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Medicni perspektivi, 2022;27(4)

    Title of the issue
Content

2022 Vol. XXVII N 4

Published
2022-12-29

THEORETICAL MEDICINE

 

Tsymbalyuk V.I., Vadzyuk S.N., Tolokova T.I., Pankiv I.B. Reproductive health under global warming

https://doi.org/10.26641/2307-0404.2022.4.271113

Reproductive health under global warming

     

 

Key words: global warming, premature birth, reproductive health, adverse effects of pregnancy

Abstract. Reproductive health under global warming. Tsymbalyuk V.I., Vadzyuk S.N., Tolokova T.I., Pankiv I.B. Reproductive health problems are attracting the attention of biomedical scientists in connection with changes in the environment. Climate change in the direction of rising temperatures is an urgent threat to human health with negative long-term effects. Under conditions of global warming, the number of negative consequences of pregnancy is increasing, namely idiopathic premature termination of pregnancy with the birth of premature newborns. The priority to reduce the negative health effects of climate change is to identify most sensitive risk groups to the negative impacts of climate change on health, which include pregnant women and newborns. The strategy to prevent and reduce changes in reproductive health is based on the recognition of global warming as a risk factor that contributes to the growth of premature birth and the associated adverse effects of pregnancy.

 

Yavorovsky O.P., Zazuliak T.S., Ostapiv D.D., Riabovol V.M., Demetska O.V. Comparative assessment of the effect of titanium dioxide – based nanoparticles on boar germ cells in vitro 

https://doi.org/10.26641/2307-0404.2022.4.271117 

Comparative assessment of the effect of titanium dioxide – based nanoparticles on boar germ cells in vitro

     

 

Key words: nanoparticles of titanium dioxide, nanocomposite of titanium dioxide with silver, nanotoxicology, succinate dehydrogenase, cytochrome oxidase, boar germ cells

Abstract. Comparative assessment of the effect of titanium dioxide – based nanoparticles on boar germ cells in vitro. Yavorovsky O.P., Zazuliak T.S., Ostapiv D.D., Riabovol V.M., Demetska O.V. Modern titanium dioxide nanomaterials, in particular modified with nanosilver, have antiviral, antibacterial, antifungal activity, cytotoxic effects in vitro experiments and can affect germ cells of warm-blooded laboratory animals. The research aims to study the effect of different types of titanium dioxide nanoparticles on the physiological and biochemical characteristics of wild boar germ cells in vitro. When applying the maximum dose (LD50) of the studied nanopowders in all samples, sperm survival was probably lower than in the control: by 41.9% (р<0.001) ‒ under the action of TiO2 nanoparticles (hereinafter NPs) (Frantsevich Institute for Problems of Materials Science of NAS of Ukraine, hereinafter IPM), by 28.0% (р<0.05) ‒ under the action of TiO2 NPs (Acros Organics), by 53.5% (р<0.001) ‒ under the action of 4% Ag-TiO2 NPs (IPM) and by 55.9% (р<0.001) ‒ are the action of NPs 8% Ag-TiO2 (IPM). Nanopowders of different based on titanium dioxide manufacturers, characterized by similar morphological characteristics and varying degrees of nanosilver addition (Ag content from 0 to 8%), starting from a dose of 1/10 LD50, can have a damaging effect on the germ cells of wild boars, which is manifested by a decrease in the respiratory activity of sperm and cytochrome oxidase activity, by increasing succinate dehydrogenase activity. The most sensitive marker was the sperm survival rate, the value of which significantly decreased under the action of 8% Ag-TiO2 nanoparticles (IPM) at a dose of 1/100 LD50, which is a consequence of disruption of the activity of mitochondrial enzymes and, accordingly, resynthesis of ATP. Our results confirm and extend the data on the nature of the damaging effect of titanium dioxide-based nanoparticles on germ cells of warm-blooded animals due to oxidative stress. The obtained experimental data will be taken into account in the hygienic regulation of the investigated nanopowders.

  

 

Feshchenko Yu.I., Iashyna L.A., Opimakh S.G., Gumeniuk G.L., Ignatieva V.I., Polianska M.A., Zvol I.V., Moskalenko S.M. Features of lung impairment due to COVID-19 in patients of the first wave of the pandemic (literature review)

https://doi.org/10.26641/2307-0404.2022.4.271118

Features of lung impairment due to COVID-19 in patients of the first wave of the pandemic (literature review)

     

 

Key words: COVID-19, lung impairment, inflammation, fibrosis, thrombosis

Abstract. Features of lung impairment due to COVID-19 in patients of the first wave of the pandemic (literature review). Feshchenko Yu.I., Iashyna L.A., Opimakh S.G., Gumeniuk G.L., Ignatieva V.I., Polianska M.A., Zvol I.V., Moskalenko S.M. During the COVID-19 pandemic number of patients suffering from symptoms, decreased work ability and the deterioration in quality of life for several weeks and even months after the onset of the disease is increasing. The aim of the literature review is to search and study the existing literature data regarding the lung impairment features in COVID-19, as well as the morphological and pathophysiological prerequisites for the long-term respiratory disorders in patients who have had this disease. The most common complaints of patients after acute COVID-19 are fatigue, dyspnea, cough and chest discomfort. In these cases restrictive pattern in the pulmonary function test, a reduced gas transfer and persistent changes in computed tomography often in the form of fibrosis are observed, less often in the form of bullous-emphysematous changes, bronchiectasis and pleural effusion. The main pathophysiological mechanisms of acute lung impairment in COVID-19 are direct viral toxicity, impaired function of the immune system, hyperinflammatory response, endotheliopathy, microcirculatory disorders and increased blood clotting with small and large vessels thrombosis, which can lead to pneumonia or acute respiratory distress syndrome. After the acute phase of COVID-19 the pathology of the lung can be caused by an immunogenic and hyperinflammatory response, hypercoagulability and lead to pulmonary fibrosis. The possible mechanisms of the pulmonary fibrosis are thrombotic processes, hemosiderosis, necrotic capillaritis, angiogenesis, hypoxia, cytokine storm. Thus abnormal immune response, hyperinflammation, endothelial dysfunction and excessive coagulation not only cause pneumonia or acute respiratory distress syndrome in acute COVID-19, but also may persist for a long time and contribute to pulmonary fibrosis in some patients. The causes of a longer duration and increased severity of the lung impairment in some people compared to others are the subject of current investigations.

 

Sokolova K.V., Stavytskyi V.V., Konovalova S.О., Podpletnya O.A., Kovalenko S.I., Avdeenko A.P. Design and search for prospective diuretics (CA II Inhibitors) among aroylhydrazones of esters quinone oxime using in silico and in vivo methodology

https://doi.org/10.26641/2307-0404.2022.4.271120

Design and search for prospective diuretics (CA II Inhibitors) among aroylhydrazones of esters quinone oxime using in silico and in vivo methodology

     

 

Key words: design, molecular docking, carbonic anhydrase inhibitors, synthesis, aroylhydrazones of esters quinone oximes, diuretic activity, SAR analysis

Abstract. Design and search for prospective diuretics (CA II Inhibitors) among aroylhydrazones of esters quinone oxime using in silico and in vivo methodology. Sokolova K.V., Stavytskyi V.V., Konovalova S.О., Podpletnya O.A., Kovalenko S.I., Avdeenko A.P. The design and search for new selective inhibitors of CA II with a better pharmacological profile, which would cause minimal electrolyte disturbances in the body, remains an urgent problem of medical chemistry and pharmacology today. It is important that the discovered new classes of inhibitors do not always contain the main “pharmacophoric” function (sulfamide), which is characteristic of “classic” drugs (Acetazolamide, Methazolamide, Ethoxzolamide, Dorzolamide and others), but are derivatives of phenols, polyamines, coumarins/thiocoumarins, ureas, thioureas, hydroxamates, etc. These molecules also bind in the active site of the enzyme, but do not interact directly with the catalytic zinc ion or interact through zinc-coordinated water molecules/hydroxide ion. However, this leads to an increase in their selectivity and, as a result, pharmacological action. Continuing the search for compounds that affect urination, we were interested in aroylhydrazones of esters of quinone oxime. Firstly, they are characterized by certain structural features (dynamic and geometric isomerism); secondly, they exhibit redox properties; thirdly, the presence of aromatic fragments makes it possible to create a voluminous combinatorial library for analysis. These compounds are ligands in complexation reactions, and an additional increase in the number of hydrogen acceptors in the molecule due to structural modification will improve ligand-enzymatic interactions with carbonic anhydrase (CAII) and, as a result, reveal new promising diuretics. The aim – design and search for potential diuretics (CA II inhibitors) among aroylhydrazones of esters of quinone oxime using in silico, traditional synthesis and in vivo methodologies. Methods of organic synthesis, physico-chemical methods of analysis of organic compounds (NMR 1H-spectroscopy, elemental analysis). Prediction of affinity to the biological target, prediction of toxicity and lipophilicity of the combinatorial library of benzohydrazides O-aroyl esters of quinone oxime using computer services. The study of compounds affecting the excretory function of rat kidneys was carried out according to the generally accepted method of E.B.Berkhin with water load. The investigation of the probable mechanism was carried out using flexible molecular docking, as an approach to search for molecules that have affinity for human carbonic anhydrase type II (CA II). Macromolecular data of the crystal structure of CA II (PDB ID – 3HS4) were downloaded from the Protein Data Bank (PDB). The design was developed and the search for diuretic agents among benzohydrazides of O-aroyl esters of quinone oximes was developed using in silico methods (prediction of affinity, lipophilicity, toxicity and enzyme-ligand interactions), traditional organic synthesis, and in vivo methods (effect on excretory function of rat kidneys). The synthesis of benzohydrazides of O-aroyl esters of quinone oxime was carried out by the interaction of aroylhydrazines with 4-[(aroylimino)]cyclohexa-2,5-dien-1-ones. The structure of the synthesized compounds was confirmed by elemental analysis and 1H NMR spectra. Studies of the effect of synthesized compounds on the excretory function of rat kidneys allowed us to identify a number of promising compounds among aroylhydrazones of quinonexime esters, which increase daily diuresis by 54.2-352.8% compared to the control group. At the same time, it was established that the most active was N'-(4-[(2-chlorobenzoyloxy)imino]cyclohexa-2,5-dien-1-ylidene)-3-nitrobenzohydrazide, which increased daily diuresis by 352.8% in comparison with the control group, while exceeding the effect of “Hydrochlorothiazide” (170.8%). The developed and implemented strategy for the search for diuretics among benzohydrazides of O-aroylesters of quinone oxime allowed the identification of an effective compound, which in terms of diuretic effect exceeds the comparison drug “Hydrochlorothiazide”. Visualization of the molecular docking of the active compounds showed that their geometry makes it difficult to place them in the pocket of the active site of CA II, but the pronounced diuretic effect can also be associated with their ability to form coordination bonds with the zinc cation. The obtained results justify the further targeted search for potential diuretics among this class of compounds for a more detailed understanding and study of the mechanism of action.

 

Ivanov V.S., Makarenko O.A., Dienha O.V. Correction of metabolic changes in the tissues of oral cavity of rats using a complex of drugs under the conditions of pathological factors

https://doi.org/10.26641/2307-0404.2022.4.271123

Correction of metabolic changes in the tissues of oral cavity of rats using a complex of drugs under the conditions of pathological factors

     

 

Key words: intrauterine tissue hypoxia, cariogenic diet, caries-prophylactic effect, plant polyphenols, rats

Abstract. Correction of metabolic changes in the tissues of oral cavity of rats using a complex of drugs under the conditions of pathological factors. Ivanov V.S., Makarenko O.A., Dienha O.V. Hypoxia is a typical pathological process that occurs when tissues are insufficiently supplied with oxygen or when its utilization is impaired. One of the most important pathogenetic factors in the development of tissue hypoxia is the disintegration of the structure of mitochondrial membranes which occurs under the influence of various etiological factors. In children who suffered hypoxia in the antenatal period, the frequency of developmental delays is significantly increased, and the incidence of caries is also shown to increase as compared to healthy children. Based on the above, this work is relevant for modern dentistry. The work is devoted to the study of the state of the maxillofacial system and tissues of the oral cavity of rats under the influence of the complex of drugs under the conditions of intrauterine hypoxia, cariogenic diet, thyroid insufficiency and fluorine deficiency. The subjects of the study were 25 female white rats of the Wistar line of herd breeding from the vivarium of the SE “ISMFS NAMS” kept on a standard vivarium diet. The animals were divided into three groups – intact (7 rats), pathology model (8 rats), pathology model and drug complex (8 rats). Animals were removed from the experiment under thiopental anesthesia (40 mg/kg). Lower jaws and pulp were removed. As a result of the research, it was established that the proposed treatment-prophylactic complex has a pronounced caries-prophylactic and periodontoprotective effect. The caries-preventive effectiveness of the complex was due to its ability to stimulate the mineralizing function of the dental pulp, namely, to increase the activity of alkaline phosphatase of the pulp, as an indicator of the activation of osteoblasts, against the background of a decrease in the activity of acid phosphatase, a marker of osteoclasts.

 

Koval T.I., Syzova L.M., Pryimenko N.O., Sydorenko A.Н., Kulіsh M.V., Ilchenko V.I., Lymarenko N.P. The role of TLR-4 gene in the functioning of the natural human immune system and the immunopathogenesis of chronic hepatitis C (literature review)

https://doi.org/10.26641/2307-0404.2022.4.271169 

The role of TLR-4 gene in the functioning of the natural human immune system and the immunopathogenesis of chronic hepatitis C (literature review)

     

 

Key words: TLR-4 gene, polymorphism, Asp299Gly, chronic hepatitis C, immunopathogenesis

Abstract. The role of TLR-4 gene in the functioning of the natural human immune system and the immunopathogenesis of chronic hepatitis C (literature review). Koval T.I., Syzova L.M., Pryimenko N.O., Sydorenko A.Н., Kulіsh M.V., Ilchenko V.I., Lymarenko N.P. To date, despite significant advances in the study of the immunopathogenesis of chronic hepatitis C (CHC), many open questions remain in the diagnosis, prediction and course of treatment. In the context of the study of this infection, the Toll-like gene family of innate immune system receptors (TLRs) is of considerable interest. The article analyzes and summarizes the data of professional scientific sources on the role of the TLR-4 gene in the functioning of the natural human immune system, as well as Asp299Gly polymorphism of this gene in the immunopathogenesis of CHC. The relevance of the study is due to the fact that the innate immune system is crucial in the primary protection of the macroorganism from pathogens, the recognition of which largely depends on the TLRs receptor gene family, and genetic analysis is a modern and promising direction in personalized medicine. The importance of determining genetic markers lies in the fact that regardless of age and other factors of the external and internal environment, they carry information about the predisposition to various diseases, which can be used in the formation of a genetic passport. The data concerning the influence of the Asp299Gly polymorphism of the TLR4 gene on the immunopathogenesis of CHC are contradictory and require further investigation. An in-depth study of this issue will improve the therapeutic and diagnostic tactics of this disease based on a comprehensive assessment of the features of the immune response, which are caused by the carriage of the indicated polymorphism in the human genome.

 

Shtrygol’ S.Yu., Koiro O.O., Kudina O.V., Yudkevych T.K., Gorbach T.V. Comparative analysis of the effect of diclofenac sodium and etoricoxib on energy metabolism in rat liver in the acute general cooling model

https://doi.org/10.26641/2307-0404.2022.4.271171

Comparative analysis of the effect of diclofenac sodium and etoricoxib on energy metabolism in rat liver in the acute general cooling model

     

 

Key words: nonsteroidal anti-inflammatory drugs, acute general cooling, energy metabolism, liver

Abstract. Comparative analysis of the effect of diclofenac sodium and etoricoxib on energy metabolism in rat liver in the acute general cooling model. Shtrygol’ S.Yu., Koiro O.O., Kudina O.V., Yudkevych T.K., Gorbach T.V. When the ambient temperature decreases, physiological mechanisms that prevent heat loss are activated. However, under cold stress hypothermia develops, which significantly disrupts the functioning of the body and can be transformed into life-threatening. Preventive use of nonsteroidal anti-inflammatory drugs, especially diclofenac sodium and etoricoxib, has been found to reduce the severity of cold trauma. Given that their frigoprotective effect can accompany the impact on the synthesis of eicosanoids when exposed to low temperatures, it is advisable to study mechanisms for preventing hypothermia independent of cyclooxygenase, particularly the influence on energy metabolism. The aim of the study was to figure out the effect of diclofenac sodium and etoricoxib on the indicators of energy metabolism in the liver of rats after acute general cooling. Experiments were carried out on 28 sexually mature male rats, which were given diclofenac sodium (7 mg/kg), etoricoxib (5 mg/kg), or solvent 30 minutes before cold trauma intragastrically (in the intact control and pathology control groups). Acute hypothermia was caused by exposure of animals for 2 hours at a temperature of -18°C. Rectal temperature was measured before and after acute general cooling. The content of lactate, pyruvate and adenosine triphosphate  in the liver was measured and the lactate/pyruvate ratio was calculated. Diclofenac sodium, unlike etoricoxib, was found to significantly reduce the severity of hypothermia. Both nonsteroidal anti-inflammatory drugs prevent energy metabolism disorders caused by exposure to cold, namely, reducing the concentration of lactic acid and the ratio of lactate/pyruvate, increasing the content of pyruvate and adenosine triphosphate  in the liver of animals. Etoricoxib normalizes the content of energy metabolism intermediates to their levels in intact animals. Diclofenac sodium has a similar effect, the expression of which is inferior to the selective cyclooxygenase-2 inhibitor. Therefore, when administered prophylactically before acute general cooling, diclofenac sodium effectively prevents hypothermia in rats, surpassing etoricoxib. Etoricoxib completely prevents a decrease in the content of pyruvate and adenosine triphosphate, as well as the accumulation of lactic acid in the liver. Diclofenac sodium is inferior to etoricoxib in its effect on energy metabolism, which indicates other mechanisms of frigoprotective action of a non-selective cyclooxygenase inhibitor. The frigoprotective and energotropic properties of nonsteroidal anti-inflammatory drugs dissociate.

Kuzminov B.P., Zazulyak T.S. Medicinal products as a causative agent of occupational diseases in pharmaceutical workers (literature review)

https://doi.org/10.26641/2307-0404.2022.4.271172 

Medicinal products as a causative agent of occupational diseases in pharmaceutical workers (literature review)

     

 

Key words: medicinal products, occupational diseases, pharmaceutical companies

Abstract. Medicinal products as a causative agent of occupational diseases in pharmaceutical workers (literature review). Kuzminov B.P., Zazulyak T.S. The issue of occupational diseases in chemical and pharmaceutical workers is urgent because it stems from the rapid pace of development, the functional features, and the high biological activity of raw materials used by that industry. The study is aimed at summarizing the information on preconditions and nature of occupational diseases among chemical and pharmaceutical workers based on the analysis of literature data. An important prerequisite for the emergence of occupational diseases is the shortcomings in the production process, leading to pollution of surfaces and workspace air with chemicals through the use of semi-automatic equipment in particular. The harmful substances then enter the bodies of workers through the respiratory system, which is the main and most harmful way. The most dangerous processes are the production and processing of substances with high pharmacological activity, and thus the active pharmaceutical ingredients maybe considered to be the leading causative agents of occupational diseases in the industrial production of medicinal products. The range of diseases diagnosed in pharmaceutical workers is diverse and includes acute intoxication, effects on internal organs, reproductive function, changes in hormonal status, and changes in the hemic system and nervous system. The most common are diseases of respiratory organs and diseases of allergic origin. As a result, influential international organizations and many authors emphasize the need to develop criteria and methods for assessing the harmful effects of medicinal products on the health of workers when authorizing their production.

 

CLINICAL MEDICINE

Menekse Oksar, Hasibe G. Baytan, Selim Turhanoglu, Tayfun Aybek, Nazife Y. Ardicoglu, Oguzhan Ozcan Changes in tryptase levels during cardiac surgery in patients at low risk for allergic reactions

https://doi.org/10.26641/2307-0404.2022.4.271173 

Changes in tryptase levels during cardiac surgery in patients at low risk for allergic reactions

     

 

Key words: hypersensitivity, anaesthesia, cardiac procedures, protamines, adverse effects, tryptases

Abstract. Changes in tryptase levels during cardiac surgery in patients at low risk for allergic reactions. Menekse Oksar, Hasibe G. Baytan, Selim Turhanoglu, Tayfun Aybek, Nazife Y. Ardicoglu, Oguzhan Ozcan. Tryptase test can be used as a clinical marker of mast cell activation. The present study is was aimed to identify variations in serum tryptase levels and their possible relationships with allergic reactions to protamine in low-risk patients undergoing cardiac bypass surgery. Thirty patients according to American Society of Anesthesiologists physical status III who underwent cardiac bypass surgery were enrolled. This prospective, non-randomised, clinical study was conducted in an operating room. Venous blood samples for tryptase measurements were obtained from cardiac bypass surgery patients upon admission to the operating room and immediately before and 30 min after the initiation of protamine administration. Signs of allergic reactions were recorded and management steps based on rapid effect response-based clinical assessments for diagnosis and treatment decisions during protamine administrations were described. Serum tryptase levels and clinical signs of allergic reactions, primarily mean arterial pressure (MAP), were recorded. Serum tryptase levels increased significantly and progressively during the bypass procedure (study power, 80%; sample size, 28; power of analysis, 99.8% with α=0.05); however, tryptase levels did not reach a sufficiently high level to confirm an allergic reaction. The MAP and heart rate decreased in 50% of the patients. Although tryptase increased significantly when compared with baseline levels, protamine-associated increases were not significant and failed to provide an unequivocal indication of an allergic response to protamine.

 

Zabolotnyi D.I., Zabolotna D.D., Babkina T.V., Tsvirinko I.R., Telukha K.I., Kizim Ya.V., Valchyshyn S.V. Radiological research methods in the diagnosis and treatment of patients with the parapharyngeal space tumors

https://doi.org/10.26641/2307-0404.2022.4.271175

Radiological research methods in the diagnosis and treatment of patients with the parapharyngeal space tumors

     

 

Key words: parapharyngeal space tumors, diffusion-weighted magnetic resonance imaging, perfusion magnetic resonance imaging, transoral surgical approach

Abstract. Radiological research methods in the diagnosis and treatment of patients with the parapharyngeal space tumors. Zabolotnyi D.I., Zabolotna D.D., Babkina T.V., Tsvirinko I.R., Telukha K.I., Kizim Ya.V., Valchyshyn S.V.  The parapharyngeal space is a complex structure, being narrow and difficult for surgical approach. Surgical treatment is the main treatment for parapharyngeal space (PPS) tumors, it is performed on the basis of information obtained from imaging methods (computed tomography (CT) and magnetic resonance imaging (MRI)). Objective – to investigate the effectiveness of advanced visualization of radiological research methods in the diagnosis of the parapharyngeal space tumors in order to select the necessary tactics of surgical treatment. This retrospective study included 43 patients who underwent surgery for primary parapharyngeal space tumors from 2010 to 2021. 32 patients were treated in previous 10 years, 11 – patients who underwent examination and surgical treatment over the past 2 years with advanced methods of MRI and CT to select a safe surgical approach. Patients of the 2nd group underwent advanced MRI and CT studies in order to choose the correct method of surgical approach and prevent postoperative complications and recurrence. The histological conclusion in 90.1% of the operated patients confirmed the preliminary data of MRI perfusion regarding the probable histological structure of the neoplasm. Due to a comprehensive preoperative study, in 81.8% of patients in this group transoral approach was used. Our experience confirms the necessity for a thorough preoperative diagnostic procedure that should take advantage of imaging modalities (CT, MRI), especially new techniques (MRI-perfusion and diffusion weighted imaging).

 

Sirko A.H., Dziak L.A., Perepelytsia V.A., Cherednychenko Yu.V. Compensation pathways for venous drainage of the brain in superior sagittal sinus occlusion by parasagittal meningioma

https://doi.org/10.26641/2307-0404.2022.4.271177 

Compensation pathways for venous drainage of the brain in superior sagittal sinus occlusion by parasagittal meningioma

     

 

Key words: superior sagittal sinus, occlusion of superior sagittal sinus, cerebral collateral flow, parasagittal veins, meningioma, parasagittal meningioma, cerebral digital subtraction angiography

Abstract. Compensation pathways for venous drainage of the brain in superior sagittal sinus occlusion by parasagittal meningioma. Sirko A.H., Dziak L.A., Perepelytsia V.A., Cherednychenko Yu.V. This study aims to determine the existing pathways of collateral cerebral circulation in parasagittal meningiomas that cause superior sagittal sinus occlusion based on literature review and analysis of own clinical observations. Results of clinical and instrumental examination of 221 patients treated in Dnipropetrovsk Regional Clinical Hospital named after I.I. Mechnikov from 2000 to 2021 were subjected to retrospective and prospective analysis. Inclusion criteria were: patient age of 18+, parasagittal extracerebral tumor according to computed tomography/magnetic resonance imaging, histologically verified meningioma, superior sagittal sinus occlusion (type V-VI according to M.P. Sindou and J.E. Alvernia) according to selective cerebral angiography. This study is based on the analysis of examination of 43 patients who met the inclusion criteria. The selected patients were analyzed for demography (sex, age), brain computed tomography/magnetic resonance imaging before and after intravenous contrast enhancement, and computed tomography angiography and selective cerebral angiography data. Transformed venous drainage pathways were analyzed depending on the location of superior sagittal sinus occlusion by parasagittal meningioma: anterior, middle, or posterior third of the superior sagittal sinus. It was determined that preoperative diagnosis of parasagittal meningiomas that, based on brain computed tomography/magnetic resonance imaging, has signs of type V or VI superior sagittal sinus invasion according M.P. Sindou and J.E. Alvernia, must include selective cerebral angiography. Dynamic images of selective cerebral angiography in the venous phase allows to fully assess the established pathways of collateral blood flow and the blood flow direction. Information on collateral venous circulation in case of superior sagittal sinus occlusion by parasagittal meningioma is extremely important in a surgery planning. It helps avoiding iatrogenic damage to eloquent veins, which increases radical tumor removal with maintaining/improving a patient’s functional state in the early postoperative period and improving long-term treatment outcomes.

 

Radchenko A.O, Kolesnikova O.V. Evaluation of metabolic disorders and aging rates depending on SIRT1 polymorphism in patients with arterial hypertension and subclinical hypothyroidism

https://doi.org/10.26641/2307-0404.2022.4.271180 

Evaluation of metabolic disorders and aging rates depending on SIRT1 polymorphism in patients with arterial hypertension and subclinical hypothyroidism

     

 

Key words: arterial hypertension, subclinical hypothyroidism, aging, metabolic diseases, SIRT1

Abstract. Evaluation of metabolic disorders and aging rates depending on SIRT1 polymorphism in patients with arterial hypertension and subclinical hypothyroidism. Radchenko A.O., Kolesnikova O.V. There is an increase in the frequency and severity of metabolic disorders in patients with arterial hypertension (AH) in combination with subclinical hypothyroidism (SH), that is accompanied by accelerated aging rates, but the research findings on the aging rates in this category of patients are extremely few in number. Therefore, the aim of our study was to assess metabolic disorders and the aging rates depending on the SIRT1 rs7069102 polymorphism in patients with AH and SH. A total of 132 patients with a median age of 47.6 years were included in the study and divided into 3 groups: a control group (n=30), a group of patients with AH without SH (n=49) and patients with AH in combination with SH (n=53). Anthropometric parameters, biochemical parameters, pro-inflammatory and oxidative states were evaluated in all pa­tients. The aging rates were assessed using two different methods. The frequencies of SIRT1 rs7069102 genotypes carriers in the study sample of patients were 8% for the CC genotype, 51% for the CG genotype and 41% for the GG genotype. There was a significant difference in the incidence of CC homozygosity and carriers of the G allele between groups of patients with AH depending on the SH presence (p<0.001). We showed that carriers of the G allele and GG genotype of the SIRT1 gene (rs7069102) polymorphic marker with AH and SH had significantly higher (p<0.05) insulin resistance, higher levels of low-density lipoprotein cholesterol, alkaline phosphatase, C-reactive protein and lower glomerular filtration rate, which negatively affected the aging processes in this category of patients. In addition, patients with AH had a marked effect of carrying the G allele on the lipid profile and biological age of patients. Therefore, timely detection of a polymorphic variant of the SIRT1 gene may be effective in premature aging prevention in patients with AH and SH.

 

Stepanov Yu.M., Didenko V.I., Klenina I.A., Tatarchuk O.M., Petishko O.P. Improvement of liver fibrosis verification using new minimally invasive markers in patients with chronic diffuse liver diseases

https://doi.org/10.26641/2307-0404.2022.4.271181

Improvement of liver fibrosis verification using new minimally invasive markers in patients with chronic diffuse liver diseases

     

 

Key words: non-alcoholic fatty liver disease, chronic hepatitis associated with virus C, alcoholic liver disease, toxic drug-induced hepatitis, cytokines, biochemical markers of fibrosis

Abstract. Improvement of liver fibrosis verification using new minimally invasive markers in patients with chronic diffuse liver diseases. Stepanov Yu.M., Didenko V.I., Klenina I.A., Tatarchuk O.M., Petishko O.P. The aim of our research was to obtain new minimally invasive serum markers of fibrotic changes of liver in patients with chronic diffuse liver diseases of different etiology and compare them with traditional markers. 364 patients aged 30 to 66 years were examined: 221 women (60.7%) and 143 men (39.3%). Depending on the etiological factors, all patients were divided into 4 groups: group I consisted of 108 patients with non-alcoholic fatty liver disease (NAFLD), group II – 143 patients with chronic hepatitis associated with virus C (CHC), group III – 56 patients with alcoholic liver disease (ALD), group IV – 57 patients with toxic drug-induced hepatitis (TH). The control group consisted of 30 practically healthy people. Using correlation and ROC-analyzes, we obtained minimally invasive diagnostics markers that show the risk of developing liver fibrosis. For patients with NAFLD these were the levels of HOMA-IR, TNFα/IL-10 and α1-acid glycopeptide content, which are better in quality of the diagnostic model than the traditional Forns index, APRI, FIB-4, AAR. For patients with CHC, these were the protein-bound hydroxyproline (HPp/b) /HPf ratio, phospholipids content, and IL-6, CD4+ levels, which are better diagnostic models than the traditional Forns index, APRI, FIB-4, AAR. The following markers were obtained for patients with ALD – TNFα levels, HPp/b and glycosaminoglycans content, which are better diagnostic models than the traditional Forns index, APRI, FIB-4, AAR. For patients with TH, these were medium molecular weight peptides content, IL-6/IL-10 ratio and CD4+/CD8+, which are better diagnostic models than the traditional Forns index, APRI, FIB-4, AAR. Thus, new minimally invasive markers of fibrosis in patients with chronic diffuse liver diseases have been obtained.

 

Klygunenko O.M., Kravets O.V., Marzan O.O. Albumin solution as an important component of intensive infusion therapy in women with preeclampsia

https://doi.org/10.26641/2307-0404.2022.4.271184

Albumin solution as an important component of intensive infusion therapy in women with preeclampsia

     

 

Key words: albumin solution, preeclampsia, infusion therapy, body water compartments, hemodynamics, markers of inflammation

Abstract. Albumin solution as an important component of intensive infusion therapy in women with preeclampsia. Klygunenko O.M., Kravets O.V., Marzan O.O. The aim of the study is to determine the efficiency and effectiveness of albumin solution in intensive infusion therapy for pregnant women with preeclampsia based on measuring indicators of central and peripheral hemodynamics, body water compartments, and markers of inflammation. 60 women were divided into two groups and examined. The first group (n=30) included women whose average age was 30.06±5.13 years, gestation period – 260.18±6.34 days. 16.7% of women in this group had moderate preeclampsia, 83.3% – severe preeclampsia. Patients of this group received standard intensive infusion therapy according to approved treatment protocols. The second group (n=30) included women, whose average age was 30.62±6.02 years, and pregnancy period 258.75±5.74 days. The patients of this group received intensive infusion therapy, like the women of the first group but in combination with a continuous infusion of a 20% albumin solution (8 ml/h – on the 1 st day; 4 ml/h – on the 2nd and 3rd day) and furosemide (0.05 mg/kg/h – on the 1st day; 0.025 mg/kg/h – on the 2nd and 3rd day) for 72 hours starting from the moment of the end of vaginal delivery or Cesarean section surgery. The comparative analysis showed that the dynamics of changes in the main indicators of homeostasis, hemodynamics, body water compartments and markers of inflammation in parturient women with preeclampsia strongly depend on the type of intensive infusion therapy. In women with preeclampsia, continuous administration of a 20% albumin solution immediately after delivery ensures the normalization of body water compartments till the 7th day of the postpartum period. It is the result of a rapid decrease in the total volume of fluid (by 17.2%, p<0.001 from the baseline) and interstitium (by 31.8%, p<0.001 from the prenatal level). The provided treatment in parturient women with preeclampsia helps to ensure a eukinetic type of blood circulation from the 5th day of the postpartum period already. It is also accompanied by the restoration of adaptation mechanisms that participate in maintaining the proper functioning of the cardiovascular system. The use of albumin and furosemide solution infusion reduces the degree of the background inflammatory process by 3.8 times (according to the index of inflammatory activity IL-6/IL-10) which comes along with preeclampsia.

 

Khaskhachikh D.A., Potapov V.O. Molecular mechanisms of resistance of endometrial hyperplasia to progestogen therapy based on the study of the expression of estrogen and progesterone receptors and paracrine cellular markers of cellular interaction

https://doi.org/10.26641/2307-0404.2022.4.271185

Molecular mechanisms of resistance of endometrial hyperplasia to progestogen therapy based on the study of the expression of estrogen and progesterone receptors and paracrine cellular markers of cellular interaction

     

 

Key words: endometrial hyperplasia, estrogen receptors, progesterone receptors, E-cadherin, β-catenin, progesterone resistance

Abstract. Molecular mechanisms of resistance of endometrial hyperplasia to progestogen therapy based on the study of the expression of estrogen and progesterone receptors and paracrine cellular markers of cellular interaction. Khaskhachikh D.A., Potapov V.O. The problem of resistance of non atypical endometrial hyperplasia (NEH) to traditionally accepted, pathogenetically sound therapy with different types of progestins is currently an unsolved problem. In about 17-20% of cases there is a recurrence or even progression of atypical forms of endometrial hyperplasia (AEH), which required the use of surgical treatments. The aim of the study was to investigate the results of hormone therapy with different types of progestins for the treatment of endometrial hyperplasia in women with different types of expression of estrogen and progesterone receptors in combination with the expression of intercellular adhesion molecules E-cadherin and β-catenin to determine the cause of hormonal resistance, formation of groups of women with progestogen-sensitive endometrial hyperplasia (EH) non atypical type NEH (+), which can use progestogens for treatment, and progestogen-resistant forms of endometrial hyperplasia with non atypical NEH (-), which should be offered alternative therapy. The study was performed on the morphological material of the endometrium obtained by diagnostic biopsy in women with abnormal uterine bleeding who were diagnosed with NEH by histological examination. For immunohistochemical study, 80 endometrial samples were taken from women with abnormal uterine bleeding (AUВ) and in the same women after treatment of endometrial hyperplasia without atypia in 3 and 6 months of therapy. The control group (CG) consisted of a group of 20 women who were followed-up without treatment tactics. All women were divided into 3 groups in which different types of progestins were used for treatment: group I – continuous intake of 100 mg of micronized progesterone per os twice a day for 6 months, group II – 20 mg of dihydrogesterone per os twice a day for 6 months, group III – in which LNG-IUD was used. The state of proliferation and differentiation in the studied tissues was assessed by the expression of their key molecular participants – estrogen receptors (ERα) and progesterone (PGR), transmembrane glycoproteins of E-cadherin and β-catenin. ERα and PGR expression were determined by immu­nohistochemistry and calculated by the semi-quantitative H-index method. Evaluation of the expression of E-cadherin and β-catenin was performed by determining the percentage of IHH-positive cells to these antigens depending on the degree of their color. The criterion for the effectiveness of NEH treatment was considered to be a biopsy in 3 and 6 months of treatment in the absence of pathological changes in the endometrium. The results showed that after the use of progestogens in group I there was a change in the endometrium to the secretory type in 45% of cases, in group II with dydrogesterone therapy – in 55% there was a reduction of EH to normal histological picture. The intrauterine system with levonorgestrel (LNG-IUD) showed the greatest efficiency, with the use of which in 75% of cases normalization of the endometrial structure was observed. In the control group in 32% of cases the structure of the endometrium normalized. After 6 months of treatment with gestagens, both oral forms (micronized progesterone, dydrogesterone) and the use of LNG-IUDs showed a positive effect from their use; the therapeutic form of gestagens for therapy is not significant in reducing excessive endometrial proliferation. In the control group of patients who did not receive therapy or discontinued therapy for various reasons, it was shown that 47% of patients had spontaneous regression of EH. The overall percentage of no effect from treatment was 20% in groups I, II and III. Determination of ERα expression in all groups showed a pronounced expression in glands and stroma, which did not differ significantly in the group with NEH (+) and in NEH (-). Analysis of PGR expression of NEH in endometrium (-) showed that in glandular cells (50.82±0.73) and in the stroma (47.34±0.82) it was lower than in the endometrium of women with NEH (+) (gland 187±3.1; stroma 166.4±2.3; p<0.05), as well as in the unchanged endometrium in the proliferative phase (glands 193.2±8.5; stroma 178.7±6.3; p<0.05) and the secretory phase (glands 140.2±4.4; stroma 116.6±3.1; p<0.05). A study of E-cadherin expression in women with EH (-) showed that in 86.4% of cases the expression was absent and in 13.6% it decreased. In NEH (+) women, 49.2% of E-cadherin expression was weak, in 34.4% – moderate, and in 16.4% – negative, indicating an association between PGR and E-cadherin expression. In women with NEH (-) there was marked cytoplasmic expression of β-catenin up to 80%, which can be interpreted as potentially threatening the progression of NEH in atypical forms and relapses. Thus, the study of molecular mechanisms of resistance of endometrial hyperplasia to progestogen therapy will help to develop a differential approach to its diagnosis and treatment.

 

Yuryeva L.M., Shusterman T.Y., Podolska L.V. Clinical and psychometric study of asthenia in foreign applicants for medical education at different stages of training

https://doi.org/10.26641/2307-0404.2022.4.271189

Clinical and psychometric study of asthenia in foreign applicants for medical education at different stages of training

     

 

Key words: foreign applicants, asthenia, asthenic syndrome, adaptation disorders, psychometry

Abstract. Clinical and psychometric study of asthenia in foreign applicants for medical education at different stages of training. Yuryeva L.M., Shusterman T.Y., Podolska L.V. This article analyzes the results of the clinical and psychometric study of asthenia in foreign applicants for higher medical education at different stages of training. The study involved 110 applicants of the preparatory department (group 1) and 44 applicants of the I-II course (group 2). They were trained at Dnipro State Medical University. Duration of training was from 1 to 2 months and from 6 months to 2 years, respectively (at the time of participation in the study). The clinical and psychopathological examination was conducted using the semi-structured interview method and the psychometric investigation of the level of asthenia with using the Multidimensional Fatigue Inventory scale (MFI-20). It was found that the investigated group 2 had the significantly higher frequency of detection of both complaints/symptoms and nosological forms (by 1.8 times) than group 1. The analysis of the MFI-20 scale data confirmed the clinically obtained results: the normal (24,5%) and moderate level (23,5%) of asthenia was significantly more often observed in group 1. The high level (32%) of asthenia was in group 2 that proves the maladaptive process deepening. The obtained result indicates the necessity to develop preventive, differential and corrective measures to improve the quality of life of this contingent.

 

Ogorenko V.V., Shornikov A.V., Zavalko Yu.М. The structure of non-psychotic mental disorders, alexithymia and anxiety in patients with aseptic necrosis of the femoral head

https://doi.org/10.26641/2307-0404.2022.4.271212

The structure of non-psychotic mental disorders, alexithymia and anxiety in patients with aseptic necrosis of the femoral head

     

 

Key words: alexithymia, avascular necrosis, neurotic disorders, anxiety

Abstract. The structure of non-psychotic mental disorders, alexithymia and anxiety in patients with aseptic necrosis of the femoral head. Ogorenko V.V., Shornikov A.V., Zavalko Yu.М. Aseptic necrosis of the femoral head (ANFH) is a severe chronic poliaethiologic disease of the hip joint which is prevalent mainly in young people with a loss of professional and social skills. It is known that the non-psychotic mental disorders appearance in patients with ANFH can lead to the increasing disability, the decreasing in the quality of life, and difficulties in organizing the rehabilitation period. Current researches prove that the preoperative mental state assessment in patients can lead to the statistically significant decrease of the pain intensity in the postoperative period, an improvement in the quality of life related to health, a decrease in anxiety, depression and behavioural problems in the postoperative period. The aim of this research was to study the syndromic features of non-psychotic mental disorders, alexithymia and anxiety levels in patients with ANFH at the preoperative stage. The study involved 137 people aged 25 to 75 years, who were diagnosed with ANFH and identified non-psychotic mental disorders. Clinical-psychopathological and psychodiagnostic methods of examination were used (AUDIT test, Toronto alexithymia scale-20, Taylor manifest anxiety scale). The patients were divided into two groups depending on the ANFH duration. The results of the study revealed the main leading syndromes: asthenic-depressive – in 35.8%, depressive-hypochondriac – in 18.2%, anxious-phobic – in 16.1%, anxious-depressive - in 15.3% and astheno-apathetic – in 14.6% of cases. The average anxiety score was 26 (19; 37), which indicates the presence of a medium-high level of anxiety in the examined, while 52.5 percent of patients had high and very high levels of anxiety. A multivariate logistic regression analysis was performed and as a result, the duration of the disease (OR: 2.23; 95% [CI]: 1.11-4.47; p<0.05), estimates of alexithymia (OR: 2.52; 95% [CI]: 1.00-6.36; p<0.05) and female sex (OR: 2.16; 95% [CI]: 1.03-4.50; p<0.05) were found to be independent risk factors associated with the level of anxiety in persons with ANFH at the preoperative stage.

 

Basanets A.V., Gvozdetskyi V.A. Functional state of the peripheral nervous system in miners suffering from chronic lumbosacral radiculopathy of occupational origin

https://doi.org/10.26641/2307-0404.2022.4.271214

Functional state of the peripheral nervous system in miners suffering from chronic lumbosacral radiculopathy of occupational origin

     

 

Key words: chronic lumbosacral radiculopathy, musculoskeletal system, occupational pathology, electroneuromyography

Abstract. Functional state of the peripheral nervous system in miners suffering from chronic lumbosacral radiculopathy of occupational origin. Basanets A.V., Gvozdetskyi V.A. Exercise is a major factor in the development of occupational pathology of the connective tissue and musculoskeletal system, including chronic lumbosacral radiculopathy (LSRP), which accounts for 20% of occupational diseases in Ukraine. Some problems remain insufficiently studied despite a significant number of scientific works devoted to the study of issues of etiology, pathogenesis, features of clinical manifestations, the use of diagnostic and prophylactic measures in LSRP. The criteria for diagnosing changes in the peripheral nervous system need to be clarified and systematized by in-depth study of the functional state of the nervous apparatus in patients with LSRP of professional genesis.  The research was carried out in a group of 60 miners of the main professions (coal-cutter, mining worker of a clearing pit (MWCP), drifter) suffering from LSRP. The activity of the neuromuscular apparatus was assessed according to the indices of electroneuromyography (ENMG), namely: the amplitude of the M-response during stimulation at the distal point of the right and left m. Abductor Hallucis, n. Plantar Medial, S1, S2 (mV), as well as indicators of terminal and residual latencies (ms), the speed of the impulse along the indicated nerves (m/s). It was found that the average amplitude of the M-response during stimulation at the distal point m. Abductor Hallucis, n. Plantar Medial in the MWCF group was at 6.37 mV (with a reference value of 4-5.8 mV), the average pulse conduction velocity was 38.46 m/s (with a reference value of 40.00 -50.00 m/s), it was found that most often in the group of coal-cutters (64.2%), a pathological indicator of terminal latency was recorded, while in a group of drifter, it did not go beyond the normal range in one of the surveyed miners suffering from LSRP of occupational genesis. Thus, ENMG of the long nerves of the lower extremities is a useful tool of objectifying the diagnosis of LSRP of ocupational genesis, it allows to determine the degree of impairment of the functional activity of peripheral nerves, neuromuscular synapses and the contractility of the striated muscles.

 

Isaiev O.A., Serdiuk V.M. Prediction of the rate of progression of primary open-angle glaucoma depending on gender and polymorphism of the endothelial NO-synthase (NOS3) gene

https://doi.org/10.26641/2307-0404.2022.4.271215

Prediction of the rate of progression of primary open-angle glaucoma depending on gender and polymorphism of the endothelial NO-synthase (NOS3) gene

     

 

Key words: primary open-angle glaucoma, NOS3, rs1799983, rs2070744, prognosis

Abstract. Prediction of the rate of progression of primary open-angle glaucoma depending on gender and polymorphism of the endothelial NO-synthase (NOS3) gene. Isaiev O.A., Serdiuk V.M. Relevance – it is promising to develop a system for the diagnosis and prevention of primary open-angle glaucoma (POAG), which would be based on the determination of constitutive propensity factors and would be able to predict the onset and progression of the disease. The aim of the study was to develop a model for predicting the rate of progression of primary open-angle glaucoma depending on gender and endothelial NO-synthase (NOS3) gene polymorphism. There were genotyped 153 patients with POAG aged 36-84 years. Genotypes rs1799983 and rs207074 were determined in the blood of patients by real-time polymerase chain reaction (amplifier Gene Amp® PCR System 7500; USA) using the TaqMan Mutation Detection Assays Life-Technology test system (USA). For mathematical processing of the obtained results, the Statistica 10 program (StatSoft, Inc., USA) was used. The rate of progression of POAG was higher in the presence of risk alleles in the haplotype of the NOS3 gene polymorphisms: T rs1799983 and C rs2070744 (haplotypes TT-CC, GT-CC and GT-CT), which, when distributed by gender, was more pronounced in women than in men of each of the possible haplotypes. The maximum difference was noted for carriers of the TT-SS haplotype, in whom the rate of progression of POAG in women exceeded that in men by 1.4 times (p<0.001). A regression model was built with satisfactory prediction indicators (multiple correlation coefficient R=0.963; coefficient of determination R2=0.928; p<0.001). The probable “hereditary” age of patients in which one or another stage of POAG should be expected is calculated. Gender and haplotypes rs1799983 and rs2070744 of the NOS3 gene were shown to be associated with the onset and rate of progression of POAG, which was implemented in the prognostic model of the disease. Separately for men and women, carriers of different haplotypes, the rate of progression and the possible age of POAG development by stages were calculated.

 

Gavrylyak I.V., Grebin N.K., Bilous V.L., Korsa V.V., Zhaboedov D.G., Ağca C.A., Tykhomyrov A.O. The levels of hypoxia- and angiogenesis-related regulators and matrix metalloproteinase 9 activity in tear fluid of patients with non-penetrating ocular traumas

https://doi.org/10.26641/2307-0404.2022.4.271217

The levels of hypoxia- and angiogenesis-related regulators and matrix metalloproteinase 9 activity in tear fluid of patients with non-penetrating ocular traumas

     

 

Key words: tear fluid, corneal trauma, D-dimer, HIF-1α, angiostatins, matrix metalloproteinase 9

Abstract. The levels of hypoxia- and angiogenesis-related regulators and matrix metalloproteinase 9 activity in tear fluid of patients with non-penetrating ocular traumas. Gavrylyak I.V., Grebin N.K., Bilous V.L., Korsa V.V., Zhaboedov D.G., Ağca C.A., Tykhomyrov A.O. This article was focused on the evaluation of protein biomarkers related to thrombosis, hypoxia, angiogenesis, and tissue remodeling in tear fluid of patients with non-penetrating corneal trauma. 32 patients with non-penetrating corneal injures were enrolled in the study, the control group consisted of 15 healthy patients. Samples of tear fluid were collected from the patients and control volunteers with the use of a disposable end micropipette. Protein levels of D-dimer, hypoxia-inducible factor 1α (HIF-1α), angiostatins, and matrix metalloproteinase 9 (MMP-9) in tear fluids were determined by western blot analysis. Proteolytic activity values of MMP-9 were measured by gelatin zymography. Results of western blot and zymography assay were calculated by densitometry analysis and expressed as arbitrary units. Significant increase of D-dimer and HIF-1α levels in tear fluid of patients with injured cornea by 7.3 (p<0.05) and 56 (p<0.001) folds, respectively, was shown compared with control, indicating thrombotic events and hypoxia condition to be involved in pathogenesis of ocular trauma. Dramatically elevated levels/activity of MMP-9 enzyme (by 105 folds vs. control, p<0.001) suggest intense tissue remodeling and degradation of extracellular matrix in the damaged cornea. Up-regulation of angiostatin level, products of proteolytical cleavage of plasminogen, in tear fluid collected from patients with traumatic eye in comparison with healthy volunteers (by 7.3 folds, p<0.05), could represent an adaptive mechanism, which counteracts excessive hypoxia-induced neovascularization in injured cornea. It is summarized that there was a strong association between elevation of D-dimer, HIF-1α, angiostatins, and MMP-9 levels suggesting thrombosis- and hypoxia-mediated mechanisms triggering wound healing of injured cornea. The findings of this study are novel and provide a basis for further investigations of the reparation mechanisms during non-penetrating ocular trauma. Studied proteins of the tear fluid can serve as relevant biomarkers of corneal wound healing and are appropriate for diagnostic and prognostic purposes.

 

Svyatenko T.V., Starostina O.A., Zakharov S.V., Solovyiova S.V. The results of using Blue cap® foam for skin care with signs of xerosis

https://doi.org/10.26641/2307-0404.2022.4.271220

The results of using Blue cap® foam for skin care with signs of xerosis

     

 

Key words: xerosis, atopic dermatitis, acne, seborrheic dermatitis, rosacea, correction of skin dryness, emollients

Abstract. The results of using Blue cap® foam for skin care with signs of xerosis. Svyatenko T.V., Starostina O.A., Zakharov S.V., Solovyiova S.V. A significant increase in the severity of clinical manifestations of various dermatoses accompanied by dry skin often increases the feeling of discomfort and itching of the skin, significantly reducing the patient's quality of life. This leads to the search for effective ways to correct the dryness of the skin and maintain the proper functioning of the epidermal barrier of the skin in various dermatoses. The aim of the study was to study the effect of using a combined emollient, which includes components of a classic emollient (with the inclusion of ceramides and substances with moisturizing and softening effects), as well as substances with antiseptic and fungistatic effects. The results of treatment of 100 patients with skin diseases and conditions accompanied by dry skin and itching were analyzed. The study group included patients with acne undergoing treatment with retinoids and external preparations with an irritating effect, patients with atopic dermatitis in remission, patients with seborrheic dermatitis, rosacea, follicular hyperkeratosis, and skin xerosis. Using the method of corneometry, the dynamics of changes in skin hydration during the use of a combined moisturizer and changes in the indicators of the dermatological index of the quality of life of patients were studied. The data obtained showed a pronounced increase in skin hydration in terms of corneometry after 2 weeks of using an emollient (by an average of 31.6 units or 160%), and after a month of observation, the changes amounted to 36.7 conv. units, i.e. increased by 185%, which proves the effectiveness of using Blue cap® foam to normalize skin hydration. The level of the dermatological index of quality of life during this period decreased from 9.9±0.2 to 7.2±0.2 points, i.e. by 2.7 points or 27%,what also indicates an improvement in the subjective attitude of patients and promotion quality of life of patients. In the course of the study, a significant improvement in skin hydration when using the combined Blue cap® foam to correct signs of skin xerosis was proven. In the case of dermatoses accompanied by itching associated with dry skin, a marked reduction in itching was noticed, as well as a significant improvement in the quality of life of the patient after a month of using the combined moisturizer.

 

Pechkovskyi K.E., Kolotilov M.M., Pechkovska I.M., Timokhina T.O. Systemic correction of osteoporosis of the alveolar processes of the jaw in complex treatment of patients with generalized periodontitis

https://doi.org/10.26641/2307-0404.2022.4.271221

Systemic correction of osteoporosis of the alveolar processes of the jaw in complex treatment of patients with generalized periodontitis

     

 

Key words: generalized periodontitis, melatonin, vitamin D, alveolar process

Abstract. Systemic correction of osteoporosis of the alveolar processes of the jaw in complex treatment of patients with generalized periodontitis. Pechkovskyi K.E., Kolotilov M.M., Pechkovska I.M., Timokhina T.O. Generalized periodontitis is accompanied by progressive bone atrophy of the alveolar process of the jaws. The first signs of osteoporosis appear in the alveolar process already in the early stages. Complex treatment of generalized periodontitis includes, first of all, an etiopathogenetic approach. The object of the study is to investigate the effectiveness of biotherapeutic correction of osteoporosis of the alveolar processes of the jaws in the complex treatment of patients with generalized periodontitis adding melatonin and vitamin D. The study involved 121 patients aged from 26-40 years with generalized periodontitis of initial-I and I stages with a chronic course, and 45 apparently healthy volunteers from the control group. All patients gave voluntary informed consent to participate in the study. Groups of patients were randomized approximately by same age and gender. Before onset of treatment and 6 months after the complex treatment the level of vitamin D and melatonin level was measured and examined for osteoporosis using a cone-beam computed tomography. In order to give a qualitative and quantitative assessment of the state of mineralization of the spongy and compact bone tissue of the alveolar processes of the jaws histographic analysis of computed tomography was used. 55 patients in addition to traditional local treatment were added vitamin D intake of 4000 IU/d with meals and melatonin intake of 1.5 mg at bedtime for 1 month. It was stated, that level of melatonin in saliva is inversely proportional to the level of vitamin D in the blood serum in patients with generalized periodontitis and patients from the group with clinically healthy periodontium. Using  melatonin and vitamin D in the complex of treatment of patients with generalized periodontitis leads to an increase X-ray density of bone tissue of the alveolar processes of the jaws, which allows to achieve restoration of bone density of alveolar processes and longer stabilization of dystrophic – inflammatory process in the periodontium. To strengthen the bone tissue of the alveolar processes of the jaws in patients with generalized periodontitis, it is advisable to use  melatonin and  vitamin D in a complex treatment.

 

PREVENTIVE MEDICINE

Omelchenko E.M., Yelizarova O.T., Polka N.S., Polka O.O., Hozak S.V. Heritability of body mass index and physical activity in Ukrainian adolescents

https://doi.org/10.26641/2307-0404.2022.4.271223

Heritability of body mass index and physical activity in Ukrainian adolescents

     

 

Key words: adolescents, physical activity, body mass index, heritability, familial aggregation

Abstract. Heritability of body mass index and physical activity in Ukrainian adolescents. Omelchenko E.M., Yelizarova O.T., Polka N.S., Polka O.O., Hozak S.V. The article analyzed the lifestyle and physical development of Ukrainian adolescents and their parents and estimated the familial aggregation and heritability of body mass index and physical activity. 408 nuclear families were examined (1216 people with complete information).  Anthropometric measures such as weight, height were measured following standardized procedures of WHO. Questionnaires were used to estimate the levels of physical activity. The method of genetic epidemiology research was used to explore heritability (h2) and family aggregation (ρ). Analysis was performed using the software product S.A.G.E. The study showed that 12.0±1.6% of children were overweight or obese, 6.4±1.2% were underweight and 81.6±1.9% with normal weight. It was found that among adolescents aged 12-15 years, 17.5±3.1% of boys and 32.7±2.9% of girls were physically inactive. Body mass index values higher than 25.0 kg/m2 were found in 34.3±2.4 mothers and in 70.6±2.3% of fathers. The proportion of physically inactive persons was 45.7±2.5% among mothers and 51.1±2.7% among fathers. Heritability values were significant for both body mass index (h2 =0.41±0.09; p<0.001) and physical activity (h2 =0.23±0.07; p<0.001). Significant familial correlations were obtained between parents-offspring for physical activity (ρ=0.20±0.04; p<0.001) and body mass index (ρ=0.25±0.03; p<0.001). The study estimated that the familial correlations for physical activity between mother-son and mother-daughter pairs were higher than in father-son and father-daughter pairs. The highest is the mother-daughter aggregation (ρ = 0.29 ± 0.06; p <0.001), the lowest is the father-son (ρ=0.19±0.08; p<0.05) by body mass index. As physical inactivity and overweight increase the risk of non-communicable diseases development, the data obtained should be taken into account while planning preventive measures.

 

 

Lebets I.S., Dynnik V.O., Matkovska T.M., Medvedovska N.V., Kashkalda D.A. Рrevention and rehabilitation of health problems of schoolchildren from the zone of military conflict in Ukraine

https://doi.org/10.26641/2307-0404.2022.4.271225 

Рrevention and rehabilitation of health problems of schoolchildren from the zone of military conflict in Ukraine

     

 

Key words: school-age children living in the zone of military conflict, сhildren-migrants, rehabilitation, medical and psychological support

Abstract. Рrevention and rehabilitation of health problems of schoolchildren from the zone of military conflict in Ukraine. Lebets I.S., Dynnik V.O., Matkovska T.M., Medvedovska N.V., Kashkalda D.A. The purpose of the research is to justify the necessity for rehabilitative medical and psychological support of schoolchildren from the zone of military conflict with psychosomatic disorders, psychological divergences in conditions of post-traumatic stress of different levels. There were surveyed 286 children of school age who suffered as a result of military conflict in the East of Ukraine. Anxiety, the level of stress, psychological, emotional internal health, the intensity of stress-realizing systems (cortisol, adrenaline, norepinephrine, diene conjugates, thiobarbituric acid-active products) and stress-limits of systems (serotonin, methlorinate, recovered glutathione, glutathionoperoxidase, superoxide-midase) were assessed. It is established that in the majority (59.52%) of schoolchildren from the Joint Forces Operation (JFO) zone in both boys and girls an increased level of emotional tension was recorded. It was found that the past stress provokes the activation of stress-regulating systems, the severity of which depends on the intensity of stress. Cortisol, diene conjugates, thiobarbituric acid-active products, reduced glutathione, melatonin play a special role in these processes. Children-migrants have a higher level of certain indices of the stress-realizing system (adrenaline) compared to schoolchildren from the military zone, which confirms the influence of a place of living as an additional stress factor on the child's body. It was found that most of the surveyed children have numerous somatic and psychosomatic complaints, and clinical symptoms are characterized by polymorphism. Among organic and functional disorders, diseases of the digestive, endocrine system, neurotic and non-psychotic disorders of residual-organic genesis dominate. The problem of deteriorating health status of schoolchildren from the zone of military conflict was revealed, a possibility of systematic impact on preservation and strengthening the health of this contingent was justified. The revealed disorders of the psychosomatic health of children from the zone of military conflict require a multidisciplinary approach (consulting and follow-up of specialist-doctors of various profiles) to prevent their progression.

 

Korobchanskyi V.O., Sarkis-Ivanova V.V., Bohachova O.S., Oliinyk Y.O., Biеleсka S.V. Implementation of the principles of the scientific concept “Medicine of borderline states” regarding donosological diagnosis and overcoming the risks of health deterioration in student youth

https://doi.org/10.26641/2307-0404.2022.4.271227 

Implementation of the principles of the scientific concept “Medicine of borderline states” regarding donosological diagnosis and overcoming the risks of health deterioration in student youth

     

 

Key words: medicine of borderline states, donosological diagnosis, overcoming the risks, health deterioration in student youth

Abstract. Implementation of the principles of the scientific concept “Medicine of borderline states” regarding donosological diagnosis and overcoming the risks of health deterioration in student youth. Korobchanskyi V.O., Sarkis-Ivanova V.V., Bohachova O.S., Oliinyk Y.O., Biеleсka S.V. Today, the methodological basis of disease pre­vention among various categories of the population, including students, is an innovative area of medical science and health care practice, namely medicine of borderline conditions. The development of a system of prenosological diagnosis of pathological conditions in young students and their hygienic correction for disease prevention are important both from a scientific and practical point of view. The study was conducted in the conditions of a natural experiment on the basis of three types of educational institutions, at the place of study of representatives of both sexes aged 14 to 23 years, adolescents and yound adults. In order to achieve the relevant objectives, the study used the following methods: analytic addressed at the study of educational programs, curricula, schedules, profile and regulatory documents; sanitary-hygienic; psychophysiological; psychological, statistic. Set of risk factors related to the educational process among young people studying in three types of educational institutions – secondary educational institutions, higher educational institution, Professional Agrarian Lyceum was analyzed. It is established that unfavorable living conditions affect donosological mental states of asthenic, hypochondriac and depressive nature.

 

SOCIAL MEDICINE

Shevchenko O.A., Sheviakov O.V., Kornienko V.V., Burlakova I.A., Slavska Y.A., Sizov V.V., Dorohan S.B. Psychologial components of the rehabilitation potential of specialists of low enforcement forces structures

https://doi.org/10.26641/2307-0404.2022.4.271228

Psychologial components of the rehabilitation potential of specialists of low enforcement forces structures

     

 

Key words: rehabilitation potential, psychological state, specialists of law enforcement forces, development, methodological approach, social support, psychological support

Abstract. Psychologial components of the rehabilitation potential of specialists of low enforcement forces structures. Shevchenko O.A., Sheviakov O.V., Kornienko V.V., Burlakova I.A., Slavska Y.A., Sizov V.V., Dorohan S.B. To study the rehabilitation potential of law enforcement officers and the process of its development, a verbal-communicative diagnostic method was used to collect information about subjects with depressive disorders using "Google Form". The study was conducted on the social network Facebook during 2020-2021. The study involved 452 people from the Central, Southern and Eastern regions of Ukraine aged 20 to 49 years with depressive disorders of the neurotic spectrum and 182 subjects without affective disorders. Socio-demographic features of the subjects with depressive disorders of different genesis are analyzed. It was found that women (54.51%) and subjects aged 30-49 years (70.0%) predominated among the surveyed. The majority of respondents are city dwellers (58.51%), with incomplete higher education (33.33%), mostly working and having family (with neurotic depression (54.95% and 51.65% respectively) and organic depression) (51.16% and 55.81%, respectively) and mostly unemployed and single (with endogenous depression) (59.14% and 58.06%, respectively). It was determined that among the factors of mental trauma in subjects with neurotic depression factors related to family and personal relationships (DC=3.32) dominated, in organic depression – with their own health (DC=2.08), in endogenous depression – factors of socio-psychological nature (DC=2.75). It was found that such factors as young age (20-29 years), higher education, living in the city, having a family, can be favorable factors for the formation of the rehabilitation potential of people with depressive disorders of various genesis. It was also determined that according to many socio-demographic indicators, subjects with neurotic disorders coincided with the respondents of the control group, which may indicate a higher level of rehabilitation potential of people with neurotic depression.

 

Bezverkhniuk T.M., Babova I.K. Ensuring of rehabilitation care quality provision: organizational-methodological aspect

https://doi.org/10.26641/2307-0404.2022.4.271230

Ensuring of rehabilitation care quality provision: organizational-methodological aspect

     

 

Key words: rehabilitation in health care, standards, quality, recommended rehabilitation program

Abstract. Ensuring of rehabilitation care quality provision: organizational-methodological aspect. Bezverkhniuk T.M., Babova I.K. Introduction of international treatment protocols into medical care determines the need for scientific substantiation of the mechanisms of their adaptation in rehabilitation care. On the basis of a systemic approach we substantiated the organizational model of quality assurance for the provision of rehabilitation care in health care system in Ukraine, which consists of four interacting subsystems: management, functional, monitoring (resultative) and supply (process) subsystems. The state of rehabilitation care provision in Ukraine at the expense of the Social Insurance Fund of Ukraine and the National Health Service of Ukraine was analyzed. Need to renovate medical and technological documentation of rehabilitation care for the main groups of socially significant diseases that lead to disability of the population was grounded. Recommended program of rehabilitation at the health-resort stage of patients after coronavirus disease (COVID-19) is proposed for health-resort institutions as a methodical basis for the introduction of updated medical-technological standardization documents, which will contribute to improving the quality of rehabilitation care in Ukraine. Typical (recommended) rehabilitation program consists of general provisions on the organization of rehabilitation care, in particular the existing documentary base; indications, contraindications and criteria for admission to the health-resort stage of rehabilitation (in the post-acute or long-term period); diagnostic plan; regulation of actions in case of deterioration of the patient's clinical condition; approximate duration of the rehabilitation course; tasks of the rehabilitation stage; general characteristics of the resort and available natural healing resources; list of rehabilitation procedures; indicators of the effectiveness of rehabilitation care. The program was implemented in a number of health-resort institutions of Ukraine.

 

Kodynets A.O., Doroshenko O.F., Volynets I.P., Dorozhko G.K., Petrenko V.O., Belitsky V.V. Protection from unfair competition on the pharmaceutical market in the conditions of the COVID-19 pandemic

https://doi.org/10.26641/2307-0404.2022.4.271235 

Protection from unfair competition on the pharmaceutical market in the conditions of the COVID-19 pandemic

     

 

Key words: medicines, unfair advertising, intellectual property, COVID-19, legal protection, unfair competition

Abstract. Protection from unfair competition on the pharmaceutical market in the conditions of the COVID-19 pandemic. Kodynets A.O., Doroshenko O.F., Volynets I.P., Dorozhko G.K., Petrenko V.O., Belitsky V.V. The article reveals the problems and prospects of combating dishonest advertising of medicinal products in the conditions of the COVID-19 pandemic. Using the example of the USA and Ukraine, the criteria for banning the advertising of medicinal products by researching scientific sources, international and domestic legal acts, prescriptions and instructions of state bodies, etc. were analyzed. The differences and specifics of the regulatory requirements for the advertising of medicinal products in Ukraine and the USA have been determined. It has been established that in the USA it is allowed to advertise prescription drugs, and in Ukraine a ban has been introduced to advertise "antiviral drugs of direct action". Attention was drawn to the qualification of the division of advertising slogans in the USA, which made it possible to draw an analogy with Ukrainian advertising of medicinal products. It has been proven that individual pharmaceutical manu­facturers, by providing advertisers with incomplete information about the drug, can mislead consumers about its effecti­veness. The Antimonopoly Committee of Ukraine has demonstrated cases of countering the spread of false information about the properties of medicinal products, which became more frequent in connection with the emergence of the strain (SARS-CoV-2) in 2019. The advantages and disadvantages of a complete ban on medicines on television and radio, as well as other mass media are indicated in connection with the entry into force of the decision of the National Security and Defense Council of Ukraine "On the state of the national health care system and urgent measures to ensure the protection of citizens of Ukraine with medical assistance" dated July 30, 2021. As an alternative to the complete rejection of drug advertising it is proposed, the introduction of the mechanism of "corrective advertising", which is actively used in the USA and consists in correcting or making amendments to already published drug advertising and eliminating statements that mislead consumers, contain incomplete, inaccurate, false information about the medicinal product.

 

Lytovchenko V.P. Medical interview in the system of dental care providing to patients with special needs

https://doi.org/10.26641/2307-0404.2022.4.271238

Medical interview in the system of dental care providing to patients with special needs

     

 

Key words: dental care, doctor-patient relationship, universal design in dentistry, patients with hearing impairment, medical interview model/ guide to the medical interview

Abstract. Medical interview in the system of dental care providing to patients with special needs. Lytovchenko V.P. Among the leading trends in the field of medicine – improving the quality of various services; focus on individually targeted care, experience and needs of patients; creating equal opportunities and favorable treatment conditions. Relevant in this context is the “Cambridge guide to the medical interview” designed to identify effective communication skills between physician and patient and to provide a sound framework for their analysis. To solve the two leading tasks, an adapted interview model for dentists was developed and tested, taking into account the communicative needs of patients with severe hearing impairment (to the general tasks of “providing structure”, “building the relationship”), which are cross-cutting for each stage of medical interview, “ensuring a universal design of the environment” included, before the stage of “initiating the session” an additional “selection of priority means of communication/necessary adaptations”, etc.) was proposed. Based on the described modern approaches to building trusting relationships in medical practice, taking into account the adapted version of the interview, the key components of working with patients with special needs (hearing impairment) in dentistry are identified.

 

Kapustynska O.A. Ischemic heart disease in the evacuated adult population as a cause of health loss in the long term after the Chernobyl accident. Results of epidemiological studies 1988-2016

https://doi.org/10.26641/2307-0404.2022.4.271241

Ischemic heart disease in the evacuated adult population as a cause of health loss in the long term after the Chernobyl accident. Results of epidemiological studies 1988-2016

     

 

Key words: Chernobyl accident, adult evacuated population, morbidity, disability, mortality, coronary heart disease

Abstract. Ischemic heart disease in the evacuated adult population as a cause of health loss in the long term after the Chernobyl accident. Results of epidemiological studies 1988-2016. Kapustynska O.A. Ischemic heart disease (CHD) is one of the most common diseases of the circulatory system, which is the main cause of death in Ukraine. The purpose of this study was to analyze the incidence, disability, mortality from ischemic heart disease, its individual nosological forms in the adult population evacuated from the 30 km zone of the Chernobyl nuclear power plant in the post-accident period, taking into account the age at the date of the accident, sex and time after the accident for further improving the system of dispensary observation evacuees and reducing the risk of cardiovascular complications. The study used epidemiological surveillance data (1988-2016) for the category of the adult evacuated population (18-60 years old as of the date of the accident) with a population of 42 982 people, of which 58.7% are women according to the data of the State Register of Ukraine of persons injured in as a result of the Chernobyl disaster (GRU). The research results were assessed both in general for ischemic heart disease and the main nosological forms according to ICD-9 and ICD-10. In the study, epidemiological, analytical, mathematical and statistical methods were used, as well as the method of internal comparison (with indicators of 1988-1992). As the results of the study have shown, in the structure of the causes of morbidity, disability and mortality of the adult evacuated population from diseases of the circulatory system, IHD takes a leading place. The statistically significant influence of age, calendar observation period, gender was established. Among nosological forms, chronic CHD is in the lead. Evacuees at the age of 18–39 years show an increase in the incidence of coronary artery disease with a maximum rate after 17 years, and at the age of 40-60 years – at the beginning of the observation with a subsequent noticeable decrease since 2003. In recent years (2013-2016), there has been a significant decrease in the incidence of coronary artery disease at the age of 40-60 years by 9.3 times, and at the age of 18-39 years, on the contrary, an increase by 3.8 times. During the post-accident period, the level of disability and mortality of the studied contingents from ischemic heart disease has significantly increased. High rates of growth of disability in recent years in persons aged 18-39 at the date of the accident. The mortality rate of the evacuees in recent years has increased in comparison with the early observation period by 5.8 times, higher mortality rates in men compared to women. Further more in-depth studies are required to assess the contribution of non-cancer diseases to the total radiation damage to human health.

 

A CASE FROM PRACTICE

Shkrobot S.I., Milevska-Vovchuk L.S., Duve Kh.V., Naumova L.V., Budarna O.Yu. A Clinical Case report:  stroke in a young patient with systemic lupus erythematosus on the background of secondary antiphospholipid syndrome 

https://doi.org/10.26641/2307-0404.2022.4.271243

A clinical case report: stroke in a young patient with systemic lupus erythematosus on the background of secondary antiphospholipid syndrome

     

 

Key words: antiphospholipid syndrome, ischemic stroke, antiphospholipid antibodies

Abstract. A clinical case report: stroke in a young patient with systemic lupus erythematosus on the background of secondary antiphospholipid syndrome. Shkrobot S.I., Milevska-Vovchuk L.S., Duve Kh.V., Naumova L.V., Budarna O.Yu. The article describes a clinical case report of a young patient with ischemic stroke on the background of antiphospholipid syndrome (APLS). The uniqueness of this case lies in the complex diagnostic search that we performed. On admission, the patient had general cerebral, general infectious and focal syndromes. We suspected encephalitis due to the peculiarities of the onset of the disease and the results of computed tomography. However, after the results of lumbar puncture, the diagnosis of encephalitis required careful differential diagnosis. We performed an extensive diagnostic search. Based on clinical-laboratory, instrumental and immunological data the patient had the following final diagnosis: “Ischemic cardioembolic stroke in the right middle cerebral artery pool (15.10.17) (ICD 11: 8B11.5). Acute period with left pyramidal reflex insufficiency and changes in magnetic resonance imaging. Systemic lupus erythematous (ICD 11: 4A40.0), subacute course, activity II, with the lesion of skin (transient erythematous rash), kidneys (proteinuria, transient impaired renal function), lungs (bilateral pleurisy with immunological disorders). Secondary APLS (ICD 11: 4A45) (Acute iliofemoral thrombosis, May 2017; chronic thrombosis of the inferior vena cava, iliac veins, positive IgG to cardiolipin, beta 2 glycoproteins). Thus, we have to link thrombotic complications in young patients with APLS and to examine the patients for antiphospholipid antibody presence.