. The results of the research coincided. Results. The level of class G immunoglobulins to nucleocapsid in the subjects has gradually decreased over 8 months. It is noteworthy that in the period from 40 to 150 days in all 42 patients (100 %) antibodies did not disappear. Decreasing of antibodies occurred between 150 and 240 days. However, the data obtained for 360 days significantly changed the picture. In a certain part of the subjects, who had low or even negative levels of antibodies for 8 months, as of 12 months, the level of immunoglobulin (Ig) class G again rose above the threshold value. Thus, we see that from the group of 42 people 92.8 % have positive antibodies to the nucleocapsid, and 7.2 %. Conclusions. The data obtained illustrate that in the study group within 12 months after SARS-CoV-2, the vast majority of individuals remain with specific antibodies to the nucleocapsid and spike-protein.

THE ISSUE OF TUMOR MARKERS AND THEIR INTERPRETATION

The aim of the article is to discuss the current state of informativeness of tumor markers and errors in their interpretation. A progress report is devoted to the analysis of approaches to the interpretation of the results of the clinical laboratory examination of the patient, based on the presence of tumor markers. Particular attention is paid to fundamental errors in making a diagnosis on the basis of tests for tumor markers.

USE OF SPICES AND SPICES AS NATURAL ANTIOXIDANTS AND ANTI-CARCINOGENIC FACTORS

Spices and condiments are natural biotechnological agents that exhibit therapeutic activity in the collection of free radicals formed due to oxidative stress, thereby exhibiting both antioxidant and anticancer effects. The aim of the article is a scientific-theoretical and experimental review of the use of spices and condiments as natural antioxidants and anticancer factors, their therapeutic effect on metabolic disorders and overweight.Materials and methods. During the work, an experimental study of the anti-inflammatory effect of a mixture of spices on metabolism in humans (men) with overweight, cardiovascular disease and metabolic disorders.Results and discussion. The study revealed a change in triglyceride levels between treatment groups, and an estimated 13 subjects gave a TG difference of (15 ± 32) mg / dL (mean ± SD) with 80 % potency (α = 0.05). Quantitative assessment of inflammatory responses was performed in 22 subjects because it was not possible to collect enough blood to perform the tests needed to assess inflammatory cytokine secretion and triglyceride levels.Study participants ate foods such as foods high in saturated fats and carbohydrates 1000 kcal, containing 33 % kcal saturated fats and 36% kcal carbohydrates without additional spices; food containing 2 g of a mixture of spices; food containing 6 g of spice mixture, with a washout period ≥ 3 days between days of intervention. The study shows that the percentage of monocytes increased significantly in circulation 240 minutes after eating food containing spices.The study found that the consumption of spices can reduce the negative effects of foods that contain significant levels of carbohydrates and fats in food. Conclusions. A diet containing a mixture of spices was developed to investigate the anti-inflammatory effect of spices in the context of food consumption, and for this purpose spices were chosen that are widely used for daily consumption in the human diet.

Features of imported falciparum malaria: the case report

The clinical case of imported falciparum malaria is described in the article. The diagnosis was confirmed on the 6-th day of the disease when cerebral presentations manifested. The course of the disease was severe and it was characterized by serious complications due to late diagnosis and starting of treatment: malaria coma, malaria alhid, acute respiratory distress syndrome, nozocomial pneumonia, acute renal failure, malaria hepatitis, severe hemolytic anemia. The patient recovered. Presentations of severe anemia progressed after plasmodium disappearance in the blood and persisted after discharge of patient from the hospital.

CALCIFICATION OF ARTERIES IN PATIENTS WITH ATHEROSCLEROSIS: CAUSES AND MECHANISMS OF DEVELOPMENT

The paper shows analogies between the mechanisms of calcification of arteries, various tissues and bone mineralization. In calcification the same mechanisms are involved, as at ossification of an organic matrix of a bone, including participation of stem cells. In the arteries and capillaries of various organs found polypotent precursors – mesenchymal stem cells, presumably responsible for the pathological mineralization of the arterial wall. Circulating in the blood and present in the intima of the human atheromatous aorta colony-forming stem cells of the stromal line of differentiation. Adventitia cells or pericytes are considered as a pluripotent mesenchymal reserve for replenishment of some cellular forms of connective tissue. Bone marrow stem cells of the stromal line of differentiation with the presence of pluripotent stromal cells in the blood and granulomas (plaques) and their transformation into bone tissue cells are involved in atherogenesis. Smooth muscle cells (SMCs) and myofibroblasts of the arterial wall adventitia have an osteoblast-like phenotype. Collagen and elastic fibers are involved in the calcification of blood vessels and soft tissues. Calcification of granulomas (plaques) accompanies their inflammatory morphogenesis, accompanied by the development of scar tissue. It often accompanies and completes the inflammation in them. This process is observed with the gradual replacement of the parenchyma of some organs with connective tissue. The mineral phase in bones and soft tissues, represented by calcium (Ca) and phosphate (P), contacts with nucleators - specific areas of collagen fibers. Non-collagen proteins are also involved in arterial calcification. With the progression of atherosclerosis and calcification of granulomas/plaques by cells present in the arterial wall, osteonectin is expressed. Osteopontin content is associated with Ca deposits in them; in particular, it correlates with the Ca level in the coronary arteries. In the processes of ossification and calcification, phosphatases play a certain role. In areas of calcification of granulomas/plaques, osteoprotegerin is found, which inhibits the activity of alkaline phosphatase in the aorta and prevents calcification of the media. Arterial wall calcification and inflammation are inhibited by fetuin-A and matrix γ-carboxyglutaric protein (MGP). The rate of bone formation and tissue calcification depends on the concentration of Ca and P in plasma and extracellular fluid. With their high concentration in the extracellular fluid, the mineral phase appears where it normally does not exist. Lipids are among the initiators of granuloma / plaque calcification in the arteries. The role of inflammation and necrosis in the calcification of the arteries is confirmed by experiments on animals with repeated intravenous injections of adrenaline, which causes focal necrosis of the middle membrane, which then undergoes calcification. In arterial walls, heart muscle, bone and cartilage tissue, osteonectin, osteocalcin, osteopontin, bone sialoprotein are often formed. In general, the mechanisms of arterial and soft tissue calcification are poorly understood. There are no effective remedies for calcification.

Correction of imbalance of essentialaminoacids of blood plasma in Patients with stableangina

Introduction. Ischemic heart disease is the leading nosology calunit in the structure of cardiovascular diseases interms of disability and mortality among the population of Ukraine. The purpose. To improve the treatment of patients with stable angina by studying the effect of L-arginine on the balance of essential amino acids in blood plasma. Material and methods. It was examined 85 patients with stable angina. They were divided into two groups: group Ipatients received antianginal basic therapy, group II patients received basic antianginal therapy and L-arginine. The amino acid spectrum of patients' blood plasma was studied by ion-exchange liquid column chromatography, using an automatic amino acid analyzer T-339 Microtechna (Czech Republic, Prague). Results and discussion. In patients with stable angina who received basic therapy and L-arginine, in contrast to patients who received only basic therapy, plasma levels of arginine became normalized, which probably contributes to the synthesis of NO. The level of valine, leucine and isoleucine, which provide the synthesis of acyl-CoA and succinyl-CoA, became also normalized.Conclusion. Administration of L-arginine to patients with stable angina together with antianginal therapy helps to correct plasma amino acid imbalances, which is likely to effectively affect the course of the disease and prognosis.

FEATURES OF THE COURSE AND TIMING OF DIAGNOSIS OF PLEUROPULMONARY COMPLICATIONS OF CORONAVIRUS INFECTION

Coronavirus infection in most cases is of the type of interstitial pneumonia. According to the literature, the most common complications are thrombotic complications of the lungs, myocardium, central nervous system, liver, and kidneys. There are only isolated reports of pleural complications. The aim. To study the features of the course and term of diagnosis of pleuropulmonary complications, specifying the possibilities of their prevention and exclusion of errors. Materials and methods. Under our supervision, there were 23 patients with various complications of pleuropulmonary character. Among these patients, there were 15 males, 8 – females. There were ten patients under the age of 50 and 13 over the age of 50. The interstitial background in all patients was interstitial changes in the lung parenchyma. Results and discussion. Deterioration of patients (increased temperature, shortness of breath, cough, and decreased blood oxygenation) forced doctors to resort to additional examination and consultation with specialists after a certain period of observation (4–5 days). Pulmonary and pleural hemorrhage occurred in 2 (8,72 %) subjects, spontaneous pneumothorax, including and 1 bilateral, occurred in 5 (21,7 %) patients, pneumohydrothorax – in 4 (14,4 %), pneumomediastinum – in 2 (8,7 %), severe pneumothorax – in 7 (30,4 %) people. The most serious complications were the impression of the pleura with a violation of the integrity of the cortical lungs (pneumohydrothorax, intense pneumothorax), which led to death in 6 (26,1 %) people. The period before the diagnosis of complications was in the range of 4–6 days. Conclusions. Physical control of patients with signs of respiratory failure should be performed every 2 hours, ultrasound – three times a day, examination and lateral radiography – with the duration of shortness of breath more than two days or its increase, without waiting for the time suggested by the radiologist.

ELECTRON-MICROSCOPIC FEATURES OF THE LOWER UTERINE SEGMENT MYOMETRY IN WOMEN WITH PLACENTAL PRESENTATION

The article presents modern phenomena about electron microscopic features of the studied placentas. Placenta previa is an urgent problem of modern obstetrics, as it is the main cause of obstetric bleeding in the third trimester of pregnancy. The aim of the study was to study the electron microscopic features of the myometrium of the lower uterine segment in women with placenta previa. Materials and methods. In accordance with the aim of the research, 122 pregnant women with atypical location of the placenta were examined, who were hospitalized and delivered in the Perinatal Center of Kyiv during 20140–2020 at 36 + 6 days and 38–39 weeks of gestation. In 10 pregnant women with placenta previa performed electron microscopy of the myometrium of the lower uterine segment during placenta previa, which formed the main group. The control group included 6 pregnant women within 38 weeks with a normal location of the placenta. In all pregnant women of the main group, myometrial biopsies were taken in the placenta previa of the lower uterine segment. Results and their conclusions. The study found that the most significant electron microscopic changes were found in the myometrium, which is primarily related to the contractile function of smooth myocytes. Obviously, this is due to lack of energy supply, resulting in a decrease in both the number of mitochondria and their functional state. This process is also complicated by other energy sources – trophic inclusions. The condition of blood vessels at presentation of a placenta also changes, both a hypoxic condition of vessels, and surrounding fabrics develops. The detected electron microscopic changes of the placenta give an understanding of the further course of pregnancy and fetal development, because it is the placenta that ensures the interaction of the mother and fetus.