Medicni perspektivi, 2017;22(1).
2017 Vol. XXII N 1
Key words: neuroplasticity, neurogenesis, neuroretina, synapse, adaptation, sprouting, synapse transmission, functions recovery
Abstract. Main theoretical, pathophysiological and practical aspects of neuroplasticity. Pogorelov А.V., Bukreyeva Yu.V., Gavva О.А., Pashkovsky V.І., Tolubayev О.М., Dukhovenko Е.К. Results of the state-of-the-art review of the "neuroplasticity" term development and new data about the sanogenetic, pathophysiological, neurophysiological, bio - and neurochemical bases of the nervous system recovery processes are given in this article. Key mechanisms of adaptive, desadaptive, responsive and cross modal forms of neuroplasticity within primary and secondary neuroplasticity are distinguished. The specific character of neurogenesis and functional reorganization of neuronets in specific regulatory structures of the brain in the norm and pathogenesis are outlined. Controversies about functional and morphological aspects of neuroplastic processes are presented. Application-oriented methods of neuroplasticity study are considered and systemically classified. Clinical diagnostics with the specified neurovisualization, neurochemical, neurophysiological criteria and coefficients is considered also. Specific methods of neurorehabilitation and perspective urgent directions of neuro- sanogenesis are designated using physical, reflex, neuropsychological, behavioural brain stimulation methods and pharmacological therapy.
Key words: phytotherapy, nephroprotection, anti-inflammatories, diuretics, nephropathy, urolithiasis, herbal urolitholytics, lyophilized powder of watermelon (LPW)
Abstract. Phytotherapeutic drugs with nephroprotective activity (review). Podpletnyaia E.A., Khomiak N.V., Sokolova E.V., Kaydash S.P., Khomiak E.V. The article analyzes characteristics of chemical composition and pharmacodynamics of phytotherapeutic agents (monopreparations and complexes), used in the treatment of kidney and urinary tract diseases. Analysis of main pharmacological effects of medicinal plants and their complexes was made, comparative characteristics of herbal remedies by indications for use in acute and chronic diseases of the kidneys and urinary tract (pyelonephritis, cystitis, urethritis, glomerulonephritis, nephrolithiasis) and edematous syndrome of various etiologies was carried out. Pharmacological characteristics of diuretic, nephroprotective and nephrolitholytic action of watermelon lyophilized powder according to its composition (flavonoids, macro- and micronutrients, vitamins and so on.) was analyzed. On the basis of data on a wide range of biological activity, sufficient clinical efficacy as adjuvant therapy drugs, as well as good tolerability of herbal remedies, appropriateness and prospects of search for new plant nephroprotective drugs was concluded.
Key words: high school, innovations, teaching methods, educational technologies, educational process
Abstract. Practice of implementation of innovative means of teaching in forming of preventive thinking in students of higher medical educational establisments. Biletska E.M., Holovkova T.A., Antonova O.V. The problem of construction of a holistic methodological system of training future doctors considered in the article, is impossible outside the context of integration processes taking place in modern education and needs a careful study of international experience. The research aim is to develop a system of innovative means of education for the formation of preventive thinking in students of higher medical educational establishment, concerning professionally oriented undergraduate preparation of doctors. Analysis of the results allowed to determine the characteristic features of innovative means, forms and teaching methods, specificity of their use in interactive educational environment, this against the background of meticulous work of the teaching staff of the department of general hygiene of Dnepropetrovsk Medical Academy provides the efficiency of educational process which integrates personal, creative, social and educational purposes. The suggested innovative methods are involved in the general system of modern education in higher school being effectively used for providing a high level of professional training in teaching of academic subject area "Hygiene and Ecology".
Key words: antiseptic, antimicrobial activity, revision hip replacement
Abstract. A comparative evaluation of the antimicrobial activity of local antiseptics in revision hip arthroplasty. Loskutov A.E., Digtiar A.V., Stepanskiy D.A. In our study there is presented information on the research of antagonistic activity of medications octenidine, decamethoxine, dioxydine, myramistin, povidone-iodine, chlorhexidine in standard dosage form and in dilution (1:1 and 1:5) on microorganisms: S. aureus, S. epidermidis, S. haemolitycus, P. aeruginоsa, E. agglomerans, E. coli isolated from patients in revision hip arthroplasty. A considerable bacrteriostatic and bacreticidal activity of investigated medications on microorganisms was shown. The investigation of antagonistic activity of medications was conducted by the “well” method according to methodological guidelines for experimental (pre-clinical) investigation of medicinal products for local treatment of purulent wounds. As a solid nutrient solution there was used Mueller-Hinton agar, in which we made cavities with diameter of 8 mm where experimental medications (0,01 ml) were put. As experimental test-cultures there were used main clinical strains of microorganisms (S. aureus, S. epidermidis, S. haemolitycus, P. aeruginоsa, E. agglomerans, E. coli) isolated from patients, receiving treatment in the department of orthopaedics N 2, I.I. Mechnikov regional clinical hospital. 0.9% physiologic saline was used as a control. Chlorhexidine, octenidine, dioxydine, decamethoxine and povidone-iodine undiluted and in dilution 1:1, cause bactericidal effect on staphylococcus, in dilution 1:5 – bacteriostatic effect. Myramistin has practically no effect on staphylococcus. Dioxydine and octenidine in initial dilution have a steady bactericidal effect on E. coli and P. aeruginosa and in dilution 1:1 only dioxydine has bactericidal effect. Chlorhexidine and povidone-iodine have bacteriostatic effect on E.coli and P. aeruginosa. In dilution 1:5 only dioxydine has a bactericidal effect on E. coli and P. aeruginosa. For E. agglomerans only dioxydine in standard dosage form and in dilution 1:1 and 1:5 has bactericidal effect 36mm, 33mm and 25 mm accordingly. But octenidine in a standard dosage form has bactericidal effect on E. agglomerans and in dilution 1:1 – bacteriostatic. Other medications have no effect on E. agglomerans. Antimicrobal effect in a standard dosage form on the greatest amount of experimental microorganisms strains was in octenidine and dioxydine; in dilution 1:1 – in octenidine and dioxydine on enterobacteria, on staphylococci – chlorhexidine, octenidine and dioxydine; in dilution 1:5 – the maximal effect on enterobacteria was in dioxydine and on staphylococci in chlorhexidine.
Key words: acute coronary syndrome, epidemiology, anamnesis, registry
Abstract. A comparative characteristics of patients with acute coronary syndrome according to data of Ukrainian and European registers 2009-2015. Shchukina O.S., Koval O.A. The aim of this work was to compare basic anamnestic and demographic data in Ukrainian and European groups included in the register SNAPSHOT 2009 and local group of the year2015. It was established that by the year 2015 patients’ age advanced (from 65±13 to 68.6±11.2 years), as well as part of women (from 30% to 47.5%), previous myocardial infarction frequency (from 22% to 34.7%), heart failure (from 10% to 42.6%), and chronic kidney disease (from 2% to 14.9%). The increase of prevalence of arterial hypertension (88.1%) in local group was founded. The average body mass index had tendency to increasing (28.6±4.4 kg/m2); the part of patients with increased body mass index was equal among men and women. Simultaneous increase of such comorbidities as arterial hypertension, chronic kidney disease and complications of previous myocardial infarction and heart failure in the local register with a lower prevalence of such risk factors as smoking (13.9%), dyslipidemia (10.9%), and frequency of diabetes (10.9%) were founded. The prevalence of peripheral atherosclerosis was lower in the year 2015 research group than in European one (1% vs 6%). The prevalence of percutaneous coronary intervention (3.1%) and CABG (1.1%) for diagnostic and treatment of ischemic heart disease was extremely low in 2015 year group. The prevalence of previous stroke and chronic obstructive pulmonary disease remained approximately the same in all registers groups. The tendency of increase of malignancy prevalence in anamnesis was founded (5.9%), and probably it was associated with increase of average patients’ age.
Key words: systemic autoimmune rheumatic disease, experiment, vessels, air, xenobiotics
Abstract. Modeling systemic autoimmune rheumatic disease in rats under the adverse weather conditions. Yegudina Ye.D., Synyachenko О.V., Khanyukov О.О., Suiarko V.І., Тaktashov G.S. Changes in the lungs, heart and kidneys are found in all animals with experimental systemic autoimmune rheumatic disease and respectively in 47%, 47% and 40% of cases of intact rats in a hostile environment with xenobiotics air pollution (ammonia + benzene + formalin), herewith in every third or fourth individual lesions of visceral vessels developed. The negative environmental situation increases the frequency of morphological signs of the disease, such as proliferation of endothelial vessels of the heart by 68% and renal arterioles by 52%, in addition, there are direct correlations of angiopathy degree in individual organs; this depends on the nature of pathological process modeling and demonstrates air pollution as a risk factor of disease in humans. The impact of pulmonary vessels sclerosis on the development of bronhosclerosis, perivascular infiltration of the heart muscle on the lymphocyte-macrophage infiltration of the stroma of the myocardium and sclerosis of renal arterioles on the degree of nephroslerosis of stroma is directly associated, with the model of systemic autoimmune rheumatic diseases whereas air pollution by xenobiotics determines dependences of the degree of cellular infiltration of alveolar septa from perivascular pulmonary infiltration, the development of cardiomyocytes hypertrophy from proliferation of the heart endothelial vessels, increase of kidney mesangial matrix from the proliferation of endothelial glomerular capillaries.
Key words: traumatic brain injury, ultrasound duplex scanning, transcranial dopplerography, rheoencephalography
Abstract. The comparative characteristic of extra- and intracranial hemodynamics in patients with traumatic brain injury in the long-term period. Shkolnyk V.M., Fesenko H.D., Soya O.V. Traumatic brain injury (TBI) remains an actual problem of modern medicine, as well as of economic and social sectors. Vascular factor plays a leading role in forming of the clinical presentation of the disease in the long-term period of TBI. The aim of the study was to clarify the characteristics of hemodynamic changes at different levels of cerebral blood supply (main extra- and intracranial arteries and level of cerebral vessels) depending on the severity of TBI. We examined 100 patients in the long-term period of mild, moderate and severe TBI. All patients underwent rheoencephalography, ultrasound duplex scanning of the main arteries of the head and neck with transcranial dopplerography and functional test with visual load. Extracranial vascular changes in the long-term period of TBI are characterized by significant increase of carotid intima-media thickness and the diameters of right internal carotid artery and left internal carotid artery together with the severity of TBI. The qualitative analysis of linear blood flow velocity reveals the decrease in the number of patients with a compensatory reaction in the form of its acceleration in the middle cerebral artery with increasing TBI severity but the number of patients with reduced linear blood flow velocity increases. Abnormal autoregulation of the cerebral circulation and reduction of vascular reactivity was established in the majority of patients of all groups. In addition, the incidence of vascular disturbances increased from 1st to 3rd group. According to the results of rheoencephalography, we detected prevailing spastic changes of the curve in all groups of patients. The degree of disturbances manifestations increases with the severity of TBI.
Key words: anterior ischemic neuropathy, subtenon eye space, treatment
Abstract: Medicaments administration into the subtenon eye space in treatment of anterior ischemic neuropathy. Sakovich V.N., Grechka E.M., Stepakhina M.E., Derbina Е.А., Guzenko N.V. In spite of treatment provided in anterior ischemic neuropathy, a prognosis for visual functions is poor and depends on severity of affection of vascular system of the body. We have studied the exposure to cortexin and diprospan in subtenon administration on the eye hemodynamics in 18 patients experiencing anterior ischemic neuropathy(18 eyes) who have been treated operatively (administration of cortexin and diprospan into the subtenon space of the affected eye) against the background of complex conservative prevention. The control group was constituted of 16 patients (16 eyes) who have not been treated operatively. As a result of provided treatment the patients of the basic group showed increase of vision acuity, field of view limits and eye ground state.
Key words: wound complications, bishofit, elderly patients
Abstract. Dynamics of parameters of ultrasonic, microbiological and cytological investigations in the treatment of postoperative wound complications using magnesium containing minerals in the elderly patients. Muntyan S.O., Nosov A.Y., Getman V.V., Balash K.P., Chernyak S.P., Kruglyak N.L. 57 patients aged over 60 years with various types of wound complications after surgery for abdominal and anterior abdominal wall were treated. Treatment of wound complications included both traditional methods and the use of packs of bishofit. Оn the third day after the start of treatment there was a significant decrease in almost all computing performance indices as compared with treatment using bishofit. On the day 7 a noticeable difference of wound cavity width by 62.88%, the volume of the wound cavity by 85.76% in patients of the second group as compared with patients of the first was noted. So, bishofit use in the form of compresses in the treatment of postoperative wound complications such as hematoma, seroma and infiltration leads to a significant reduction in wound exudation, rapid decline in the concentration of microorganisms in the wound; this reduces time of wounds healing and patients’ recovery.
Key words: pulmonary tuberculosis, lung cancer, post-tuberculosis changes, bronchopulmonary and mediastinal lymph nodes
Abstract. Histomorphological features of combined forms of tuberculosis and lung cancer. Savenkov Y.F., Koshak Y.F., Malcev I.A., Korpusenko I.V., Bakulin P.E. The were studied pathological features of combined forms of tuberculosis and non-small cell lung cancer in 72 patients who underwent radical surgical resection interventions from transsternal access with mediastinal lymph node dissection, with predominance of pneumonectomy - 63.9%. There were identified three main categories of pathological changes: cancer on the background of post-tuberculosis changes, cancer in tuberculoma, cancer in the wall of the active cavity. Post-tuberculosis changes were presented by dense centers, fibrosis, cirrhosis areas, sanitized cavities with histological predominance of coarse fiber connective tissue with giant cell granulomas, with areas characterized by the appearance of the lung tissue with atypical proliferation and metaplasia of bronchopulmonary epithelium, which is a precancerous condition. This malignant tumor process was presented mainly by adenocarcinomas and squamous cell cancer and differred by polymorphic macro- and microscopic picture. Cancer in tuberculoma and fibrous wall cavity differed by pronounced activity of tuberculosis process in the form of lymphohistiocytic infiltration, foci of caseous necrosis and presence of expressed granulation layer of Pirogov-Langhans’ cells. The basic morphological causes of carcinogenesis due to secondary changes of lung tissue in patients with tuberculosis were determined. The features of metastasis of malignant tumors on the background of specific tuberculous and post-tuberculosis changes in regional lymph nodes and the interrelation between the frequency of metastatic lesions with severity of tuberculosis and post-tuberculosis changes in them were studied; this has clinical significance in the surgical treatment of patients with concomitant forms of tuberculosis and lung cancer.
Key words: tension-type headache, adolescents, myofascial disorders
Abstract. Muscle dysfunction in tension-type headache in adolescents and methods of its correction. Stepanchenko K.A. The aim of our study was to investigate the value of myofascial disorders in adolescents with tension-type headaches and evaluation of effectiveness of their treatment using non-drug therapies. A total of 320 adolescents with tension-type headache have been under study. Research of intensity of headache and pain muscle dysfunction was performed. The treatment period was 1 month. We compared treatment by individual adaptive biofeedback based on heart rate variability and pharmacotherapy. Also patients performed the complex of techniques of isometric muscle autocorrection. It was established that with the increase of incidence of headache episodes, the intensity of the local muscle tenderness and the number of muscles, involved in the formation of a painful syndrome increases. Usage of individual adaptive biofeedback was more effective in reducing the severity of muscle dysfunction, than usage of pharmacotherapy, especially in patients with chronic tension-type headache.
Key words: endometrial pathology, late reproductive and premenopausal age, myoma of uterus, quality of life
Abstract. Clinical-anamnestic features and quality of life in women with endometrial pathology on the background of uterine myoma. Dronova V.L., Kornienko S.M. A total of 325 women 35-55 years old suffering from various forms of endometrial pathology were examined. It was found that 110 (33.8%) patients had combination of endometrial pathology and uterine myoma. They made up the main group (group MM), the reference group consisted of 215 women without uterine myoma (group K). It was established that group with uterine myoma is characterized by increased extragenital morbidity: cardiomyopathy (p<0.009), hypertension (p<0.03), obesity stage III-IV (p<0.006), iron-deficiency anemia (p<0,02), vegetative-vascular dystonia (p<0,03) and nervous system diseases (p<0,01) were significantly more common. The presence of uterine myoma is associated with increased risk of recurrence of endometrial hyperplasia and polyps. These data suggest that in the pathophysiology of uterine myoma in women of late reproductive and premenopausal age with endometrial pathology somatic and somatoform disorders play a more significant role than concomitant or previous genital pathology. In late reproductive age and menopause period endometrial lesions are combined with uterine myoma in every third patient. Somatic factors have a greater impact on the development of uterine myoma than reproductive. The presence of uterine myoma is an additional criterion of reduce of quality of life and burdens the prognosis of treatment of endometrial pathology in late reproductive age and premenopausal period.
Key words: pain syndrome, NSAID, clinical efficacy, Fanigan
Abstract. Evaluation of clinical efficacy of a combined analgetic drug "Fanigan" for symptomatic treatment of patients with pain syndrome of various genesis. Mamchur V.Y., Nosivets D.S., Nalotov S.V., Palamarchuk V.I., Guryanov V.G., Ogol A.J. The authors studied the efficacy of combined drug Fanigan (paracetamol 500 mg and diclofenac sodium 50 mg) (production of "Kusum Pharm" (Ukraine) or "Kusum Heltker PVT. LTD" (India) in tablets for symptomatic treatment of patients with pain syndrome. A pronounced clinical efficiency of its application in patients with pain syndrome of various genesis in a daily dose from 2 to 3 tablets for 3 to 7 days was established. The obtained data on the clinical efficacy of the drug. Fanigan in the treatment of patients with pain syndrome of various genesis allow to recommend it for application in wide clinical practice.
Key words: embryotoxicity, intranasal administration, desloratadine
Abstract. Study of embryotoxic effects of intranasally administred desloratadine on laboratory animals. Alekhina Т.А., Turkina V.А., Grushka О.І. The study was conducted to detect possible changes in embryogenesis and negative effects of third generation antihistamine – desloratadine – after intranasal administration of 1.3 mg/m3 and 13.0 mg/m3 of the substance to laboratory animals during their prenatal period. In these circumstances, desloratadine does not cause any significant changes of embryogenesis parameters. Macroscopic examination of the fetus and placenta in animals of experimental groups did not reveal any pathology or physiological deviations from the norm. 13.0 mg/m3 concentration of the drug caused a decrease in the weight of embryos in comparison with control group of animals and physiological data, despite a well developed, without visible pathology, placenta. This necessitates an in-depth study of possible teratogenic effects of intranasally administred desloratadine to laboratory animals.
Key words: Nitroxoline, parameters of toxicity, skin-resorptive effect, locally irritating effect, cumulative activity
Absract. Primary toxicological evaluation of nitroxoline on laboratory animals. Yaskiv G.I. Nitroxoline is an effective antibacterial agent that is industrially produced by chemical and pharmaceutical enterprises in Ukraine. Parameters of its toxicity are determined under conditions of acute and subchronic toxicological experiments on 3 kinds of laboratory animals, by administering the drug orally and by application onto the skin and mucous membranes. The duration of acute experiment was 14 days, subchronical - 24 days. It was found that median lethal dose (DL50) for white female rats is 980 (852:1127) mg/kg, of white male rats – 835 mg/kg, white male mice– 660 mg/kg, by this parameter the drug can be attributed to 3 class of hazard – moderately hazardous substance. Average effective time of death (ET50) for albino rats is 28 hours. Species sensitivity of laboratory animals to nitroxoline is slightly expressed. The death of the animals starts on the first day after the injection and is recorded during three days of the experiment. In application on intact skin, locally-irritant and skin-resorptive effects are absent. After contact with the mucous membrane of the eye the drug causes weak irritant effect. Nitroxoline has a moderate cumulative activity.
Key words: cognitive functions, old age, cognitive training programs
Absract. The influence of studies in Cognitive Wellness University for the elderly people on maintaining their cognitive functions. Usenko L.V., Kanyuka G.S., Oleniuk D.V., Usenko O.O., Silkina J.V. Progressive aging of the population is accompanied by age-related changes in the body, primarily from the central nervous system, which causes a decline in the cognitive health of man and society as a whole. The emergence of cognitive deficits leads to a decrease in a person's ability to think, learn, actively perceive information, make decisions, worsen other psycho-physiological functions. The aim of our study was to assess the state of cognitive functions of the elderly people, the dynamics of their changes, depending on the age stage of life, as well as under the influence of program exercises and specially designed trainings aimed at activating mental and physical activity. 165 students of the university aged 55-85 years took part in the study. Two groups of subjects were identified. The first one numbering 100 people we divided into 3 subgroups in order to identify phased age-related changes in cognitive functions and, depending on this definition, the need for preventive or corrective measures: 1 subgroup - 55-65 years, 2 subgroup - 66-75 years and 3 subgroup - 76 years and older. The study of their cognitive functions was determined upon admission to the university. The second group consisted of 65 people, whose indicators of cognitive functions were determined in dynamics: at admission to the university and at the completion of training. To assess the level of cognitive functions, we used a formalized screening technique - the Montreal Scale. The established dynamics of the components of cognitive functions, depending on age, makes it possible to differentially approach the choice of preventive or corrective measures aimed at activating cognitive functions, in each age group with an emphasis on those of them that have been changed to a greater extent. The effectiveness of the proposed structure of studies at the university for the elderly was shown.
PAGES OF HISTORY
Key words: V.T. Skrylnikov, Yekaterinoslav Medical Society
Abstract. He lived for the sake of people. To the 180th anniversary of the Yekaterinoslav zemstvo doctor V.T. Skrylnikov (1837-1898). Pisarenko Yu.G. For the first time the article introduces to the reader biography of one of the founders of the Yekaterinoslav Medical Society, a local doctor, author of numerous scientific papers on medicine and hygiene Vasiliy Timofeevich Skrylnikov. The first part provides previously unknown details about his origin, the work as the head of the free zemstvo clinic, highlights his proposals in the field of sanitary service of the city Yekaterinoslav, wide publishing activities. The aspects of V.T. Skrylnikov’s service on guardianship of orphans, and the initiative to create Yekaterinoslav Department of Russian society of public health are touched upon.
Key words: Leshko-Popel, humanism, selflessness, moral education
Abstract. Importance of studying I.V. Leshko-Popel’s activities for the medical students’ moral education. Semenova L.S. This article is about I. V. Leshko-Popel who was a well-known doctor of Yeukaterinoslav in the late XIX century. He was called “the friend of the poor”, “People’s doctor”, “outstanding doctor-man”. He was always and everywhere ready to help selflessly the patient where poor people were waiting for him. Author of this article proposec methods to study I. V. Leshko-Popel’s activities for moral education of medical students.
Key words: history, department, pathological physiology
Abstract. The historical essay of the department of Pathological Physiology of Dnepropetrovsk Medical Academy. Kozlova Yu.V., Dovgal M.A., Koldunov V.V., Silkina Yu.V., Klopotskiy G.A., Khudyakov A.E., Khmel S.I., Bibikova V.N., Tryasak N.S., Anisimova O.V. The article presents historical information about the development of the department of Pathological Physiology of Dnepropetrovsk medical academy, about chiefs of the department and their contribution to the development of the department from its foundation (1918) up to the present (2016). The areas of scientific research, the most significant achievements as well as changes in the provision of educational process are described.