Medicni perspektivi, 2017;22(2).
2017 Vol. XXII N 2
Key words: nanoparticles, cadmium, toxicity, content in internal organs
Abstract. Dynamics of cadmium acclumulation in the internal organs of rats after exposure to cadmium chloride and cadmium sulphide nanopartiles of various sizes. Apykhtina O.L., Kozlov K.P. The article presents the results of study of cadmium accumulation in the internal organs of Wistar rats after prolonged intraperitoneal administration of cadmium chloride and cadmium sulphide nanoparticles of 4-6 nm and 9-11 nm in size in a dose of 0.08 mg /kg/day calculated as cadmium. Toxic effects were evaluated after 30 injections (1.5 months), 60 injections (3 months), and 1.5 months after the exposure has been ceased. The results of the study showed that the most intensive accumulation of cadmium was observed in the kidneys and liver of experimental animals, which is due to the peculiarities of the toxicokinetics and the route of administration of cadmium compounds. In the kidneys, spleen and thymus of animals exposed to cadmium sulphide nanoparticles, a greater concentration of cadmium than in the organs of animals exposed to cadmium chloride was found. Cadmium accumulated more intensively in the spleen after exposure to larger nanoparticles, than in the kidneys and thymus. In the liver, heart, aorta and brain significant accumulation was observed after cadmium chloride exposure.
Key words: hyperthyroidism, hypothyroidism, CNS, GABA, unsaturated fatty acids, hippocampus
Abstract. Inhibitory mechanism of influence of thyroid hormones on cognitive function of the brain. Rodynsky A.G., Demchenko E.M, Kondratieva E.J., Golubka A.J., Yaroshenko D.S. In experiments on young rats there were studied changes in the fatty acid spectrum of fraction of free fatty acids (FFA) of neocortex and hippocampus in conditions of thyroid dysfunction. Elevated levels of thyroid hormones caused accumulation of polyunsaturated linoleic and linolenic acids in the neocortex by 2 times, in the hippocampus – by 52%. State of hypothyroidism also contributed to the increase of C18: 2,3 in the neocortex by 74.4%. Growth of share of unsaturated fatty acid fraction in the content of fatty acid spectrum of neocortex also was accompanied by decrease in saturated C16:0 and C21:0 by 25% and 36% respectively. Increase of the level of unsaturated fatty acids fraction of the cerebral cortex is possibly associated with the decrease in "unsaturation" structure of lipids, which in its turn may enhance serotonergic synaptic activity. Research of concentration of neuromediator amino acids in neocortex showed increase of serotonin content both in conditions of hyperthyroidism and hypothyroidism. In conditions of hyperthyroidism increased content of GABA was observed. Activity of serotonin- and GABA- ergic neurotransmitter systems of the brain in conditions of hyperthyroidism can be considered as increase of inhibitory processes in the effect of feedback. In conditions of experimental hypothyroidism activation of the inhibitory effects of CNS serotonergic system may be one of the ways to reduce the metabolism.
Key words: synthetic cannabinoids, spices, dependency, narcotization
Abstract. Peculiarities of mental and behavioral disorders due to use of designer drugs among young population and problems of early diagnostics (literature review). Spirina I.D., Rokutov S.V., Fedenko E.S., Shornikov A.V., Holopchenko O.E. The analysis of the data of the domestic and foreign literature regarding the dynamics of narcotization among children and adolescents is carried out. It has been established that at present the growth rates of the use of psychoactive substances by minors far outstrip those of the adult population. It is also determined that in most cases "adult" drug addiction is formed in a teenage environment and therefore adolescents are a group of high-risk narcotization. Besides, new types of additions are constantly added: non-opioid analgetics, antidepressants, pharmacy products based on medicinal plants with stimulating or sedative properties, new means of perfumery and household chemicals, volatile organic compounds, etc. In this regard, in the clinical picture of drug intoxication, new variations of affective, psycho-organic and psychosomatic effects and complications are noted. In recent years, synthetic cannabinoids has rapidly gained "popularity" among young people that are successfully promoted by marketers. They are the part of the so-called designer drugs, appearing in the markets in the form of bath salts, flavors, fertilizers for indoor plants and "smoking mixtures" - spices. The publications of domestic and foreign authors give a lot of evidence of the ability of these substances not only to cause a state of intoxication, alienation, relaxation, but also leads to dependence on them with severe consequences for the psyche and all organism as a whole. Thus, the powerful anthropogenic damaging effect of designer drugs demonstrates concrete signals of a threat to health, demography and the economy of the society as a result of their use by the population.
Key words: junior specialist having medical or pharmaceutical education, postgraduate education, innovative technologies, active forms of learning, competency approach, principles of management, self- management
Abstract. Updated approaches to the organisation of educational process. Chorna Ju.V. The article examines the main aspects of postgraduate education of junior specialists with medical or pharmaceutical education in Dnipropetrovsk region. Pedagogical innovations involves active learning, competency approach and introduction of new subjects into the educational process.
Key words: pneumonia, severe community acquired pneumonia features of pneumonia
Abstract. Features of laboratory indicators of severe community-acquired pneumonia. Pertzeva T.A., Avramenko I.V. Based on data from the prospective analysis of patients with severe community-acquired pneumonia over the year of observation, the article presents data on the features of laboratory indicators of the course of severe community-acquired pneumonia. Patients included in the study were hospitalized in the pulmonology department (or therapy), and in the intensive care unit of three clinical hospitals in the city of Dnipro, namely, the Dnipropetrovsk City Clinical Hospital N 6, the Dnipropetrovsk City Clinical Hospital N 2, the Dnipropetrovsk City Clinical Hospital N 16, which are the clinical bases of the SE “Dnipropetrovsk medical academy of Health Ministry of Ukraine”. In the course of studies, the dependence of the severity of patients' state on the severity of inflammatory markers and fibrosis markers was shown. The effect of the prognostic significance of the level of the enzyme TGFβ and C-reactive protein (CRP) for the evaluation of possibility of formation of long-term pathological changes after a severe community-acquired pneumonia has been examined. It was established that a high level of CRP (38.3 [11.3, 150.9] mg / L) and TGFβ (20149.1±424.0 pg/ml) in the blood plasma of patients can be considered as an additional marker of the severity of the course of community-acquired pneumonia. The results can be the basis for a more individual approach to the development of diagnostic and therapeutic programs for patients with severe community-acquired pneumonia
Key words: quality of life, obesity, lactase gene polymorphisms, teens
Abstract. Assessment of quality of life in adolescents with obesity associated with polymorphisms of the lactase gene. Abaturov AE, Nikulina AA. The growing obesity incidence in adolescents on the background of insufficiently studied genetic markers of formation of impairments of carbohydrate metabolism associated with the lactase gene polymorphism (SNP LCT), necessitates studying life quality particularly in this age group. Associations of 13910 C>T polymorphism of lactase gene with the quality of life in 60 adolescents aged 14-18 with obesity using the MOS-SF-36 technique (MOS 36-item Short-Form Health Survey) were studied. It was established the presence of associations of the genotype C/C 13910 of the LCT gene (p<0,05) with decrease of role functioning due to physical condition of young men and decrease of the overall health of girls. Prevention of obesity should start from birth of the newborn to gether with the rational organization of alimentary behavior in the family as a whole, depending on the phenotype and formation of a certain psychotype of adolescent’s personality, defined by the lactase gene polymorphism.
Key words: chronic heart failure, atrial fibrillation, risk factors
Abstract. Frequency of risk factors of cardiovascular diseases and renal functional state in patients with chronic heart failure with atrial fibrillation. Kuryata O.V., Muhammad Muhammad, Mytrokhina O.S. There are presented and analyzed the most common and important risk factors (RF) in patients with chronic heart failure and atrial fibrillation (AF). The data indicate the need for more careful attention to this group of patients and the need in early diagnosis of AF RF and their active modification, which is very important for the development of effective measures both for the primary prevention of AF and prevention of progression of this disease.
Key words: blood, blood component, settlement of accounts of blood component supplement of military medical facilities
Abstract. Improvement of the system of supply of the Ukrainian Armed Forces with hemotransfusion agents. Zamkovyi A.D., Tymchenko A.S. The main research results substantiating the system of transfusion supply of military medical facilities of the Armed Forces of Ukraine during peacetime and in the special period are presented. It was proved that the aim of development of blood bank is to create the system of provision with blood, its components and protein preparations of blood plasma of hospitals both in terms of daily activity and at the time of their usage.
Key words: obesity, osteoarthrosis of knee and hip joints, total joints replacement
Abstract. The impact of obesity on the structure of osteoarthrosis of large joints of the lower limb. Loskutov A.E., Kuryata A.V., Cherkasova A.V. The prevalence of osteoarthrosis (OA) among adults over 40 years is taking one of the leading places in the common structure of joint pathology. Obesity – is of the comorbidities associated with OA, one of the risk factors of development and progression of OA. The aim of this study was to evaluate the influence of obesity on the structure of knee and hip OA on the stage of total joint replacement, depending on the patient`s gender, age and degree of obesity. The study involved 170 inpatient case histories of patients with OA undergoing treatment in the department of large joints replacement (64 men and 106 women): 95 patients with OA of hip joint and 75 – with OA of knee joint, among whom there were 110 patients with obesity and 60 – without it. The middle age of the patients was by 63,8±7,69 years. High prevalence of obesity among patients with OA of knee and hip joints was found, with significant higher number of obese patients with OA of knee joint and among female patients. It has been demonstrated a significant increase in the frequency of total knee joint replacement associated with the increase of body mass index among patients with OA of knee joint. The presence of obesity was associated with earlier terms of the total joint replacement performing, especially among male patients.
Key words: nephrolithiasis, urease-producing microorganisms, mineral composition of concrements,
mechanism of lithogenesis
Abstract. Mechanism of formation of oxalate concrements in the presence of ureaseproducing pathogens in urine (conception). Vozianov S.A., Koval D.V., Rudenko A.V., Zheltovska N.I. The aim of the study was to ascertain the role of U.urealyticum in formation of phosphates and oxalates in kidneys and factors promoting this process. The work represents the author’s conception of this process. There were fully examined 79 patients with nephrolithiasis with the aim to determine the species difference of pathogenic agents of the accompanying inflammatory process and there was compared the chemical structure of the removed concrements. There was stated the role of the urease-producing bacteria (P.mirabilis and U.urealyticum) in the process of phosphate and oxalate lithogenesis and the accompanying factors, which initiate these reactions (urinary pH, endogenic urease, index of oxalic acid concentration). The work presents the comparative analysis of lithogenesis in the presence of accompanying bacteria of different taxonomic position. The authors’ conception of the role of U.urealyticum and P.mirabilis in lithogenesis has been elaborated.
Key words: generalized peritonitis, programmed relaparotomy, abdominal cavity sanitations, VAC
Abstract. Staged isolation of abdominal cavity in generalized on peritonitis. Kutovoi А., Kosulnikov S., Zavizion E., Stepanskyi D. In the work we present comparative results of treatment of patients with generalized secondary and tertiary peritonitis depending on the way of surgery completion. Patients in group I (n=27) underwent only skin suturing after the surgery, in group II –laporostoma was formed with VAC in the abdominal cavity. We have evaluated the level of microbe contamination and condition after wound surgery, intensity of adhesion process in the abdominal cavity, multiple organ failure after surgery. The use of laporostoma combined with VAC at different stages of generalized peritonitis treatment helps to achieve illness rigress, less number of planned saniations of abdominal cavity. Even after the first use of VAC, quicker clearance of operation wound and appearance of new granulation tissues occurred. In group II in secondary saniation the frequency of fixing of abdominal cavity is developing 31,9% higher (p<0,05) and in the third saniation the use of VAC therapy resulted in growing number of patients with frozen abdomen.
Key words: heart rate variability, hypertension, osteoarthrosis
Abstract. Heart rate variability in patients with hypertension combined with osteoarthrosis under the impact of antihypertensive therapy. Khmel O.S., Rodionova V.V. Objective: to investigate the heart rate variability in patients with HT and OA under the influence of antihypertensive therapy. Materials and Methods: The study involved 60 persons, main group – 25 patients with HT stage II, 2nd degree, combined with knee OA of the II stage according to the Kellgren-Lawrence. The group of comparison consisted of 20 patients with HT stage II, 2nd degree. The control group consisted of 15 almost healthy individuals. During the study patients received antihypertensive therapy: Amlodipine 5 mg and Lisinopril 5 mg 1 time per day per os. The survey was carried out before and after the treatment. Results: in hypertensive patients with OA the influence of the sympathetic system and LF / HF index were reduced (before treatment – 5,64 [4,87–7,56], after treatment – 3,95 [3,74–4,54]; p<0,05); this indicates to decrease of influence of the sympathetic system on the organism. Conclusions: The presence of OA in patients with HT provides additional negative effect on the heart rate variability, which may testify to increasing mortality risk in these patients. Antihypertensive therapy with Lisinopril, 5 mg and Amlodipine, 5 mg in patients with HT and OA leads to improvement of hypertension course due to influence on sympathic system.
Key words: aerococcus, antagonistic action, model of staphylococcus infection
Abstract. Study of biological action of aerococcus аutosymbionts on the model of staphylococcal infection. Stepanskyi D.O., Kremenchutskyi G.M., Koshova I.P. The paper presents data on the study of the antagonistic effect of aerococcus autosymbionts in experimental models of infections caused by staphylococci. To study the antagonistic action of aerococcus autosymbiont on staphylococcus, a model of chronic staphylococcal infection in white mice and rabbits was used. In staphylococcal experimental infection, aerococcus antagonistic action against staphylococcus was tested by subcutaneous injection on white mice. Aerococci survival under the skin was studied. Aerococcus autosymbionts introduced under the skin to staphylococcus in 5 hours and 3 hours after administration of the latter cause antagonist effect and inhibit the development of infiltrates. Similar results were obtained when introducing aerococcus autosymbionts in the focus of infection in 5 minutes, 5 minutes and 3 hours, 1 and 5 hours after infection. Aerococci introduced after 24 and 48 hours shortened terms of disease manifestations as compared to the control group of mice. The therapeutic effect of aerococcus autosymbionts was tested on the experimental model of burns and wounds infected with staphylococcus. In animals with wounds treated with aerococcus autostrains the number of pathogenic staphylococci was 10 times less than in the control group. According to our observations aerococcus autosymbionts showed no irritant effect when applied on the wound surface, helped its healing, sharply reduced the percentage of staphylococcus inoculation from wound secretions.
Key words: recurrent and chronic bronchitis, adolescent-smokers, gene CYP1A1, gene GSTP1
Abstract. The role of polymorphism of genes of the I and II phase of xenobiotics biotransformation in the development of recurrent and chronic bronchitis in adolescent-smokers Il'chenko S.I., Fialkovskaia A.А., Kramarenko N.N., Makukh G.V. The purpose of research – to study the role of allelic polymorphism of genes of the I and II phases of xenobiotics biotransformation in the development of reccurent and chronic diseases of the respiratory system in adolescent-smokers. There was carried out molecular-genetic study of the polymorphic locus Т3801С of gene CYP1A1 and polymorphic locus A313G of gene GSTP1 in adolescent-smokers with recurrent and chronic bronchitis. It is established that TТ genotype of the polymorphic locus Т3801С of gene CYP1A is a marker of resistance to the development of this pathology in adolescent-smokers. The presence of CC genotype of the polymorphic locus Т3801С of gene CYP1A1 and GG genotype of polymorphic locus of A313G GSTP1 gene may be considered as a possible risk factor for the development of chronic inflammatory process in bronchopulmonary system. Thus, the introduction of molecular-genetic methods of research opens up new possibilities in diagnosis of recurrent and chronic diseases of the respiratory system. Based on the analysis of genetic factors in children and adolescents, it will be possible to predict the risk of COPD developing in the future; this will allow doctors to carry out the necessary preventive activities among risk groups.
Key words: threatened abortion, progesterone receptor gene polymorphism, progesterone induced blocking factor, natural micronized progesterone therapy
Abstract. Study of progesterone-induced blocking factor in the treatment of women with threatening abortion, taking into account the polymorphism of the progesterone receptor gene. Kryvopustov O.S. Actual medical and social problem of modern obstetrics is threatening abortion. In its treatment, analogues of progesterone are used. Activation of progesterone receptors induces the production of anti-abortive protein-progesterone-induced blocking factor (PIBF). The dynamics of PIBF in 28 patients with the diagnosis of threatening abortion was analyzed. Women were treated by natural micronized progesterone depending on the features of the clinical course and single nucleotide polymorphism of the progesterone receptor gene rs590688. The quantitative content of PIBF in urine in pregnant women with threatening abortion was determined, namely, the increase in the content of this factor is associated with the prolongation of pregnancy. At the time of initiation of therapy, the concentration of PIBP was 28.8±1.5 (95% CI 26.7-29.2) ng/ml, and on the 7th day of therapy its concentration was 29.4±0.1 (95% CI 29.2-29.5) ng/ml. The increase in PIBF has reached a degree of statistical significance (T-W=15.0, p<0.001). In 27 (96.4%) patients who were pregnant, PIBP levels increased, 1 (3.6%) patient had spontaneous miscarriage on the 9th day of treatment. She had a decrease in concentration of PIBF in urine from 29.18 ng/ml at the time of admission to the hospital to 28.58 ng/ml on the 7th day of therapy. The study of progesterone-induced-blocking factor can be considered as an additional laboratory method of controlling progesterone therapy in women with threatening abortion in specialized research institutions.
Key words: generalized periodontitis, catarrhal gingivitis, microbiocenosis
Abstract. Features of treatment of various clinical variants of generalized catarrhal gingivitis. Gudaryan А.А., Kuznyak N.B., Shostenko AA. The article presents the results of a complex treatment of 82 patients with generalized catarrhal gingivitis at the stage of chronic and exacerbated course through the use of scientifically based programs for the step-by-step application of occupational hygiene measures, antibacterial and immunocorrective therapy. The performed step-by-step treatment of generalized catarrhal gingivitis contributes to rapid elimination of possible causative agents of the disease, provides elimination of the deficiency of local humoral immunity, imbalance in the cytokine system, leads to the elimination of inflammatory phenomena in the gum in 93.3% of patients with chronic course and in 96.3% of patients with exacerbated manifestation of the disease.
Key words: generalized periodontitis, enzyme therapy, immunodeficiency, biocenosis
Abstract. Clinical and laboratory efficacy of systemic enzyme therapy in patients with chronic generalized periodontitis complicated by purulent foci in soft periodontal tissues. Gudaryan А.А., Kuznyak N.B., Dronik I.I. The article presents the results of complex treatment of 98 patients with chronic generalized periodontitis with purulent foci in periodontal tissues by using standard complex treatment in combination with systemic enzyme therapy, which in turn allows to increase the effectiveness of the therapeutic measures and to eliminate etiological and pathogenetic links and regress of clinical symptoms of the disease. Under its influence, clinical and laboratory rehabilitation comes faster by 5.4 ± 0.2 days, and remission throughout the year takes place in 91.7% of cases.
Key words: generalized catarrhal gingivitis, generalized periodontitis, microbiocenosis, immunodeficiency
Abstract. Complex treatment of generalized catarrhal gingivitis with precursors of early formation of destructive phenomena in the bone structures of periodontium. Gudaryan А.А., Struk V.I., Vatamanyuk N.V. The article presents the results of comprehensive rehabilitation of 92 patients with generalized catarrhal gingivitis by creating differentiated programs for prevention and treatment of the disease, depending on the absence or presence of laboratory signs that have not been detected by X-ray, early destructive processes in the bone structures of periodontal tissues. It was revealed that appearance in gums tissue of representatives of the major periodontal bacteria is a precursor to the development of initial stage of generalized periodontitis in it. It was established that the earlier objective indicators of bone resorptive process in periodontal tissues in patients with generalized catarrhal gingivitis is an overproduction of proinflammatory cytokines IL-1.beta and TNF-alpha and the lack of anti-inflammatory cytokine IL-4.
Key words: pesticides, ecotoxicological risk, groundwater, herbicides, insecticides, fungicides
Abstract. Assessment of ecotoxicological hazard and risk of contamination of groundwater with different groups of pesticides. Stavnichenko P.V., Novohatska L.O., Antonenko A.M., Vavrinevych O.P. The aim of our work was to determine ecotoxicological risk of herbicides, insecticides, fungicides of different chemical classes with different mechanisms of action by the method of Melnikov M.M. and leaching potential index by the method of Sergeev S.G. and co-workers. It was established that in soil and climatic conditions of Ukraine ecotoxicological hazard of studied herbicides by (1-6) orders of magnitude, fungicides – by (3-5) orders, insecticides – by (2-3) orders lower than DDT. The least ecotoxic are herbicides of the last generations, then fungicides and the most ecotoxic are insecticides and herbicides of the old first generations. It was proved the high danger of groundwater contamination with studied herbicides, insecticides and fungicides, except for mesotrione, the application of which has moderate danger in the soil and climatic conditions of Ukraine. It was shown that in soil and climatic conditions of Ukraine, ability of migration from the soil into groundwater of metribuzin, thiamethoxam, paclobutrazole is high, topramezone and mesotrione – moderate, for other substances – low; in terms of hygienic standards in the ground itallows to avoid them getting into the soil flow and minimize the danger of groundwater contamination to public health
Key words: functional system, functioning of the body, acceptor of result of action, adaptation of students to learn
Abstract. Hygiene and didactic criteria of adaptation to the initial stage of training in higher education establishments. Grebnyak N.P., Schudro S.A., Fedorchenko R.A. Reform of higher education in the conditions of deep social and economic transformations determines both optimization of professional training and development of functional capacity of the organism for future work. The initial stage of training is of particular importance due to incorporation into a complex new system of educational environment. The aim of the work - to study the characteristics of adaptation process in the first-year students. Functional state of students’ organism was studied by visual-motor response, function of attention, speed, of information processing, tepping-test. This cross-sectional study included 179 first-year medical students. Students with a history of hearing or visual disorder, smoking, alcoholism, cardiovascular and respiratory disease and on medication which affects cognitive performance were excluded from the study. Participation in the test was voluntary and informed written consent was taken from each participant. Academic performance was analyzed. Pearson correlation has been used to find the significance of relationship between the speed of thought processes, function of attention, factor of motometria, volume of visual memory and academic performance. Adaptation of students to training is based on the functional system of the body. Expressed correlation between the speed of thought processes (r=0,63, р<0,01), function of attention (r=0,47, р<0,05), ratio of motometry (r=0,45, р<0,05), volume of visual memory (r=0,43, р<0,05) and academic performance was established. The distribution of these indicators demonstrates the feasibility of using Standard deviation to assess the degree of adaptation.
Key words: the socio-psychological climate, health care workers, health care institution, personnel management
Abstract. The major factors of influence on the socio-psychological climate in the team of health care workers. Vezhnovets T.A. The aim of the research was to identify the major factors that can positively or negatively effect the state of the socio-psychological climate in the medical team of healthcare institutions. The psychological study of the social-psychologic climate of 152 health care workers of two hospitals of Kherson region (N 1, n=80; N 2, n=72) was conducted. It is established that the level of self-esteem of climate in the institution №1 was significantly lower than in institution N 2 (р<0,007). Moreover, these two institutions differed significantly by experience of joint work of health workers (р<0.05) and length of service of the head physicians. Health care workers with less joint work experience have been working in the institution N 1, and it was headed by the head physician with less leading experience. By the opinion of health workers of both institutions, such factors as "interesting and meaningful work", "attentive head", "relations with colleagues", have the most positive impact on the state of climate the most negative influence — "unsatisfactory management style", "tensions in the team", "lack of financial motivation", "poor working conditions". Each team has its own combination of factors that positively or negatively affect the state of the climate. It is established, that depending on the work experience of the head physician and the work experience of joint work of employees, the main factors that affect the climate in the team are "attentive manager" and "relationships with colleagues". The more work experience of the leader, the more it will affect the state of the climate in the team. The less experience of joint work of employees, the more "relationship with colleagues" will affect its condition. Evaluation of the state of socio-psychological climate and its factors by the personnel may be the indicator of efficiency of personnel management in the health care institution.
PAGES OF HISTORY
Key words: V.T. Skrylnikov, balneology, "Timofeyev clay", "Seasonal Bulletin of Slaviansk mineral water"
Abstract. He lived for the sake of people. To the 180th anniversary of the Ekaterinoslav zemstvo doctor V.T. Skrylnikov (1837-1898) (part 2). Pisarenko Yu.G. The second part of the essay about zemstvo doctor, V.T. Skrylnikov elucidates his fruitful activity in the field of balneology: study and popularization of therapeutic properties of the so-called "Timofeev clay", publication of his "Seasonal Bulletin of Slaviansk mineral water ". We describe recent years of the doctor’s life, complicated with the disease and severe family affairs. The grateful memories of his fellow doctors about him are listed.