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Published By Ukrainian Medical Stomatological Academy

2519-2302, 2073-4662

2021 ◽  
Vol 25 (5-6) ◽  
pp. 3-6
Author(s):  
В.В. Борисенко ◽  
А.М. Скрипніков ◽  
К.В. Гринь ◽  
Ю.О. Фисун ◽  
О.А. Казаков ◽  
...  

Significant consequences of alcohol abuse give grounds to classify alcohol dependence as a medical and social pathology that poses a danger to society. The number of patients registered in medical dispensaries in Ukraine reaches 1 million. Recurrences of the disease during the year after treatment are observed in 60-75% of patients with alcohol dependence. The problem is exacerbated by the medical and social consequences of alcohol abuse in the form of increased mental and physical illness, trauma, suicide attempts and aggressive behavior, criminal acts. This renders the search for new therapeutic approaches to the treatment of alcohol dependence relevant. The aim of the study was to examine the feasibility and effectiveness of using the global assessment of functioning scale (GAFS) to diagnose the dynamics of social functioning of patients with alcohol dependence. The study of the dynamics in the level of general functioning with the use of GAFS in the main and control groups yielded the following results. There was a significant increase in psychological, social and professional functioning in 74.0% of patients in whom a system of treatment and prophylactic measures was applied as compared to 46.7% of patients in the comparison group (χ2 = 6.062, p <0.05). A follow-up study showed that the number of persistent remissions was by 2 times higher in the main group than in the comparison group, 54.0% and 23.3%, respectively (p <0.001).


2021 ◽  
Vol 25 (5-6) ◽  
pp. 32-35
Author(s):  
А.В. Лавренко ◽  
О.А. Борзих

We present a clinical case that demonstrates a lack of compliance in a patient with hypothyroidism, which led to severe complications of the cardiovascular system. The clinical feature of this case is the development of severe complications of hypothyroidism due to the patient’s low adherence to therapy and untimely treatment. The patient had all characteristic signs of severe hypothyroidism with heart and skin lesions (total alopecia, edema, dryness and peeling of the skin). Fully available diagnostic criteria were as follows: critical disorders of thyroid hormone levels in the blood, hyperenzymemia, hypothyroidism, fluid in the pleural cavity, increased heart shadow, fluid in the pericardial cavity, left ventricular dilatation, decreased ejection fraction, arrhythmia. The predominant lesion of the cardiovascular system is characteristic of such cases and prevailed in the clinical presentation of the disease and was the direct reason for seeking medical help. Under the influence of treatment, the patient's sinus rhythm was restored, myocardial contractility improved, there was no fluid in the pericardial cavity and pleural cavity, edema decreased, mental activity and emotional state improved. However, the patient flatly refused further observation and treatment. As a result, hypothyroidism is underdiagnosed. Initiation of treatment in the early stages of the disease and prevention of complications relies on early diagnosis through systematic screening according to the recommendations. Heart disease, associated with hypothyroidism is a condition that can be prevented if it is detected and treated by family doctors in a timely manner in an outpatient setting. Timely detection of the disease and hospitalization will allow avoiding serious complications of hypothyroidism, timely diagnosing this pathology and prescribing adequate therapy according to the stage of the disease.


2021 ◽  
Vol 25 (5-6) ◽  
pp. 28-31
Author(s):  
О.С. Нікіфорова ◽  
О.В. Саник ◽  
М.Ю. Дельва

We present a clinical case of ischemic stroke in a man with a new-onset migraine attack. Clinical case. A 25-year-old man was admitted to the acute cerebrovascular department due to severe throbbing headache in the left temporal area, vomiting, impaired vision on the right and numbness of the right leg. Complaints appeared abruptly in the form of scotoma in the right visual field. 20 minutes later, severe throbbing headache, nausea and numbness of the right leg developed. The event was preceded by sleep deprivation for 2 days. The patient’s mother has migraine with aura. Previously, the patient never had such attacks. On examination: right-sided homonymous upper-quadrant hemianopsia, hypoesthesia of the right leg. Brain MRI - focal hyperintensity at T2 and DWI in the left occipital region (acute ischemic stroke). The patient took aspirin at a dose of 300 mg for the first day, then 100 mg per day and valproic acid at a dose of 1200 mg per day. Two days after hospitalization, the patient experienced recovery of sensitivity in the right leg and regression of right-sided homonymous upper quadrant hemianopsia to small scotoma. The patient was discharged on the 5th day with a small right scotoma. It is recommended to continue taking aspirin 100 mg/day and valproic acid 1200 mg/day for the secondary prevention of migraine attacks and stroke. Discussion. The peculiarities of this case include the lack of history of migraine (at least 5 or more migrainous headache attacks) and the development of severe migraine attack with prolonged aura symptoms, which was triggered by sleep deprivation and eventually evolved into ischemic stroke. Conclusions. It is necessary to consider the possibility of ischemic stroke even in the cases of a new-onset migraine attack. If migrainous aura duration exceeds 60 minutes, it is necessary to perform a brain MRI to detect the early signs of cerebral ischemia.


2021 ◽  
Vol 25 (5-6) ◽  
pp. 20-23
Author(s):  
Я.В. Шиманська

The article is a part of the research project at the Department of Obstetrics and Gynecology No.2 of Higher Education Institution Poltava State Medical University "The role of chronic infection of the uterus and lower genital tract in the formation of obstetric and gynecological pathology" (state registration No. 0117U005276, implementation period 2017-2022). In modern reproductive medicine, infertility in marriage is considered a problem of particular importance. That is why modern assisted reproductive technologies are chosen as a method of treatment for many married couples, and their increased application necessitates intensive monitoring of the course of pregnancy and delivery. Pregnant women after in vitro fertilization programs are at high risk of miscarriage and preterm birth. The aim of the research was to study the features of pregnancy, childbirth and the condition of newborns in women after in vitro fertilization, which are classified as high risk for preterm birth. Women were included in the study at 18-20 weeks 6 days of pregnancy. We examined 85 women who became pregnant after in vitro fertilization (study group A: 37 pregnant women who refused preventive treatment and received medications in accordance with regulations; study group B: 48 pregnant women who have received the proposed treatment since their inclusion in the study. The control group included 20 apparently healthy pregnant women with its natural pregnancy onset. In pregnant women of study group A, pregnancies ended in premature birth by 1.7 times more often, and most of them occurred before 34 weeks; during pregnancy, there was a greater risk of preterm birth, which required enhanced correction in addition to conservative measures: suturing the cervix and the use of obstetric unloading pessary; the frequency of delivery by cesarean section prevailed by 1.3 times. Moreover, only in this group, pathological bleeding was observed, surgery was performed and perinatal mortality was recorded. Pregnant women who agreed to preventive treatment developed fewer preterm births after 34 weeks. Complications of pregnancy and childbirth were much less common in these women. Surgical intervention in childbirth and the frequency of delivery by cesarean section were also much less common.


2021 ◽  
Vol 25 (5-6) ◽  
pp. 24-27
Author(s):  
Н.Д. Герасименко ◽  
Н.І. Дігтяр

The problem of morbidity and mortality due to infectious lesions of the respiratory tract, in particular nosocomial pneumonia, remain one of the most pressing problems of modern medicine. Nosocomial pneumonia ranks 3rd among all infectious diseases that a patient can contract at a medical institution after urinary and wound inflammation and it is characterized by high mortality. Nosocomial pneumonia is provoked by antibiotic-resistant microorganisms; in the intensive care patients, it is complicated by the re-aspiration of bacteria that accumulate above the cuff of the intubation tube. Identification of nosocomial and community-acquired pneumonia involves a particular flora of pathogens and, accordingly, involves empiric therapy. Routine analysis of sputum according to Gram gives approximate data, which is a clarification for empiric treatment. We present a clinical case, which demonstrates that infection is also possible due to contact of a family member with another one, working at a medical institution. Therefore, in our clinical case, we emphasize that it is very important to collect a thorough history. Careful collection of medical history can provide additional information: working in a team, being a medical professional, relatives working at a medical institution. It should be noted that in this category of patients, the causative agent of infection, including nosocomial pneumonia, may be the strains of nosocomial microorganisms. Regardless of age, we recommend the use of preventive measures (lifestyle modification, acclimatization training, sports, etc.) to increase the non-specific resistance of the body. As a preventive measure, medical personnel should follow the regimes of ventilation and wet cleaning in the premises, wash their hands and rinse their nasal passages as often as possible with saline solutions, use a mask to protect the respiratory organs, disinfect hands with alcohol.


2021 ◽  
Vol 25 (5-6) ◽  
pp. 39-42
Author(s):  
O.A. Polyvyana ◽  
V.I. Shepitko ◽  
Ye.V. Stetsuk ◽  
O.Ye. Akimov ◽  
O.S. Yakushko ◽  
...  

In recent years, researchers have focused on the problem of the dependence of the functioning of various organs and systems on the level of androgens. The effect of long inhibition of testosterone synthesis by triptorelin on liver tissue is poorly understood. The aim of this research was to establish the microscopic organization of rat livers, production of nitric oxide and the intensity of oxidative stress in the rat livers during experimental central deprivation of luteinizing hormone synthesis by diphereline injection on the 270-360th day of the experiment. The experiments were carried out on 30 sexually mature male white rats of the Wistar line. Rats were divided into 2 groups: the control group (10) and the experimental group (20). Animals from the experimental group were subcutaneously injected triptorelin at a dose of 0.3 mg of the active substance/ per kg of body weight for 360 days, while the control group received an injection of saline. It was found that oxidative stress develops in hepatocytes, which is morphologically confirmed by karyopyknosis of the nuclei, oxyphilia of the cytoplasm with the appearance of a significant number of vacuoles in it. The vessels of the microcirculatory bed react with stasis. An increase in the production of superoxide radical anion in rat liver may be due to the absence of an inhibitory effect of testosterone on macrophages and liver mitochondria, which is accompanied by depletion of antioxidant enzymes and the development of oxidative stress. The intensity of biochemical markers of oxidative stress on the 360th day is lower than on the 270th day, which is due to an increase in the activity of antioxidant enzymes and a decrease in the production of reactive oxygen species.


2021 ◽  
Vol 25 (5-6) ◽  
pp. 16-19
Author(s):  
О.В. Орлова ◽  
Л.В. Животовська ◽  
Д.І. Бойко ◽  
Л.А. Боднар

Dementia is associated with decreased memory, impaired thinking, behavior and ability to perform daily functions. This condition mainly affects the elderly and is one of the main causes of disability. Dementia affects not only patients, their families and caregivers, but society as a whole. The number of people with dementia is on the rise worldwide, and prognosis generally indicates a significant increase in overall prevalence associated with population aging. A large number of patients with dementia are at home, where their family members perform the function of caring for them. With the progression of the disease, patients lose the ability to care for themselves on their own, so the question of outside care arises for their relatives. The aim of this study is to analyze the quality of life indicators in persons performing the function of caring for patients with dementia. It has been found that almost 80% of patients with dementia are cared for by their relatives. Caregivers are at risk of depression, anxiety and psychological stress. In this study, the authors identified factors influencing the mental health of caregivers, among which the degree of dementia and the patient's ability to perform daily activities were significant. In caregivers with a low level of mental tension, manifestations of social maladaptation were less common. Depending on the level of psychological stress, individuals with a high level of tension had lower indicators of quality of life on the scales "physical functioning" (p=0.003), "role functioning due to physical condition" (p<0.001), "social functioning" (p=0.04), "role functioning due to emotional state" (p=0.003), "mental health" (p=0,004). For this category of people, it is recommended to use counseling, psycho-educational activities aimed at understanding the improvement of quality of life.


2021 ◽  
Vol 25 (5-6) ◽  
pp. 36-38
Author(s):  
І.А. Колісник ◽  
П.І. Ткаченко ◽  
А.І. Панькевич ◽  
А.М. Гоголь

Relevance of the research. The features of complex anatomical and functional organization of the maxillofacial area, peripheral nervous system, as well as autonomic structures determine a variety of pathogenetic mechanisms of prosopalgia, among which the lesions of the pterygopalatine node are the most common. Despite the presence of a significant variety of clinical manifestations of pterygopalatine ganglionitis, the prevalence and variety of autonomic manifestations in this disease, the main complaint of patients is pain, the characteristics of which are quite different. The aim of our research was to study the nature of pain in patients with pterygopalatine ganglionitis. Material and methods of research. We examined 105 patients with pterygopalatine ganglionitis aged from 30 to 74 years. Patients were examined for the nature of pain and its intensity, the predominant time of onset and duration of pain attacks, the place of primary localization of pain and the area of its spread. A visual analog scale (VAS) was used to assess pain intensity. Based on the intensity of pain and depending on the severity of the disease, all patients were divided into three groups: mild, moderate and severe pterygopalatine ganglionitis. With a mild severity of pterygopalatine ganglionitis, the intensity of pain attacks is 4-5 points, lasting up to 30 minutes and with a frequency of 1-3 times a day with localization within one or two anatomical areas. With moderate severity, the intensity of pain attacks is 5-7 points, lasting from 30 minutes to 1-2 hours and with a frequency of 4-5 times a day with the gradual spread of pain from one area to half of the face. The severe course is characterized by pain attacks of 8-10 points, lasting for 2 hours or more and with a frequency of attacks from 4 to 6-10 per day. In addition, the pain, occurring in one anatomical area, gradually spread to half of the face, radiating to neighboring areas. Thus, analyzing the features of the pain syndrome in patients with pterygopalatine ganglionitis, we can conclude: 1. The intensity of pain, which was determined by VAS, increases depending on the severity of ganglionitis and ranges from 4.3 points in mild to 8.75 in severe ganglionitis. 2. The duration and frequency of pain attacks increase from 30 minutes with a frequency of 1-3 seizures per day in patients with mild pterygopalatine ganglionitis, to 2 or more hours and 4-10 seizures per day in patients with severe ganglionitis. 3. The localization of pain attacks extends from one anatomical area in mild ganglionitis to half of the face with the possibility of irradiation of pain in severe ganglionitis. 4. These clinical symptoms should be used in determining the severity of pterygopalatine ganglionitis and the choice of treatment tactics in the future.


2021 ◽  
Vol 25 (5-6) ◽  
pp. 12-15
Author(s):  
Н.Р. Кербаж ◽  
С.І. Панасенко

Introduction. Acute pancreatitis (AP) is one of the most common diseases of the digestive system that require hospitalization. To date, the problem of stratification and differential diagnosis of AP in the early stages remains unresolved, which encourages the search for new methods of diagnosis and prediction of the severity of AP. Aim. To evaluate the possibility of creating a clinically oriented system of stratification and prognosis of AP on the basis of dynamic changes in microcirculation depending on the duration of the disease and severity of AP. Materials and methods. Assessment of the state of microcirculation (MC) of patients by laser Doppler flowmetry (LDF) was performed with the “LAKK-02” device. Kruskal-Wallis non-parametric analysis of variance and the median test were used to test statistical hypotheses when comparing independent samples. Pairwise comparison of independent samples was performed using the Mann-Whitney U test. Results. The study determined the indicators of MC in patients with different AP severity degrees on the first day of the disease. The microcirculation parameter (MP) in patients with mild, moderate, and severe AP was 3.9; 3.8 and 6.8 perfusion units (p.u.), respectively. The blood flow modulation rate (ơ) was 0.52; 0.54 and 0.69 p.u. in mild, moderate, and severe AP. In our study, the coefficient of variation (Kv) averaged 17.3%; 20.0% and 11.7% in patients with mild, moderate, and severe AP, respectively. Conclusions. LDF in AP is an informative method of diagnosing the state of MC, which is a universal link in all pathophysiological reactions of the organism. Changes of MC in AP depend on the severity of AP and the period of the disease. The pathophysiological microcirculatory phenomena, revealed on the first day of the disease, provide us with the perspectives of early clinical distinguishing the moderate and severe forms of AP from the so-called group of “destructive forms”.


2021 ◽  
Vol 25 (5-6) ◽  
pp. 7-11
Author(s):  
М.О. Дудченко ◽  
С.М. Заєць ◽  
Р.А. Прихідько

This review summarizes current knowledge about coagulation disorders associated with COVID-19 infection. Despite a significant amount of research, it is currently unclear whether COVID-19 is the direct cause of coagulopathic disorders or they occur as the infectious process progresses. Different authors have proposed several pathogenetic mechanisms for the development of coagulopathy in this disease. However, the most important is the release of a large number of cytokines that provoke interstitial inflammation, endothelial damage and activation of coagulation, in the pathogenesis of which the tissue factor plays a key role. Hyperinflammatory reactions lead to tissue damage, disruption of the endothelial barrier and uncontrolled activation of coagulation. In the lungs and, possibly, in other organs, under the influence of the virus, local damage to the vascular endothelium occurs, which leads to angiopathy, activation and aggregation of platelets with the formation of blood clots and concomitant consumption of platelets. Systemic hypercoagulation and hyperfibrinogenemia significantly increase the likelihood of large vessel thrombosis and thromboembolic complications, which are detected in 20–30% of patients in the intensive care units. Along with an increase in the level of cytokines in the blood, their content also increases in the lungs and in the bronchoalveolar lavage fluid. Cytokine storm leads to systemic intravascular coagulation, multiple organ failure and death. The review also provides the rationale for the principles of managing patients with coagulopathy based on the known mechanisms of unique disorders inherent in COVID-19. It has been shown that the problem of the pathogenesis of the development of blood clotting disorders in COVID-19 infection remains relevant.


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